Total oxidant capacity, total antioxidant capacity, ischemic modified albumin, microRNA levels, and their relationship with psoriasis area and severity index

Aims: To examine the differences in the levels of microRNA, ischemic modified albumin (IMA), total oxidant capacity (TOC), and total antioxidant capacity (TAC) of persons with and without psoriasis and, in the case group, the relationship between these parameters and psoriasis area and severity index (PASI). Methods: Blood samples were collected from patients and healthy participants to examine levels of these parameters. Results: The mean serum TOC level was higher in the case group. The mean serum TAC and IMA levels were significantly lower in the case group (P <0.001). It was observed that the mean serum miR-203 and miR-146a levels were increased in psoriasis patients. It was determined that there was only a significant positive weak correlation between miR-203 and PASI (r = 0.232, P = 0.027). Limitations: The small sample size, not controlling serum albumin and not evaluating the effects of the treatment agents used by the patients on oxidative and inflammatory processes. Conclusion: In the case group changes in the mean serum TOC and TAC levels provide evidence that oxidative stress may play a critical role in disease pathogenesis. The increase in the mean serum miR-203 and miR-146a levels suggest the possibility of therapies targeting these microRNAs as a new option

EVALUATION AND PROGNOSTIC CORRELATION OF ACUTE PANCREATITIS USING CT SEVERITY INDEX

Background: Of all abdominal emergencies, pancreatitis is one of the most complicated and clinically dif?cult. The preferred imaging technique for determining the severity of acute pancreatitis and its consequences is computed tomography (CT). To evaluate the clinical outcome of acute pancreatitis and prognostic Aim: correlation based on the CT severity index. We included 30 patients with suspected acute pancreatitis Settings and Design: attending department of Radio Diagnosis, KVG medical college and hospital during the study period (January 2022 to May 2022). All the patients were evaluated by contrast enhanced CT. The severity of pancreatitis was scored using CT severity index (Balthazar), modi?ed severity index (Mortele) and revised Atlanta classi?cation and the cases were classi?ed into mild, moderate and severe. The outcome parameters studied were Length of hospital stay, Need for surgery or percutaneous intervention, incidence of infection or organ failure and death. The age group of patients was 16 to 69 years with Results: maximum patients (36%) between 25 and 35 years. Majority were males (81%). According to Modi?ed CT Severity Index, 15% patients had mild, 42% patients had moderate and 43% had severe pancreatitis. Majority of the cases (44%) were categorized as severe pancreatitis according modi?ed Mortele CT score. Majority of the cases were categorized as mild pancreatitis according Balthazar CTSI score and revised Atlanta classi?cation. 38% patients are considered to have end organ failure. Hepatic failure is the most common system failure seen in 22% patients. 36% patients had evidence of systemic infection. 10% patients required surgical interventions. The score is simpler to calculate and the inter-observer variability is Conclusions: decreased using the modi?ed CT severity index.

Influencing factors for dynamic changes in the severity of fatty liver in patients with acute pancreatitis and fatty liver / 临床肝胆病杂志

Objective To investigate the dynamic change of fatty liver (FL) in patients with fatty liver-related acute pancreatitis (FLAP) and related influencing factors. Methods A total of 136 FLAP patients who were admitted to The First Affiliated Hospital of Baotou Medical College, Inner Mongolia University of Science and Technology, from December 2017 to December 2021 were enrolled as subjects. With the first CT examination after admission as the starting point and the last CT examination before discharge as the ending point, the subjects were divided into FL aggravation group (FLAG group), FL mild mitigation group (FLMMG group), and FL significant mitigation group (FLSMG group) according to the degree of change in FL. General information and clinical data were compared between groups. General information included age, sex, length of hospital stay, etiology of acute pancreatitis (AP), and changes in body weight and temperature, and clinical data included treatment modality and the changes in laboratory markers and AP severity. The chi-square test or the Fisher's exact test was used for comparison of categorical data between groups. A one-way analysis of variance was used for comparison of normally distributed continuous data between multiple groups, and the least significant difference t -test was used for further comparison between two groups; the Kruskal-Wallis H test was used for comparison of non-normally distributed continuous data between multiple groups, and the Mann-Whitney U test with Bonferroni correction was used for further comparison between two groups. Dynamic changes of data were expressed as the difference from the starting point to the ending point, and a covariance analysis was used for comparison of data with dynamic changes. The Spearman correlation analysis was used to investigate the correlation of indices with significant changes with the degree of change in FL. Results Among the 136 FLAP patients, 61 achieved mild mitigation of FL, 59 achieved significant mitigation of FL, and 16 experienced aggravation of FL at the ending point of the study. There were significant differences between the three groups in the length of hospital stay ( χ 2 =16.215, P < 0.001) and the change in body weight ( F =3.908, P < 0.05), and the FLSMG group had a greater reduction in body weight and a longer length of hospital stay. There were also significant differences between the three groups in the number of fasting days ( χ 2 =11.020, P =0.004) and the degree of changes in C-reactive protein (CRP) ( F =8.589, P < 0.001), white blood cell count (WBC) ( F =5.448, P =0.005), and CT severity index (CTSI) ( F =7.544, P =0.001), and the FLSMG group had greater reductions in CRP, WBC, and CTSI and a longer duration of fasting. Length of hospital stay, number of fasting days, and changes in CRP and CTSI were significantly correlated with the change in FL ( r =0.352, 0.372, -0.365, and -0.350, all P < 0.001). Conclusion Most FLAP patients tend to have mitigation of FL, and its dynamic changes are closely associated with the changes in CRP and CTSI.

Is vitamin D status relevant to psoriasis and psoriatic arthritis? A retrospective cross-sectional study

Abstract BACKGROUND: Psoriasis is a systemic, immune-mediated disease characterized by inflammatory manifestations in the skin and joints. Vitamin D deficiency is currently considered a pandemic and is associated with comorbidities including psoriasis and psoriatic arthritis (PsA). OBJECTIVES: To determine the prevalence of hypovitaminosis D [25(OH)D] in patients with plaque psoriasis, with and without PsA, and of independent predictors of serum 25(OH)D levels. DESIGN AND SETTING: Retrospective cross-sectional study conducted among 300 patients at an outpatient clinic in a university center in Juiz de Fora, Minas Gerais, Brazil. METHODS: Demographic and clinical data (psoriasis area and severity index [PASI], family history, age at onset, disease duration, and the presence of PsA according to Classification Criteria for Psoriatic Arthritis), skin phototype, and season of the year were reviewed. RESULTS: Hypovitaminosis D (< 30 ng/mL) was highly prevalent in patients with psoriasis with and without PsA (82.2% and 74.9%, respectively). An inverse correlation between PASI and vitamin D was found (without PsA r = -0.59 and, PsA r = -0.52, P < 0.001), and multivariate regression revealed that hypovitaminosis D was associated with disease severity, season, and phototype. It was confirmed by binary logistic regression between PASI and vitamin D deficiency (< 30 ng/mL), (odds ratio, OR 1.78 CI: -0.20-0.53, P < 0.001). CONCLUSION: Hypovitaminosis D (< 30 ng/mL) was highly prevalent in psoriatic patients with and without PsA. Season and skin phototype were associated with 25(OH)D levels. An inverse association between PASI and serum 25(OH)D levels was established.

The lamartina square and severity index in surgery for high-grade lumbar listhesis / O quadrado de lamartina e índice de severidade na cirurgia para listese lombar de alto grau / El lamartina square y índice de severidad en la cirurgía de la listesis lumbar de alto grado

ABSTRACT Objective: evaluate the correlation between main sacropelvic alignment measurements and pelvic retroversion reduction and assessing Lamartina Square effectiveness in choosing the proximal instrumentation level. Methods: sample comprising 21 patients with high-grade L5 -S1 spondylolisthesis subjected to arthrodesis with instrumentation from January 2004 to December 2016. Patients' demographic data, surgery type, complications, sagittal alignment parameters, Severity Index and Lamartina Square were recorded before surgery and in the last follow-up. Data processed in SPSS 22.0, with different means were calculated through Student's t test, for paired data. Linear correlation analysis was performed based on Spearman's coefficient. P <0.05 was statically significant. Results: there was significant improvement in the slip and Dubousset's lumbosacral kyphosis angles (> 100° in the last postoperative follow-up). There was significant reduction of slip rate ( and in the L4 and L5 Severity Index, which highlighted strong correlation to pelvic tilt, mismatch and slip angle. Severity index also showed strong inverse correlation between Dubousset's lumbosacral kyphosis angle and sacral slope. Conclusion: L5 Severity Index and Lamartina Square are important variables for preoperative planning of patients with high-grade lumbar spondylolisthesis. Level of Evidence IV; Case Series.

Resumo: Objetivo: avaliar a correlação entre as principais medidas do alinhamento sacropélvico com a retroversão pélvica e avaliar a efetividade do Lamartina Square na escolha do nível proximal de intrumentação. Métodos: amostra com 21 pacientes com espondilolistese de alto grau L5-S1, submetidos à artrodese com instrumentação, de 01/2004 a 12/2016. Os dados demográficos dos pacientes, tipos de cirurgias, complicações, parâmetros do alinhamento sagital, Severity Index e Lamartina Square foram registrados antes da cirurgia e no último acompanhamento. Dados processados no SPSS 22.0 com as diferenças das médias calculadas utilizando-se o teste t de Student para dados emparelhados. A análise da correlação linear foi realizada pelo coeficiente de Spearman. Significantes as análises com p < 0,05. Resultados: melhora significativa do ângulo de deslizamento e de cifose lumbosacral de Dubousset´s (> 100° no ultimo seguimento pósoperatório). Redução significativa da porcentagem de deslizamento ( e do severity index em L4 e L5. Este teve uma forte correlação direta com: tilt pélvico, mismatch, ângulo de deslizamento, porcentagem de deslizamento e uma forte inversa com: ângulo de cifose lumbosacral de Dubousset´s e o slope sacral. Conclusão: O Severity Index de L5 e o Lamartina Square devem ser consideradas variáveis importantes no planejamento pré-operatório de pacientes com espondilolistese lombar de alto grau.

Resumen: Objetivo: evaluar la correlación entre las principales medidas de alineación sacropélvica y la reducción de la retroversión pélvica y evaluar la eficacia de Lamartina Square en la elección del nivel de instrumentación proximal. Métodos: muestra compuesta por 21 pacientes con espondilolistesis L5-S1 de alto grado sometidos a artrodesis con instrumentación desde enero de 2004 hasta diciembre de 2016. Se registraron datos demográficos de los pacientes, tipo de cirugía, complicaciones, parámetros de alineación sagital, Índice de Severidad y Cuadrado de Lamartina antes de la cirugía y en el último seguimiento. Los datos procesados en SPSS 22.0, con diferentes medias, se calcularon mediante la prueba t de Student, para datos pareados. Se realizó un análisis de correlación lineal basado en el coeficiente de Spearman. P <0,05 fue estadísticamente significativo. Resultados: hubo mejoría significativa en los ángulos de deslizamiento y cifosis lumbosacra de Dubousset (> 100° en el último control postoperatorio). Hubo una reducción significativa en la tasa de deslizamiento (<50 %) y en el índice de gravedad L4 y L5, que destacó una fuerte correlación con la inclinación pélvica, la falta de coincidencia y el ángulo de deslizamiento. El índice de gravedad también mostró una fuerte correlación inversa entre el ángulo de cifosis lumbosacra de Dubousset y la pendiente sacra. Conclusión: L5 Severity Index y Lamartina Square son variables importantes para la planificación preoperatoria de pacientes con espondilolistesis lumbar de alto grado. Nivel de Evidencia IV; Serie de Casos.

The therapeutic efficacy of compound lidocaine cream on psoriasis / 药学学报

Psoriasis is a non-infectious chronic inflammatory skin disease. It′s acknowledged that interleukin (IL)-17 signaling pathway dominantly drives the development of psoriasis. Recently, the role of neuro-immune axis in psoriasis has attracted widespread attention. Lidocaine, a local anesthetic, has ability to block the conduction of nerve impulses, while its therapeutic efficacy on psoriasis remains to be confirmed. Here, we evaluated the therapeutic efficacy of topical application of compound lidocaine cream (LIDO) on imiquimod (IMQ)-induced mouse psoriasis model. Animal welfare and experimental procedures follow the regulations of the Ethics Committee of China Pharmaceutical University. The psoriasis area and severity index (PASI) scoring was used to evaluate the severity of psoriasis-like symptoms. Hematoxylin-eosin staining was used to examine histopathological changes and epidermal thickness was measured. Ki67 immunofluorescence staining was used to evaluate the proliferation of keratinocytes. The relative mRNA expression of inflammatory cytokines (including Il17, Il22, Il23 and Il36) in skin was measured by real-time quantitative PCR. Results show that IMQ-induced increases in the PASI score, epidermal thickness, number of Ki67+ cells and the mRNA expression of inflammatory cytokines are significantly alleviated by topical application of LIDO, whose therapeutic efficacy is also better than that of the positive control drug calcipotriol. Our study suggests that LIDO could be used for psoriasis treatment.

Etiological profile, prescribing pattern of antibiotics and clinical outcomes of pneumonia patients in a tertiary care hospital in South India during 5-year period

Background: Pneumonia is one of the most important and serious lower respiratory tract infections, which requires implacable attention. This work aimed to document the causative organisms, antibiotics used, and outcome of pneumonia patients hospitalized in a tertiary care hospital. Materials and Methods: A retrospective study was conducted in the medical departments of a tertiary care teaching hospital for 5 years. Demographic details and clinical details including pertinent laboratory values of patients diagnosed with pneumonia were documented and analyzed using a specifically designed data collection form. Results: The study was conducted on 190 patients. The average age of the study population was 56.7 ± 22.6 years and there was a male preponderance of 111(58.4%) patients. Klebsiella pneumonia was found to be the most frequently isolated pathogen in 12.5% of the sputum culture, followed by Acinetobacter baumannii in 10.22% and Pseudomonas aeruginosa in 9.09%. The most commonly prescribed empirical antibiotics were beta-lactam antibiotics mostly in combination with macrolides for synergy irrespective of Pneumonia Severity Index (PSI) classes. Definitive therapy was classified based on World Health Organization (WHO) Access, Watch, and Reserve (AWaRe) classification of antibiotics, watch category antibiotics were prescribed according to culture report and reserve antibiotics were prescribed only in those cases where watch category antibiotics were resistant. On analyzing PSI of community-acquired pneumonia (176 patients), most of the patients in the study belong to class 4: 61 patients (34.7%) and class 5: 44 patients (25%). For the high-risk patients (PSI class 4 and 5), mortality was approximately 3.8% (4 of 105) and for low-risk patients, there was zero mortality reported within 30 days. Conclusion: Gram-negative bacteria were the major pathogens causing Pneumonia in the study site contradictory to the data from developed countries. Identifications of pathogens and appropriate antibiotic therapy based on PSI score can bring down the duration of hospital stay and mortality of patients with pneumonia.

The Study of Correlation Between Bronchiectasis Severity Index and FACED Score for Assessment of Severity of Bronchiectasis

Introduction: Two different validated scores are currently used to assess the severity of bronchiectasis: the FACED score and the Bronchiectasis Severity Index (BSI). The study was conducted to evaluate clini-cal etiology in bronchiectasis patients. And to compare the results of the assessment of bronchiectasis severity obtained via FACED and BSI scores. Methods: The study was conducted at a tertiary care hospital in the outpatients of the department of respiratory medicine. Detailed clinical history and necessary investigations were done. BSI and the FACED score were calculated. Statistical analysis was performed using the SPSS package. Results: According to the FACED score, we found 28 patients with mild bronchiectasis, 17 with moder-ate, and 5 with severe bronchiectasis. The frequency of patients with low, intermediate, and high BSI was 24, 21, and 5, respectively. Moreover, we observed a weak but statistically significant association of 43% agreement between FACED and BSI scores: Fisher’s exact test(p=0.399), tau-b de Kendall (-0.123; p = 0.337) and kappa test (0.032; p = 0.878). Conclusions: There is a small but significant correlation between the two scales (BSI and FACED). a ten-dency is observed for patients to be classified with a higher BSI compared to the FACED score.

Escala News2 y Quick COVID-19 Severity Index: Predictores de mortalidad en adultos con infección por SARS­CoV­2 / News2 scale and Quick COVID-19 Severity Index: Predictors of mortality in adults with SARS­CoV­2 infection

La alta morbi-mortalidad asociada con COVID-19, se ha desarrollado herramientas de estratificación de riesgo clínico para estos pacientes, con el fin de predecir la progresión a enfermedad grave y/o mortalidad. En este estudio se comparó la Escala Quick COVID19 Severity Index con News2 como predictor de mortalidad en adultos con infección por SARS ­ CoV-2, precisando su validez diagnóstica. Materiales y métodos: Estudio observacional, retrospectivo, analítico, de pruebas diagnósticas. Se incluyeron a 255 pacientes, mayores de 18 años, hospitalizados en el Hospital II ­ I Moyobamba con diagnóstico de COVID-19, con requerimiento de oxígeno ≤6 Lt/min, en el periodo de enero a diciembre del 2020. Resultados: 13% (32/255) de los pacientes fallecieron, con predominio del sexo masculino 62,5% (20/32), con edad promedio de 50 años, los parámetros bioclínico valorados no demostraron asociación estadísticamente significativa, a excepción de la glucemia p: 0.01. En cuanto a las escalas, considerándose como puntaje alto ≥ 7 puntos; Quick Covid-19 Severity Index no tiene asociación significativa como predictor de mortalidad, con una sensibilidad y especificidad de 43,75% y 63,23% respectivamente; mientras que NEWS-2 arrojo sensibilidad de 87,50%; especificidad de 50,67%; AUC 0,768 (IC: 0,684-0,853; p 0,00); es decir existe más del 75% de probabilidad de pronóstico. Conclusión: la escala NEWS-2estadisticamente mostró ser una buena herramienta para el pronóstico de mortalidad en pacientes con infección con SARS ­ CoV ­ 2, se sugiere realizar estudios que confirme los hallazgos de esta investigación y valorar su aplicabilidad y reproducibilidad en otras poblaciones(AU)

Due to the high morbidity and mortality associated with COVID-19, clinical risk stratification tools have been developed for these patients, in order to predict progression to severe disease and/or mortality. In this study, the Quick COVID19 Severity Index Scale was compared with News2 as a predictor of mortality in adults with SARS-CoV-2 infection, specifying its diagnostic validity. Materials and methods: Observational, retrospective, analytical study of diagnostic tests. 255 patients were included, over 18 years of age, hospitalized in Hospital II - I Moyobamba with a diagnosis of COVID-19, with an oxygen requirement of ≤6 Lt/min, from January to December 2020. Results: 13% (32/255) of the patients died, with a predominance of males 62.5% (20/32), with an average age of 50 years, the bioclinical parameters evaluated did not show a statistically significant association, except for the blood glucose p: 0.01. Regarding the scales, considering a high score ≥ 7 points; Quick Covid-19 Severity Index has no significant association as a predictor of mortality, with a sensitivity and specificity of 43.75% and 63.23%, respectively; while NEWS-2 showed sensitivity of 87.50%; specificity of 50.67%; AUC 0.768 (CI: 0.684-0.853, p 0.00); that is, there is more than 75% probability of prognosis. Conclusion: the NEWS-2 scale statistically showed to be a good tool for the prognosis of mortality in patients infected with SARS - CoV - 2, it is suggested to carry out studies that confirm the findings of this research and assess its applicability and reproducibility in other populations(AU)

Treatment of psoriasis vulgaris using Bacteroides fragilis BF839: a single-arm, open preliminary clinical study / 生物工程学报

Psoriasis is considered as an inflammatory disease driven by T cells, and its pathogenesis is closely related to the imbalance of intestinal bacteria flora. It has been reported that Bacteroides fragilis could play an anti-inflammatory role by regulating the expression of cytokines in T cells. To date, there is no report using B. fragilis to treat psoriasis. In this study, we explored the therapeutic effect of B. fragilis BF839 on psoriasis. We selected 27 psoriasis patients who were treated in the Second Affiliated Hospital of Guangzhou Medical University from April to October 2019. The patients were given B. fragilis BF839 orally for 12 weeks while maintaining the original treatment. The psoriasis area and severity index (PASI) score was evaluated before and after the treatment. The rate of drug withdrawal and reduction after 12 weeks of treatment were calculated. Our results showed that the rate of 12-week trial completion was 96.3% (26/27). We used PASIN to define the proportion of people whose PASI score decreased more than or equal to N% after treatment. At 12 weeks, PASI30, PASI50, and PASI75 were 65.4%, 42.3%, and 19.2%, respectively. The PASI score was 9.1±5.9 and 5.8±4.9 before and after 12 weeks of treatment respectively, and the difference was statistically significant (P0.05). The adverse reaction rate of patients was 3.8% (1/26) within 12 weeks of treatment, including 1 case of constipation, and the rate of drug withdrawal and reduction was 60.0%. The above results suggest that B. fragilis BF839 may be functional on the treatment of psoriasis by reducing the PASI score and the drug usage rate with few side effect, which deserves further study.

Clinical study of acute lower respiratory tract infection caused by respiratory syncytial virus in neonates / 中华实用儿科临床杂志

Objective:To investigate the clinical characteristics of acute lower respiratory tract infection (ALRTI) in neonates caused by respiratory syncytial virus (RSV), and to analyze the factors associated with the severe infection.Methods:Clinical data of 399 ALRTI neonates with positive nucleic acids or antigen of RSV admitted to Shenzhen Children′s Hospital from January 2014 to December 2020 were retrospectively analyzed for their clinical cha-racteristics.They were divided into mild-to-moderate group and severe group according to the severity index (SI), and the clinical data of the 2 groups were compared.Relevant factors of severe ALRTI of RSV in neonates were analyzed by multivariate Logistic regression. Results:(1) A total of 399 ALRTI neonates with RSV infection were included, involving 239 males (59.9%) and 160 females (40.1%) with a male-to-female ratio of 1.49∶1.00.There were 349 cases (87.5%) and 50 cases (12.5%) in the mild-to-moderate group and severe group, respectively.The disease mainly occurred from March to October.(2) There were significant differences in the preterm delivery [15 cases (4.3%) vs.9 cases (18.0%)], low birth weight [11 cases (3.2%) vs.6 cases (12.0%)], previous hospitalization history [12 cases (3.4%) vs.5 cases (10.0%)], and breastfeeding [167 cases (47.9%) vs.16 cases (32.0%)] between the mild-to-moderate group and severe group ( χ2=14.524, 8.394, 4.616 and 4.426, respectively, all P<0.05). (3) There were significant differences in fever [78 cases (22.4%) vs.18 cases (36.0%)], shortness of breath [156 cases (44.7%) vs.36 cases (72.0%)], poor appetite [48 cases (13.8%) vs.15 cases (30.0%)], wheezing [20 cases (5.7%) vs.10 cases (20.0%)], cyanosis [30 cases (8.0%) vs.16 cases (32.0%)] and mental status (irritability/malaise) [20 cases (5.7%) vs.8 cases (16.0%)], and duration of cough[(8.1±2.6) days vs.(9.4±2.9) days ] between the mild-to-moderate group and severe group ( χ2=4.460, 13.057, 8.682, 12.806, 23.486 and 7.068, t=-3.054, all P<0.05). Moist rales in the lungs [29 cases (58.0%) vs.114 cases (32.7%)] and three concave signs [14 cases (28.0%) vs.20 cases (5.7%)] were commonly found in the severe group, while pulmonary phlegm sounds [168 cases (48.1%) vs.14 cases (28.0%)]was commonly found in the mild-to-moderate group, and the differences were statistically significant ( χ2=12.208, 27.823 and 7.149, respectively, all P<0.05). (4) Multifactorial analysis showed that premature delivery was an independent risk factor for the development of severe ALRTI caused by RSV in neonates ( OR=3.717, 95% CI: 1.257-10.987), and shortness of breath ( OR=2.216, 95% CI: 1.061-4.629), cyanosis ( OR=3.621, 95% CI: 1.638-8.004) and three concave signs ( OR=2.688, 95% CI: 1.077-6.711) may be early warning factors for the severe condition. Conclusions:Preterm infants with RSV infection are prone to develop into severe disease, and neonates with RSV infection with shortness of breath, cyanosis and three concave signs as symptoms of severe infection should be well concerned for a close monitoring.

Carga horária de enfermagem aplicada ao paciente com infarto agudo do miocárdio / Nursing hour load applied to the patient with acute myocardial infarction / Carga horaria de enfermería aplicada al paciente con infarto agudo de miocardio

Objetivo: identificar a Carga Horaria de enfermagem aplicada ao Infarto agudo do Miocárdio, de acordo com a classificação de Killip. Método: pesquisa de campo com abordagem quantitativa, descritiva, exploratória, retrospectiva. Foram utilizados prontuários de pacientes que obtiveram como diagnostico inicial o Infarto Agudo do Miocárdio, e que apresentaram alterações nos marcadores bioquímicos Resultados: foram avaliados 200 prontuários. A partir dos dados obtidos conseguimos traçar uma progressão de carga horaria entre as categorias Killip, sobre as necessidades de assistência prestada. Conclusão: a carga horaria de enfermagem varia de acordo com a complexidade que o Infarto do Miocárdio pode manifestar. O paciente necessita de maior número de pessoal de enfermagem devido alta carga horaria para atender todas as intervenções necessárias

Objective: to identify the nursing time load applied to acute myocardial infarction, according to the Killip classification. field research with quantitative, descriptive, exploratory, retrospective approach. The medical records of patients Methods: who obtained an initial diagnosis of acute myocardial infarction and who presented alterations in the biochemical markers were used. Results: 200 medical records were evaluated. From the data obtained we were able to trace a progression of time load between the Killip categories, on the assistance needs provided. Conclusion: the nursing time load varies according to the complexity that the Myocardial Infarction can manifest. The patient needs a larger number of nursing personnel due to high workload to attend all necessary interventions

Objetivo: identificar la carga horaria de enfermería aplicada al infarto agudo de miocardio, de acuerdo con la clasificación de Killip. Métodos: investigación de campo con abordaje cuantitativo, descriptivo, exploratorio, retrospectivo. Se utilizaron prontuarios de pacientes que obtuvieron como diagnóstico inicial el Infarto Agudo del Miocardio, y que presentaron alteraciones en los marcadores bioquímicos. Resultados: se evaluaron 200 prontuarios. A partir de los datos obtenidos conseguimos trazar una progresión de carga horaria entre las categorías Killip, sobre las necesidades de asistencia prestada. Conclusión: la carga horaria de enfermería varía de acuerdo con la complejidad que el Infarto del Miocardio puede manifestar. El paciente necesita un mayor número de personal de enfermería debido a una alta carga horaria para atender todas las intervenciones necesarias

Alelos asociados al índice de severidad de la enfermedad Mal de Río Cuarto en germoplasma exótico de maíz / Alleles associated to disease severity index of Mal de Río Cuarto disease in maize exotic germplasm

RESUMEN El Mal de Río Cuarto (MRC) es una de las enfermedades virales más importantes del maíz en Argentina. El índice de severidad de enfermedad (ISE) permite combinar la incidencia y la severidad de una enfermedad en una métrica única. La reacción genotípica a MRC ha sido muy estudiada en poblaciones biparentales, sin embargo este carácter complejo no se ha analizado mediante estudios de mapeo por asociación. El objetivo del presente trabajo es identificar nuevos alelos de resistencia asociados con el ISE de la enfermedad MRC de maíz en un germoplasma exótico del Centro Internacional de Mejoramiento de Maíz y Trigo (CIMMYT). Una población de líneas de maíz del CIMMYT se evaluó fenotípicamente en ambientes donde la enfermedad es endémica. Los predictores del efecto genotípico (BLUP, best linear unbiased predictor) del ISE de MRC y 78.376 marcadores SNP (Single Nucleotide Polymorphism) se usaron para realizar el mapeo por asociación en 186 líneas de maíz. Los componentes de varianza y los valores de heredabilidad sugieren una amplia variabilidad genotípica en la población de líneas. El mapeo por asociación permitió identificar 11 posibles QTL de resistencia a MRC. La incorporación de germoplasma exótico en los programas de mejoramiento de maíz locales podría contribuir favorablemente a la creación de genotipos híbridos con mayor nivel de resistencia a MRC. La capacidad predictiva de los marcadores asociados con la resistencia a MRC indican que la selección asistida por marcadores es una herramienta recomendable para seleccionar genotipos resistentes a MRC.

ABSTRACT Mal de Río Cuarto (MRC) is one of the most important viral diseases of maize in Argentina. The disease severity index (DSI) allows to combine the incidence and severity of a disease in a single metric. The genotypic reaction to MRC has been extensively studied in biparental populations. However, this complex trait has not been analyzed by genome-wide association studies (GWAS). The aim of this work is to identify new resistance alleles associated with DSI of MRC in an exotic germplasm from the International Maize and Wheat Improvement Center (CIMMYT). A population of maize lines from CIMMYT was phenotypically evaluated in environments in the area where the disease is endemic. The predictors of genetic effects (BLUP, best linear unbiased predictor) and 78,376 SNP markers (Single Nucleotide Polymorphism) were used to perform the GWAS in 186 maize lines. The values of variance components and mean-basis heritability suggest a wide genotypic variability in the population. The GWAS allowed to identify 11 putative QTL of resistance to MRC. The incorporation of exotic germplasm into local maize breeding programs could contribute favorably to the creation of hybrids with a higher level of resistance to MRC. The predictive ability of associated markers with MRC resistance indicates that marker-assisted selection is an advisable tool for selecting MRC resistant genotypes.

Clinical Profile of Community Acquired Pneumonia (CAP) in Patients with Type 2 Diabetes Mellitus - A Hospital Based Study

It is well known fact that diabetics are prone to develop infections and have increased mortality and morbidity than non-diabetics. However, the effect of diabetes mellitus on the risk of pneumonia remains uncertain. We wanted to study the aetiology, clinical features, and the outcome of pneumonia in diabetic patients. METHODSA comparative observational study was conducted in a tertiary care hospital, southern India which included 50 diabetic patients with pneumonia and 50 non-diabetic patients with pneumonia. Clinical characteristics, x-ray findings, aetiological agents, and outcome of diabetic patients were analysed and compared with data from the control group. RESULTSDiabetic patients with pneumonia were more unwell at the time of admission in the form of high PSI (Pneumonia Severity Index) score (p = 0.004**), intensive care admissions and prolonged hospital stay (p = < 0.001**). Diabetic patients were significantly associated with multilobar involvement (p = 0.045*). There was no significant difference in age, gender, coexisting underlying disease and complications. In patients with diabetes mellitus, mortality was associated with multilobar infiltrate, increased PSI score (p = 0.078*) at admission. CONCLUSIONSThese is a significant difference between pneumonia in diabetics compared with non-diabetics. Diabetic patients had presented with higher PSI score, required more ICU admissions and had prolonged hospitalization. Diabetes is also associated with bad prognosis and high mortality.

Risk factors for critical care admission in acute pancreatitis

Background: Acute pancreatitis is one of the most common gastrointestinal causes of emergency hospital admissions. One in four patients will develop severe acute pancreatitis requiring critical care admission (CCA) frequently for a prolonged period leading to a considerable burden on health care resources. The main objective of this study was to analyse factors that may predict the need for CCA in patients diagnosed with acute pancreatitis.Methods: In this study, authors analyzed the health records of all patients (154 patients) admitted to Salmaniya Medical Complex (SMC) with the diagnosis of acute pancreatitis.Results: A total of 10 (6.5%) and 24 (15.6%) patients were admitted to the intensive care unit (ICU) and surgical high dependency unit (SHDU) respectively. There were no differences between different admission locations when it came to age, gender, comorbidities, frequency of attacks and number of computed tomography (CT) scans. After adjusting for all covariates in a multivariate binary logistic regression, the following factors were found to predict CCA: Nationality OR (95% CI): 7.64 (1.14-51.29), dyslipidaemia etiology OR (95% CI): 0.025 (0.001-0.755) and CT severity index - CTSI (95% CI): 1.463 (1.014-2.111). CCA was associated with higher length of stay (6 days vs. 9 day) OR (95% CI): 0.79 (0.015-0.413) and higher in-hospital mortality (1.7% versus 17.6%) OR (95% CI): 5.58 (3.38-7.78).Conclusions: This study results indicate that nationality, dyslipidaemia etiology and CTSI were associated with higher CCA. ICU admission was associated with longer length of hospital stay and higher mortality rates.

Acute biliary pancreatitis: a prospective observational hospital-based study

Background: Acute biliary pancreatitis (ABP) is one of the most serious complications of gall stone disease with a high risk of morbidity and mortality. Hence accurate diagnosis and prompt management of ABP is very crucial. Different management strategies exist regarding indications and timing for interventions, endoscopic retrograde cholangio-pancreaticography (ERCP) and cholecystectomy.Methods: Ours is a prospective observational study of the different clinical presentations and management strategies and their respective outcomes in our hospital. All cases of ABP admitted over a period of one year were included in the study. The clinical presentation, severity and course of the disease, imaging studies, duration of ICU and hospital stay and timing of ERCP and cholecystectomy were studied.Results: A total of 56 cases were included in the study. Average age was 45 years. Pain abdomen was the most common symptom at presentation. About 82% patients had mild to moderate disease while the rest had severe disease. The mean duration of intensive care unit stay was 8 days. ERCP was done in 6 cases. Cholecystectomy during the same admission was dine in 20 cases. There were 2 deaths during the course of the study.Conclusions: Early intervention definitely reduces morbidity, mortality and recurrent admissions in cases of acute biliary pancreatitis. Same admission laparoscopic cholecystectomy is preferable in mild ABP. All cases of severe ABP must undergo early ERCP irrespective of biliary obstruction. This also helps in reducing readmissions due to pancreatic-biliary complications and is cost-effective.

A comparative study of PSI and Curb-65 scoring systems in predicting ICU admissions and mortality in cases of community-acquired pneumonia

Background:Community-acquired pneumonia (CAP) is a leading cause of morbidity and mortality worldwide. Despite advanced diagnostic modalities and treatment options, CAP is the fourth leading cause of death in developing countries.Several severity scores have been proposed to guide initial decision making on hospitalization and to predict the outcome. Pneumonia Severity Index (PSI) and CURB 65 are the two most widely used scoring systems to prognosticate pneumonia. Aim: To compare the efficacy of PSI and CURB 65 scoring systems inprognosticating the ICU admission and outcome in cases of CAP. Methodology: This wasan observational study conducted at a tertiary care hospital in westernMaharashtra.A hundred patients of CAP fulfilling the inclusion criteria were enrolled in the study, classified as per CURB 65 and PSI system and their outcome compared. Result: The study subjects comprised of 100 patients (64 men and 36 women) of CAP. Twenty-four patients needed ICU admission.In both PSI and CURB-65 risk scoring systems, the need for intensive care unit (ICU) admission and mortality rates increased progressively with increasing scores.PSI class ≥IV and CURB 65 ≥III had 77.52% and 40.24% sensitivity and 88.46% and 69.48% specificity respectively in predicting ICU admissions. The PSI class ≥IV had more sensitivity and specificity in predicting ICU admission than CURB-65.CURB 65 class III and IV had sensitivity86.59% and 89.64% and specificity 89.64% and 97.54% respectivelyin predicting mortality, while PSI class IV and Vhadsensitivity68.92% and 72.58% and specificity 24.74% and 54.86% respectively. CURB 65 had more sensitivity and specificity than PSI in predicting mortality. Conclusion: The PSI is better in predicting the need for ICU admission and CURB 65 is a better predictor of mortality in cases of community-acquired pneumonia.

Confusion, blood urea, respiration and blood pressure 65, pneumonia severity index and shock index and hypoxemia scores in community acquired pneumonia and outcome prediction: a descriptive study from Dr B R Ambedkar Memorial Hospital Raipur, India

Background: According to WHO, pneumonia is the third important cause of death worldwide despite various advances in medical science. Incidence of Community acquired pneumonia is about 20% to 30% in developing countries compared to 3% to 4 % in developed countries. Incidence of CAP is much higher in the very young and the elderly individuals. Objectives of the study was to compare CURB 65, PSI (Pneumonia severity index) and SIPF (shock index and hypoxemia) scores with respect to outcome prediction in community acquired pneumonia (CAP).Methods: The present hospital based descriptive observational study was conducted in the Dept of medicine, Pt. J.N.M. Medical College and Dr B. R. A. M. Hospital, Raipur, during 2016-2018 involving a total of 98 patients of community acquired pneumonia.Results: Majority of them i.e. 22 (22.4%) subjects belonged to age group 41-50 years. 34 (34.7%) subjects were found to have CURB65 score 1. 28(28.6%) subjects PSI score was noted to be class I. 89 (90.8%) subjects were discharged while, there was death of 9 (9.2%) subjects. The difference in the mean score was statistically significant (p<0.001). PSI score was found to have diagnostic sensitivity of 94.4% and specificity of 100% while CURB 65 score having 83.1% sensitivity and 100 % specificity. SIPF score had least AUC 0.88.Conclusions: Maximum diagnostic ability was noted with PSI score followed by CURB 65 and SIPF score.

Role of total calcium and corrected calcium in comparisons with computed tomography to predict severity of acute pancreatitis

Background: The objective of the study was to evaluate corrected calcium levels in patient of acute pancreatitis and to evaluate role of corrected calcium as predictor of severity in acute pancreatitis in comparison to computed tomography (CT) scan.Methods: The study was conducted in Department of Biochemistry of G.G.S Medical College in collaboration with the Department of Surgery and Department of Radio diagnosis. 50 patients, with clinical diagnosis of acute pancreatitis, attending the Inpatient Department of Department of Surgery, were taken. 50 patients, of either sex of 18 to 70 age groups suffering from acute pancreatitis were enrolled for the study.Results: On exploring the data, highly significant negative correlation found between CT severity index (CTSI) and serum calcium (p≤0.001; r value=-0.520) whereas the non-significant correlation found between CTSI and amylase (p=0.778; r value=-0.041). The corrected calcium and CTSI shows highly negative significant correlation (p≤0.001; r value=-0.654). Serum albumin with CTSI also shows significant correlation (p=0.006; r value=0.385). But no significant association with lipase (p≥0.05).Conclusions: We observed that corrected calcium and calcium is better and alternative marker for predicating the severity of disease because corrected calcium and calcium is having good positive predictive value to indicate progression of damage and also a highly significant negative predictive value to rule out severity of acute pancreatitis.

Assessment of ventilatory function in patients with spinocerebellar ataxia type 2 / Avaliação da função ventilatória em pacientes com ataxia espinocerebelar tipo 2

Abstract Subclinical ventilatory dysfunction is observed in individuals with spinocerebellar ataxias (SCA). No studies have correlated ventilatory dysfunction to clinical and functional decline in SCA2. Objective: To evaluate the relationship between the values of peak expiratory flow (PEF), maximum inspiratory pressure (MIP), and presence of respiratory complaints with age, disease duration, age at onset of symptoms, balance scores, independence in basic (ADL) and instrumental (IADL) Activities of Daily Living (ADLs), and severity of ataxia (SARA) in individuals with SCA2. Methods: Cross-sectional study evaluating age, disease duration, age at onset of symptoms, scores in the Berg Balance Scale and in the SARA, Functional Independence Measure and Lawton's scale, values of PEF and MIP, and the presence of respiratory complaints. Results: The study included 36 individuals with SCA2, with a mean age of 42.5±2.4 years, disease duration of 7.6±8.2 years, age 33.7±11.5 years at onset of symptoms, and 9.9±10.3 points in the SARA scale. The lowest PEF values correlated with the longer disease duration (p=0.021). The lowest values of PEF and MIP correlated with greater balance impairment (p=0.019 and p=0.045, respectively), increased degree of dependence in the ADL (p=0.006 and p=0.050, respectively) and IADL (p=0.003 and p=0.001, respectively) scales, and highest severity of ataxia (p=0.00 and p=0.017, respectively). Respiratory complaints were observed in 12 (33.3%) individuals and were not related to age, disease duration, age at onset of symptoms, balance, independence, ataxia severity, or PEF and MIP values. Conclusion: Ventilatory dysfunction, even when asymptomatic, is related to balance impairment, independence, and ataxia severity in individuals with SCA2.

Resumo Disfunção ventilatória subclínica tem sido observada em indivíduos com ataxias espinocerebelares (SCA). Não existem estudos relacionando disfunção ventilatória ao declínio clínico e funcional na SCA2. Objetivo: Avaliar a relação dos valores de Pico de Fluxo Expiratório (PFE), Pressão Inspiratória Máxima (PIMAX) e presença de queixas respiratórias com idade, tempo de doença, idade de início dos sintomas, escore de equilíbrio, independência para atividades básicas (AVD) e instrumentais (AIVD) de vida diária e gravidade da ataxia (SARA) em indivíduos com SCA2. Métodos: Estudo transversal, considerando: idade, tempo de doença, idade de início dos sintomas, escores nas Escalas SARA, Equilíbrio de Berg, Medida da Independência Funcional e de Lawton, valores de PFE, PIMAX e queixas respiratórias. Resultados: Foram avaliados 36 indivíduos com SCA2 com média de 42,5±2,4) anos de idade, 7,6±8,2 anos de tempo de doença, 33,7±11,5 anos de idade de início dos sintomas e 9,9±10,3 pontos na escala SARA. Os menores valores de PFE estiveram relacionados ao maior tempo de doença (p=0,021). Os menores valores de PFE e PIMAX estiveram relacionados ao maior comprometimento do equilíbrio (p=0,019; p=0,045, respectivamente), maior dependência para ADV (p=0,006; p=0,050, respectivamente) e AIVD (p=0,003; p=0,001, respectivamente) e maior gravidade da ataxia (p=0,006; p=0,017, respectivamente). Foram observadas queixas respiratórias em 12 (33,3%) indivíduos que não estiveram relacionadas à idade, idade de início dos sintomas, tempo de doença, equilíbrio, independência, gravidade da ataxia, ou valores de PFE e PIMAX. Conclusão: A disfunção ventilatória, mesmo quando assintomática, está relacionada ao comprometimento do equilíbrio, à independência e à gravidade da ataxia em indivíduos com SCA2.