The Significance of Epidermal Growth Factor and Other Urinary Cytokines since Subclinical Aki in Patients with Covid-19

Introduction: In hospitalized COVID-19 patients, disease progression leading to acute kidney injury (AKI) may be driven by immune dysregulation. We explored the role of urinary cytokines and their relationship with the kidney stress biomarkers neutrophil gelatinase-associated lipocalin (NGAL), tissue inhibitor of metalloproteinases-2 (TIMP-2) and insulin-like growth factor binding protein (IGFBP7) in COVID-19 patients without AKI at study entry. Method(s): Prospective, longitudinal cohort study included critically ill COVID-19 patients without AKI at the time they were enrolled to the study. Urine samples were collected on admission to critical care areas for determination of NGAL, [TIMP-2]*[IGFBP7] and cytokines concentrations with a second sample 5 days after the first urine sample. Demographic information, clinical and laboratory data were collected. Diagnosis and staging of AKI were based on KDIGO criteria using serum creatinine (sCr) levels and urine output. The urinary concentrations of TIMP-2 and IGFBP7 were determined ELISA in the same way NGAL. The concentrations of cytokines and chemokines in urine were measured with a Luminex 200 instrument. We performed descriptive statistics including means and standard deviations for normally distributed continuous variables;medians and interquartile ranges (IQR) for non-parametric distributions;and proportions for categorical variables. Logistic regression analysis was used to identify the association between relevant covariates with AKI. Principal component analysis (PCA) was performed to compress and simplify the size of the data set by keeping the most important information and analyzing the structure of the observations and the variables. Correlation of identified cytokines with kidney stress biomarkers was explored using the Spearman test. All statistical tests were two-sided, p values <0.05 were considered statistically significant. The analysis was conducted using R Studio 1.4.1717. Result(s): Of included 51 patients. Of those, 30 were males (58.8%);the median age was 53 years (IQR: 40-61);14 had systemic arterial hypertension (27.5%);16 had diabetes (31.4%);and 21 were obese (41.2%). 54.9% developed AKI. After adjusting for possible confounding variables, only EGF >4600 pg/ml remained associated with lower risk of AKI (OR=0.095, 95% CI: 0.01-0.81, p=0.031.In the PCA of day 1, Epidermal Growth Factor (EGF) and interferon (IFN)-alpha were associated with a lower risk of AKI (OR=0.24, 95% CI: 0.07-0.78, p=0.017), while Interleukin (IL)-12 and macrophage inflammatory protein (MIP)-1b were associated with a higher risk of AKI (OR=51.09, 95% CI: 2.12-1233, p=0.015). In the PCA of day 5, EGF and IFN-alpha remained associated with a lower risk of AKI (OR=0.09, 95% CI: 0.01-0.74;p=0.024), while IL-1 Receptor, granulocyte-colony stimulating factor (G-CSF), interferon-gamma-inducible protein 10 (IP-10) and IL-5 were associated with a higher risk of AKI (OR=7.7, 95% CI: 1.06-55.74, p=0.043). EGF had an inverse correlation with [TIMP2] x IGFBP7] (R-0.73, p=<0.001) and with NGAL (R= -0.63, p=0.002). Conclusion(s): Subclinical AKI was characterized by a significant up-regulation of NGAL, TIMP-2, IGFBP7 and proinflammatory cytokines. The lack of EGF regenerative effects and IFN-alpha antiviral activity seemed crucial for renal disease progression. AKI involved a proinflammatory urinary cytokine storm. No conflict of interestCopyright © 2023

Neurosurgical patient reported experience measures (PREMs) survey in a University Public Hospital

Background: The Catalan Health Care National Department (CatSalut) launches distinct safety phone questionnaires (PLAENSA program) every three years to some random selected patients from all public hospitals in order to benchmark PREMs. Written surveys tend to be the most cost effective and reliable approach. Our aim was to know more precisely the measured experience of our surgical attended patients, using and/or adapting some questions obtained from one specific PLAENSA Survey (patients undergoing hospital admission for any pathology). Selected questions focused with emotional aspects (appropriate care, pain control, and privacy), information (before and after surgery) and overall satisfaction. Method(s): Through an encrypted on-line platform (LimeSurvey) we created the surveys, sent the e-mails and analyzed the results. Starting on 2019, we continued with the project during 2020 and 2021, the COVID- 19 pandemic years. We started sending the surveys to patients operated on the first semester of 2019 and 2021. On 2020, with the COVID-19 pandemic, the scheduled surgery diminished until summer, so we launch the surveys at the end of October. We compared Neurosurgical patients' responses with overall results. Result(s): Answers to the survey are described in Table 1. Main results of some selected questions may be seen in Fig. 1. Conclusion(s): Patients demand receiving more comprehensive and understandable information and more involvement in several steps of their perioperative journey. We need well-informed patients at the center of the care process. In our opinion, on-line surveys are a good tool to connect with patients and give them a space to explain their opinions, feelings and experiences. In our randomly included populations, patient experiences did not vary during the pre-pandemic year compared to the two years of the pandemic. However, the percentage of responses in 2021 was lower than the previous ones. (Figure Presented).

Dentistry 2020, a congress in the time of COVID-19

Introduction: Due to the COVID-19 pandemic, the International Congress programmed to mark the 120th anniversary of the Dental School of Havana had to change its format and was held virtually in November 2020. Objective: Characterize the virtual International Congress Dentistry 2020, held in the time of COVID-19. Methods: A descriptive study was conducted based on the final statistical reports provided by the Congress website and applying historical-logical and document review methods. Results: A total 970 users were registered in the Congress page. Of these, 899 were Cuban and 71 were foreign. All the provinces were represented. 81% of the users were professionals and 16.8% were students. 391 papers were accepted and published, for 82.8%;373 papers were written by Cuban authors and 18 by foreign authors. 18% of the papers dealt with general comprehensive dentistry in primary health care, followed by orthodontics (14.3%). 2 405 comments were made, with 92.3% of the published papers receiving comments. 354 papers were recorded in the Congress Proceedings. Conclusions: Most of the users registered were Cuban, female and professionals. All the provinces were represented. Most of the papers received met the publication requirements and almost one fifth dealt with general comprehensive dentistry in primary health care. Students had an outstanding participation. © 2021, Editorial Ciencias Medicas. All rights reserved.

Respiratory viruses detected through molecular biology in childrenhospitalized for acute respiratory infection in times of SARS-CoV-2/COVID-19

Introduction: viral acute respiratory infections have been considered of the main causes of mortality and morbidity in pediatrics, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which has become an important problem for global public health for its high transmissibility. The objective of the study is to describe the behavior of respiratory viruses detected by RT-PCR in children hospitalized for acute respiratory infection (ARI) in times of SARS-CoV-2 / COVID19 in pediatric care center in Cali Colombia Methodology: observational with a retrospective cross-sectional study. 113 patients older than 28 days and under 18 years in March to November 2020, hospitalized with a confirmed diagnosis of ARI and Real Time Polymerase Chain Reaction (RT-PCR) positive for respiratory viruses. Results: Predominance of gender male 64.6%. 74.3% with a diagnosis of low ARI, main symptoms presented were cough 92% and fever 74.3%, SARS-CoV-2 identified 53%, Human Rhinovirus / Enterovirus 27.41% and Respiratory Syncytial Virus 15%. 34.5% of the patients required an intensive care unit with mechanical ventilation requirement 15.9% Conclusions: infection by SARS-CoV-2 was more common in hospitalized patients in both general wards as in the pediatric intensive care unit.

International responses to COVID-19: challenges faced by early childhood professionals

The COVID-19 pandemic has caused a world crisis of an unprecedented nature. In March 2020, due to closing of non-essential private and public educational institutions, early childhood professionals had to quickly adapt and respond to the demands for social distancing, hygiene, new protocols and transition to online education. Alternatively, educators engaged in distance teaching and learning, when the families they serve lacked technological resources for online modalities. The present study examines how early childhood teachers in the United States and several Latin American countries are facing the challenges presented by COVID-19. The study clearly reflects the relevancy of the challenges faced by educators of young children, such as lack of preparation for distance teaching and learning, deficiencies in the pre-and in-service trainings to address the educational needs of young children distantly, and the need to work differently with caregivers. Teacher training and development should include the knowledge, skills, and dispositions necessary to successfully reconsider and participate in distance teaching and learning.

COVID-19 pandemic in Uruguay: evolution, lessons learned and challenges

America has become a new epicenter of the COVID-19 pandemic but the epidemic in Uruguay has had an atypical behavior compared to the region, with positive results in the management and control of the health crisis. This article describes the socio-sanitary characteristics of the country, the evolution of the pandemic, and the sanitary policies implemented, as well as the challenges to face the next stages. Since the beginning of the pandemic, the national health emergency was declared, the national emergency system was launched and a Coronavirus Fund was created to finance the required interventions. An outbreak mitigation strategy was implemented by recommending non-mandatory physical distancing. Likewise, the increase in diagnostic testing capacity through national developments, the management of suspected cases at the household level, and the implementation of telemedicine stand out. There is currently little community circulation of the virus. The largest increases in the number of cases have occurred mainly in clusters, institutional agglomerations, and small cities. In all these situations, index cases and contacts were quickly identified. An important role is attributed to the participation of the academic scientific community and the epidemiological surveillance system of the Ministry of Health, which has made it possible to effectively manage the outbreaks through surveillance and active search for cases. © 2020 Academia Nacional de Medicina. All rights reserved.