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Metformin is a biguanide, evolved as one of the most widely used medicines. The applications of this component include but are not limited to reducing blood glucose, weight loss, and polycystic ovary syndrome. Studies about other probable indications have emerged, indicating that this agent can also be utilized for other purposes. In this review, applications of metformin are noticed based on the current evidence. Metformin commonly is used as an off-label drug in non-alcoholic fatty liver disease (NAFLD), but it worsens inflammation and should not be used for this purpose, according to the latest research. Metformin decreased the risk of death in patients with liver cirrhosis. It is an effective agent in the prevention and improvement of survival in patients suffering hepatocellular carcinoma. There is evidence of the beneficial effects of metformin in colorectal cancer, early-stage prostate cancer, breast cancer, urothelial cancer, blood cancer, melanoma, and bone cancer, suggesting metformin as a potent anti-tumor agent. Metformin shows neuroprotective effects and provides a potential therapeutic benefit for mild cognitive impairment and Alzheimer's disease (AD). It also has been shown to improve mental function and reduce the incidence of dementia. Another condition that metformin has been shown to slow the progression of is Duchenne muscular dystrophy. Regarding infectious diseases, tuberculosis (TB) and coronavirus disease (COVID-19) are among the conditions suggested to be affected by metformin. The beneficial effects of metformin in cardiovascular diseases were also reported in the literature. Concerning renal function, studies showed that daily oral administration of metformin could ameliorate kidney fibrosis and normalize kidney structure and function. This study reviewed the clinical and preclinical evidence about the possible benefits of metformin based on recent studies. Numerous questions like whether these probable indications of metformin can be observed in non-diabetics, need to be described by future basic experiments and clinical studies.
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To report findings on brain MRI and neurocognitive function, as well as persisting fatigue at long-term follow-up after COVID-19 hospitalisation in patients identified as high risk for affection of the central nervous system. Ambidirectional observational cohort study. All patients (n=734) previously hospitalized with a laboratory-confirmed COVID-19 in a total regional population in Sweden during the period March 1st to May 31st 2020. A subgroup (n=185) with persisting symptoms still interfering with daily life at a telephone follow-up 4 months after discharge were invited for a medical and neuropsychological evaluation. Thirty-five of those who were assessed with a neurocognitive test battery at the clinical visit, and presented a clinical picture concerning for COVID-19-related brain pathology, were further investigated by brain MRI. N/A. Findings on brain MRI, neurocognitive test results and reported fatigue. Twenty-five patients (71%) had abnormalities on MRI;multiple white matter lesions were the most common finding. Six patients had had MRI performed in the acute phase during their hospitalisation, and all of these patients had additional white matter lesions at the follow-up MRI. Sixteen patients (46%) demonstrated impaired neurocognitive function, of which 10 (29%) had severe impairment. Twenty-six patients (74%) reported clinically significant fatigue. Patients with abnormalities on MRI had a lower Visuospatial Index (p=0.031) compared with the group with normal MRI findings. A majority in this group of patients selected to undergo MRI after a clinical evaluation, showed signs of possible COVID-19 related brain affection detectable by brain MRI and/or neurocognitive test results. Even in a previously fairly healthy group of patients, COVID-19 might have a substantial negative impact on cognition in several domains, persisting several months post discharge. Abnormal findings were not restricted to patients with severe disease. Thus, for clinicians it is important to consider post-covid related changes when facing patients' reports of neuropsychological deficiency, regardless of severity of disease. The authors declare no competing interests.
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A case report of COVID-19 infection in a patient presenting with upper and lower gastrointestinal and respiratory symptoms, ending in respiratory failure and the need for invasive mechanical ventilation, presenting with improvement in his respiratory and gastrointestinal symptoms, but with limitations for extubation due to altered state of consciousness despite weaning from analgesia for more than 72 hours, in whom elevated levels of ammonia were found without signs of liver failure. Diarrhoea and liver involvement are frequent manifestations in patients with COVID-19, which can possibly lead to a decrease in carnitine levels and secondary hyperammonaemia, becoming a challenge for clinicians. © 2021 Asociación Colombiana de Medicina Crítica y Cuidado lntensivo
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This article provides a brief overview of the 31st meeting of the International TaskForce for Disease Eradication (ITFDE) that was convened at The Carter Center in Atlanta, GA, USA on 20-21 October 2020 to discuss "The impact of the COVID-19 pandemic on eradication and elimination programmes and the way forward." It highlights the results of 7 eradication programmes, with specific conclusions and recommendations for each: Guinea Worm Eradication Programme(dracunculiasis;GWEP);Global Polio Eradication Initiative (GPEI);elimination programmes for measles and rubella (MR), malaria, river blindness (onchocerciasis;RB), and lymphatic filariasis (LF);and the program for the Global Elimination of Trachoma.
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This conference proceeding contain 39 articles that discuss epidemiology in the US. Topics include the Millenium Cohort Study, The CRONICAS Cohort Study, religious beliefs, coping mechanisms and type 2 diabetes, spatio-temporal modelling of COVID-19, cigarette smoking and spinal pain, self-perceived health status and obesity, oral cancer and smoking, renal impairment and diabetes, depression and BMI, affordable housing and COVID-19, opioid misuse among youth, emotions and cancer prevention, influenza vaccination among adults, blood lead levels and private wells, and air pollution and amyotrophic lateral sclerosis.
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July Infographic : COVID‐19 Infection Enhances Susceptibility to Oxidative Stress–Induced Parkinsonism
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Statins and parkinsonism Repeated assessments of 2800 community dwelling older adults suggest that statin users have a reduced risk of developing parkinsonian signs and symptoms. Exercise following a cardiovascular event Physical activity is well known to promote cardiovascular health. Consider the patient’s life expectancy before initiating intensive treatment of blood pressure (JAMA Intern Med doi:10.1001/jamainternmed.2022.1657).
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This special issue consists of the following papers: (1) Long-term immunologic effects of SARS-CoV-2 infection: leveraging translational research methodology to address emerging questions;(2) From ARDS to pulmonary fibrosis: the next phase of the COVID-19 pandemic?;(3) COVID-lateral damage: cardiovascular manifestations of SARS-CoV-2 infection;(4) Central nervous system outcomes of COVID-19;(5) Impaired glucose regulation, SARS-CoV-2 infections and adverse COVID-19 outcomes;(6) COVID-19 Survival and its impact on chronic kidney disease;(7) Immune mechanisms in cancer patients that lead to poor outcomes of SARS-CoV-2 infection;and (8) Immune mechanisms in cancer patients that lead to poor outcomes of SARS-CoV-2 infection.
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In December 2021, a total of 64 infectious diseases were reported globally, affecting 228 countries and regions. Except for influenza, the top five infectious diseases affecting greatest number of countries and regions were corona virus disease 2019 (COVID-19, 228), measles (29), dengue fever (28), cholera (12) and chikungunya fever (9). The top five infectious diseases with highest case fatality rates were Ebola virus disease (81.8%), Middle East respiratory syndrome (34.4%), yellow fever (22.0%), Lassa fever (20.0%) and plague (10.8%). The top five infectious diseases with greatest number of deaths were COVID-19, malaria, measles, dengue fever and cholera. The prevalent infectious diseases in Asia were COVID-19 and dengue fever, the prevalent infectious diseases in Africa were COVID-19, cholera, yellow fever, plague, Lassa fever, poliomyelitis, malaria and measles, the prevalent infectious diseases in America were COVID-19, dengue fever, chikungunya fever and Zika virus disease, the prevalent infectious disease in Europe was COVID-19.
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In late December 2019, an outbreak of a novel coronavirus causing severe acute respiratory syndrome (SARS) was reported in Wuhan, Hubei Province, China. The disease has been referred to as COVID-19, and the causative agent has been labelled SARS-CoV-2 due to its genetic resemblance to the virus SARS-CoV-1 responsible for SARS epidemic almost 20 years before. The epidemic has since spread to much of the world, having been considered as a pandemic with over 12 million confirmed cases and 5,52,143 deaths worldwide till July 10, 2020. COVID-19 pandemic demonstrates that infection with SARS-CoV-2 affects the central nervous system (CNS), the peripheral nervous system (PNS) and the muscle. Initially thought to be restricted to the respiratory system, it is now understood that (COVID-19) also affects other multiple organs, including the central and peripheral nervous system. The number of recognized neurologic manifestations of SARS-CoV-2 infection is rapidly increasing. The pathobiology of the COVID-19 in CNS is still not known. Of the neurological disorders, some appear to be the consequence of direct viral invasion of the tissues of nervous systems, others arise as a postviral autoimmune process, and still, others are the result of metabolic and systemic complications due to the associated critical illness. This review deals with the preliminary observations regarding the neurological disorders reported with COVID-19 to date and illustrates some of the disorders that are anticipated from prior experience with similar coronaviruses.
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Coronavirus disease 2019 (COVID-19) can affect the neurological as well as the respiratory system. Neurological manifestations may involve the central or peripheral nervous systems, or musculoskeletal system. Findings can range from mild presentations, such as headache and anosmia, to severe complications, such as stroke and seizure. To evaluate the neurological findings and to determine etiological risk factors for mortality in patients hospitalized for COVID-19. Medical records of patients with COVID-19 who were hospitalized and sought neurological consultation between March 2020 and March 2021 at a reference pandemic hospital in Turkey were reviewed retrospectively in a cross-sectional study design. We included data from 150 (94 male) patients. Their mean age .. standard deviation was 68.56 .. 16.02 (range 21-97) years. The patients were categorized into 2 groups according to any acute neurological event or progression of neurological disease. Ischemic cerebrovascular events, seizures, and encephalopathy were the most common acute neurological events, while deterioration in consciousness, epileptic seizures, and Parkinson disease were observed in those with progression of neurological disease. Abnormal neurological findings were found at a mean of 7.8 .. 9.7 days following COVID-19 diagnosis and 50 (a third of) patients died. A logistic regression model found that advanced age, increased Modified Charlson Comorbidity Index (MCCI) score, and prolonged duration of hospitalization were factors significantly associated with increased mortality;however, sex and day of abnormal neurological findings after COVID-19 diagnosis were not. Common conditions accompanying neurological events were hypertension, coronary artery disease-heart failure, and diabetes mellitus. COVID-19 may present with neurological symptoms in our Turkish patients and comorbidities are often present.
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Resumen Reporte de un caso de infección por COVID 19, en un paciente que se presenta con síntomas gastrointestinales y respiratorios altos y bajos, terminando en falla respiratoria y necesidad de ventilación mecánica invasiva, presentando mejoría de su cuadro respiratorio y gastrointestinal, pero con limitaciones para la extubación por alteración del estado de conciencia a pesar del destete de sedo analgesia por más de 72 horas, en quien se encontró niveles elevados de amonio sin signos de falla hepática. La diarrea y el compromiso hepático son manifestaciones frecuentes en pacientes con COVID 19, que pueden llevar posiblemente a una disminución de los niveles de carnitina e hiperamonemia secundaria, convirtiéndose en un verdadero desafío para los clínicos. A case report of COVID 19 infection in a patient presenting with upper and lower gastrointestinal and respiratory symptoms, ending in respiratory failure and the need for invasive mechanical ventilation, presenting with improvement in his respiratory and gastrointestinal symptoms, but with limitations for extubation due to altered state of consciousness despite weaning from analgesia for more than 72 hours, in whom elevated levels of ammonia were found without signs of liver failure. Diarrhoea and liver involvement are frequent manifestations in patients with COVID 19, which can possibly lead to a decrease in carnitine levels and secondary hyperammonaemia, becoming a challenge for clinicians.
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Central nervous system (CNS) diseases are currently one of the major health issues around the world. Most CNS disorders are characterized by high oxidative stress levels and intense inflammatory responses in affected tissues. Lactoferrin (Lf), a multifunctional iron-binding glycoprotein, plays a significant role in anti-inflammatory, antibacterial, antiviral, reactive oxygen species (ROS) modulator, antitumor immunity, and anti-apoptotic processes. Previous studies have shown that Lf is abnormally expressed in a variety of neurological diseases, especially neurodegenerative diseases. Recently, the promotion of neurodevelopment and neuroprotection by Lf has attracted widespread attention, and Lf could be exploited both as an active therapeutic agent and drug nanocarrier. However, our understanding of the roles of Lf proteins in the initiation or progression of CNS diseases is limited, especially the roles of Lf in regulating neurogenesis. This review highlights recent advances in the understanding of the major pharmacological effects of Lf in CNS diseases, including neurodegenerative diseases, cerebrovascular disease, developmental delays in children, and brain tumors.
Subject(s)
Central Nervous System Diseases/metabolism , Lactoferrin/metabolism , Animals , Brain/embryology , Brain/pathology , Child , Child Development , Humans , Neurodevelopmental Disorders/pathologyABSTRACT
BACKGROUND: Increasing evidence supported the possible neuro-invasion potential of SARS-CoV-2. However, no studies were conducted to explore the existence of the micro-structural changes in the central nervous system after infection. We aimed to identify the existence of potential brain micro-structural changes related to SARS-CoV-2. METHODS: In this prospective study, diffusion tensor imaging (DTI) and 3D high-resolution T1WI sequences were acquired in 60 recovered COVID-19 patients (56.67% male; age: 44.10 ± 16.00) and 39 age- and sex-matched non-COVID-19 controls (56.41% male; age: 45.88 ± 13.90). Registered fractional anisotropy (FA), mean diffusivity (MD), axial diffusivity (AD), and radial diffusivity (RD) were quantified for DTI, and an index score system was introduced. Regional volumes derived from Voxel-based Morphometry (VBM) and DTI metrics were compared using analysis of covariance (ANCOVA). Two sample t-test and Spearman correlation were conducted to assess the relationships among imaging indices, index scores and clinical information. FINDINGS: In this follow-up stage, neurological symptoms were presented in 55% COVID-19 patients. COVID-19 patients had statistically significantly higher bilateral gray matter volumes (GMV) in olfactory cortices, hippocampi, insulas, left Rolandic operculum, left Heschl's gyrus and right cingulate gyrus and a general decline of MD, AD, RD accompanied with an increase of FA in white matter, especially AD in the right CR, EC and SFF, and MD in SFF compared with non-COVID-19 volunteers (corrected p value <0.05). Global GMV, GMVs in left Rolandic operculum, right cingulate, bilateral hippocampi, left Heschl's gyrus, and Global MD of WM were found to correlate with memory loss (p value <0.05). GMVs in the right cingulate gyrus and left hippocampus were related to smell loss (p value <0.05). MD-GM score, global GMV, and GMV in right cingulate gyrus were correlated with LDH level (p value <0.05). INTERPRETATION: Study findings revealed possible disruption to micro-structural and functional brain integrity in the recovery stages of COVID-19, suggesting the long-term consequences of SARS-CoV-2. FUNDING: Shanghai Natural Science Foundation, Youth Program of National Natural Science Foundation of China, Shanghai Sailing Program, Shanghai Science and Technology Development, Shanghai Municipal Science and Technology Major Project and ZJ Lab.