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Rhino-orbital-cerebral mucormycosis is an invasive disease caused by fungi. Diabetes mellitus and solid organ transplantation are known risk factors, while it is increasingly recognized in patients with COVID-19 although the exact causal relationship is unknown. Early diagnosis and treatment with liposomal amphotericin B with surgical debridement carries a better outcome in these patients. We present a case of extensive rhino-orbital-cerebral mucormycosis involving the paranasal sinuses, left orbit, cavernous sinus, middle cranial fossa with abscess formation in the left middle cerebellar peduncle in a 46-year-old kidney transplant recipient with concomitant COVID-19 infection.
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Reserve systems are a tool to allocate scarce resources when stakeholders do not have a single objective. This paper introduces some basic concepts about reserve systems for pandemic medical resource allocation. At the onset of the Covid-19 pandemic, we proposed that reserve systems can help practitioners arrive at compromises between competing stakeholders. More than a dozen states and local jurisdictions adopted reserve systems in initial phases of vaccine distribution. We highlight several design issues arising in some of these implementations. We also offer suggestions about ways practitioners can take advantage of the flexibility offered by reserve systems.
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Background: The novel coronavirus disease (caused by SARS-CoV-2) has become a disaster all over the world. Based on available evidence, the main organ infected by this virus is the respiratory system;however, various other vital systems can also be affected by potential outcomes. One of the critical affected organs is the kidney. Objectives: This study aimed to report and reviewed Risk of Renal Stones in Patients With COVID-19 Infection.
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This article discusses measures to prevent and treat Covid-19 infection. Collaboration at the local, regional, national and international levels, with a focus on high-quality research, evidence-based practice, the sharing of data and resources, and upholding all ethical standards in the face of unprecedented challenges, will be key to the success of these efforts. In addition, the demand for unproven therapies can lead to shortages of drugs that are approved and indicated for other conditions, leaving patients who rely on these drugs for chronic conditions without effective therapy. Copyright © 2022 Wolters Kluwer Medknow Publications. All rights reserved.
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The COVID-19 pandemic is a global health emergency. The relevance of this problem in immunoinflammatory rheumatic diseases is due to the increased risk of infection with SARS-CoV-2 and its severe course. The paper describes the clinical features and morphological changes in organs in a patient with rheumatoid arthritis and secondary amyloidosis of the heart and kidneys, who died from an infection caused by SARS-CoV-2. © 2022, Ima-Press Publishing House. All rights reserved.
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Background: Kidney recipients constitute a vulnerable group of population and may have high risk of morbidity and mortality when infected with COVID-19. Objective(s): To a assess the overall outcome as well as the incidence and impact of COVID-19 among recipients who underwent transplantation during the pandemic Methods: A pre-designed follow up protocol was set to prospectively analyse the data obtaining from the recipients who underwent renal transplantation since 8 March 2010, the first appearance of COVID-19 in Bangladesh till 31 December, 2020. Outcome parameters were renal functional status;surgical, urological, immunological and medical complications;and incidence of COVID-19 and its outcome during the first 12 weeks post-transplant period. Result(s): Out of 100 patients, 82.0% were male and 18.0% were female. Serum creatinine levels (micromol/L) at 4, 8 and 12 weeks post-transplant were 200 in 6.0%, 5.0% and 6.0% respectively. Graft nephrectomy was done in 3 cases due to vascular complications. Five (5.0%) patients presented with symptoms of COVID-19, among them, 2 cases were confirmed with RT-PCR. There were 6 death cases, and septicaemia was the most common cause of death. The overall mortality rate was 6.0% in our study population but in COVID-19 confirmed cases it was 50.0%. Conclusion(s): During this pandemic, the overall outcome of renal transplantation was excellent and the incidence of symptomatic COVID-19 among transplant recipients was not higher than the incidence observed in general population of Bangladesh. But among the COVID-19 confirmed recipients, mortality rate was significantly higher. Copyright © 2022 Bangladesh Medical Research Council. All rights reserved.
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Coronavirus disease 2019 (COVID-19) is a severe acute respiratory disease with a high prevalence. According to the research and statistical data, in January 2021, there have been 92,262,621 confirmed cases of COVID-19 and more than two million deaths. Infection with the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the main cause of this disease. In addition to the respiratory system, the disease affects the gastrointestinal tract, central-peripheral nervous system, circulatory system, and kidneys. Therefore, any therapeutic action to reduce COVID-19-related symptoms and complications is essential. In this study, we conducted a systematic review of the published literature and preprints on the efficacy of erythropoietin (EPO) and recombinant human EPO as a safe stimulant and tissue protector in the treatment of COVID-19. We also briefly described the structure of coronavirus, its pathogenesis, and the structure of EPO and recombinant human EPO. All relevant articles published in the Science Direct, PubMed, and Google Scholar databases were searched. According to the results, EPO is a cytoprotective cytokine induced by hypoxia. The pleiotropic effects of EPO are associated with its erythrocyte-forming, anti-apoptotic, anti-inflammatory activities. It also exerts protective effects on the heart, lungs, kidneys, arteries, and central and peripheral nervous systems. It has been demonstrated that EPO can increase hemoglobin levels, thereby increasing oxygen delivery to the tissues. Therefore, recombinant human EPO therapy can be used for counteracting the adverse effects of COVID-19 including hypoxic myocarditis, acute renal failure, pulmonary edema, and brain-spinal cord ischemic injury. Overall, the use of EPO and recombinant human EPO therapy increases blood coagulation, tumor growth, thromboembolism, and purification of red blood cells, which must be accompanied by anticoagulants such as heparin.
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Background: Continuous renal replacement therapy (CRRT) has become an important multiple organ support therapy and it is widely used in the intensive care unit (ICU). The aim of this study was to clarify the association between CRT and 28-day mortality in critically ill coronavirus disease 2019 (COVID-19) patients receiving mechanical ventilation. Materials and methods: 112 respiratory decompensated critically ill adult patients with COVID-19 admitted to a COVID-19-designated ICU were included in this retrospective cohort study. Data on demographic information, comorbidities, laboratory findings upon ICU admission, and clinical outcomes were collected. The Kaplan-Meier method and Cox proportional hazard model were applied to determine the potential risk factors associated with 28-day mortality.
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The presentation of kidney damage in Coronavirus disease 2019 (COVlD-19) varies significantly. According to recent studies. the development of acute kidney injury (AKI) in severe cases of COVID-l9 infection significantly worsens the prognosis of these patients. The pathological changes in kidneys might be caused directly by the cytopathic effect mediated by local replication of the severe acute respiratory syndrome coronavirus-Z (SARS-CoV-Z) or indirectly because of systemic immune response or by- percoagulation, so-called immunothrombosis. Other causes. such as hypovolemia and hypoxia. may also contribute to AKI. Acute kidney disease often develops in elderly patients with underlying comorbidities or in critically ill patients with severe respiratory failure. It is known that AKJ is a risk factor for mortality in C OVID-l9 patients.
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Introduction: Remdesivir, has been evaluated in the treatment of SARS-CoV-2 pneumonia in several clinical trials, then it has been used in routine care since the European approval in this indication. Objective: The main objective of the RESPIR'Nantes study was to describe the clinical outcome and safety of patients treated with remdesivir in real life. We chose here to focus on safety outcomes. Methods: To describe the safety, we considered adverse events (AEs), based on those reported to date in the Summary of Product Characteristics and potential post-marketing signals from the inter- national pharmacovigilance database Vigilyze®. AEs were classified according to the System Organ Class (SOC) of the Medical Dic- tionary of Adverse Events terminology. The AEs of SOC "hepatobiliary disorders" and "renal and urinary disorders" being the most reported to date, a detailed analysis was performed Results: A total of 76 patients were included in the study from March 13 to December 31, 2020. The most common AEs were metabolism and nutrition disorders, hepatobiliary disorders, gastrointestinal dis- orders and renal and urinary disorders. Patients with hepatobiliary disorders had mainly include transami- nases increases and 60% had pre-existing hepatobiliary disease that worsened during treatment. The median time to onset or worsening of hepatobiliary disease was one day [1-2]. It led to discontinuation of treatment in one case. Among patients with renal and urinary disor- ders, 50% had increased blood creatinine levels prior therapy initiation. The median time to onset or worsening of renal and urinary disorders was one day [0-16]. It led to discontinuation of treatment in two cases. Conclusion: A potential signal of pharmacovigilance has been identified for liver and renal disorders in Vigilyze® and we have reported the expected remdesivir Aes. However, it is difficult to suspect remdesivir only without considering the pathology itself, but remdesevir appears to have favorable safety profile in patients who require minimal supplemental oxygen.
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The whole world has been frightened because of the rapid rise in the number of cases and deaths due to novel coronavirus (officially referred to as coronavirus disease 2019 [COVID-19]) which was found in late 2019 in Wuhan city, China. Till date, the increased spread of novel coronavirus disease (COVID-19) is even now at an uncontrollable rate, and the amount of confirmed patients and mortality rate are still increasing at an exponential rate. Till October 1, 2020, from 216 different nations, regions, and territories, the World Health Organization received reports of 33,842,282 confirmed cases and 1,010,635 confirmed deaths. This virus causes a variety of symptoms which can range from mild illness to moderate illness. Difficulty in breathing and death occur in severe cases. The common earliest manifestations include fever, cough, fatigue, myalgia, diarrhea, and headaches. The disease is mainly transmitted through respiratory droplets from a person who is infected, via coughing, sneezing, or exhaling. Adding together expertize across various domains to search for new and effective solutions is the need of hour. Very little is known about how coronavirus affects the kidneys. There is no such proof that shows if people with renal diseases are more susceptible than the general public. Studies have been made over complications of coronavirus disease in patients with renal diseases and how to tackle them. This review article summarizes the analysis of the present situation with subject to coronavirus pandemic, its sequel on people with renal disorders, and the seriousness of the disease. Majorly, it gives an outline in management of this critical condition. © 2022 Wolters Kluwer Medknow Publications. All rights reserved.
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Study Objective: There have been concerns that some patients with sepsis-life-threatening organ dysfunction caused by a dysregulated host response to infection-may be overlooked with a quick Sequential Organ Failure Assessment (qSOFA)2 in the emergency department (ED). Despite this, little is known about the risk factors associated with sepsis among patients with qSOFA<2 in the ED.
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TEN/DRESS overlap syndrome can be difficult to diagnose, especially if it is masked by comorbidities in critically ill patients in intensive care units. The existing therapy for the two conditions is also a major challenge for the treating team. A possible alternative, especially for refractory cases, is benralizumab as an IL-5-receptor alpha-chain-specific humanized monoclonal antibody (IgG1k). We are able to show a successful treatment in this case report.
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Introduction. SARS-CoV-2 infection have been reported to have a greater mortality rate in adults receiving dialysis, as compared to general population. Hence, vaccination is very important in this vulnerable population group, in order to achieve an acceptable level of immunity. The aim of this study was to compare the level of anti-SARS-CoV-2 anti-spike protein receptor-binding domain IgG neutralizing antibody before and after vaccination with two doses of SinopharmR vaccine, in patients undergoing hemodialysis. Methods. Ninety patients on maintenance in-center hemodialysis received two doses of SinopharmR COVID-19 vaccine with an interval of about 28 days. Anti-SARS-CoV-2 anti-spike protein receptor-binding domain IgG (Anti-RBD) neutralizing antibody was measured with an ELISA kit. All statistical analyses were performed by SPSS-26 software. Results. The absolute mean (+or- SE) change in antibody titer following full-scheduled vaccination was 8.98 +or- 1.49 micro g/mL. The rate of seroconversion was 31.1% after two doses of vaccine. In addition, the rate of seroconversion was higher in those with a history of COVID-19 than in those without a history of COVID-19. Conclusion. Conclusion. The administration of booster doses, doubling of the dose in each episode of vaccination schedule as well as combination of different vaccine platforms are recommended to increase COVID-19 vaccine efficacy in hemodialysis patients.
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This study aimed to analyze the proliferation characteristics of porcine deltacoronavirus (PDCoV) in suspension cultured porcine kidney cells LLC-PK1, so as to provide Candidate cell for large-scale production of PDCoV inactivated vaccine. LLC-PK1 cells were suspended by gradually decreasing serum method. PDCoV adaptive monoclonal cell lines were screened by limited dilution method. Indirect immunofluorescence method was used to identify the infectivity of PDCoV. The initial cell density, MOI, time of receiving virus collection and TPCK pancreatin concentration were screened to determine the best suspension culture conditions. The suspension cell strain LLC-PK1Sa which can proliferate PDCoV efficiently was screened out;PDCoV can specifically infect LLC-PK1 cells;PDCoV inoculated LLC-PK1Sa cells with a density of 2 x 106 cells.mL-1 according to the MOI of 10-3, When the final concentration of TPCK pancreatin reached 7.5 g.mL-1, the titer of virus solution harvested 48 h after inoculation was the highest. In this study, the efficient proliferation of PDCoV in LLC-PK1Sa suspension cells was realized for the first time, and the suspension culture conditions were preliminarily optimized, which could provide theoretical reference for large-scale production of PDCoV inactivated vaccine.
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Background: Renal mucormycosis (RM) is a rare presentation of invasive mucormycosis with a high mortality rate. There is no single systematic review of the literature that indicates the different clinical aspects of RM. Methods: A systematic search of PubMed/Medline was performed to collect individual case reports of RM in patients of all ages published between 2010 and April 2022. Results: Seventy-one individual cases were detected through PubMed bibliographic database searches, with a final assessment performed on 60 patients with RM. India and Asia had the largest number of reported cases, with 30 (50%) and 42 (70%) reports, respectively. Also, 74 and 26% of the patients with a mean age of 33 years were male and female, respectively. RM showed 44% mortality rate in the analyzed cases. Immunosuppressive agent therapy followed by tissue transplantation (kidney and liver) and diabetes were the most remarkable risk factors in patients. Nevertheless, 22% of the patients were immunocompetent with no apparent underlying condition. COVID-19 positivity was detected in eight adult patients with an 87% mortality rate. The most common signs of infection were fever, flank pain, and oliguria; additionally, isolated RM was reported in 57% of the cases. In 55% of the patients, histopathologic examination alone was sufficient to diagnose RM, whereas molecular methods and culture were used in only 18 and 35% of patients, respectively. Surgery alone, surgery plus anti-infection therapy, and anti-infection therapy alone were used in 12, 60, and 13% of patients, respectively. Furthermore, 15% of the patients died before any treatment. Conclusion: The early diagnosis of RM is necessary. In this regard, the use of molecular-based diagnostic assays can help identify the fungus at the genus and species levels and use an appropriate treatment in the shortest possible amount of time. Because of the increase in antibiotic resistance in recent years, determining microbial susceptibility tests can lead to the better infection management. Additionally, withdrawal of immunosuppressant, appropriate surgical intervention, and antifungal therapy are the main factors associated with a successful outcome in RM.
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A male Munchkin cat was brought to a small animal teaching hospital at Mahanakorn University of Technology. The patient presentation with vomiting, chronic diarrhea, and intermittent fever. From history-taking, the owner previously had a cat that was diagnosed with feline infectious peritonitis (FIP) living in the same house but had isolated in a separate area. Fecal examination revealed bacterial enteritis. Hematology and blood chemistry results shown lymphopenia, hypoalbuminemia, and low serum albumin/globulin ratio (0.3 A: G ratio). Abdominal ultrasound revealed mesenteric lymph node (MLN) enlargement and cholecystitis. Cell cytology from the liver and MLN revealed suppurative inflammation. Reverse transcription PCR (RT-PCR) was negative for the Feline coronavirus (FCoV) in the blood sample. On the 4th day of treatment, the cat developed pleural and peritoneal effusion. Thoracentesis and abdominocentesis were performed and submitted for analysis. The fluid's results were classified as modified transudate, low A: G ratio (0.3), Rivalta's test (positive), and positive for FCoV by using RT-PCR. On the 8th day of treatment, the cat died from systemic hypotension. Viscous straw yellow-colored fluid and pyogranulomatous lesions at the liver, lung, kidney, and MLN were observed from the necropsy. Histopathology's results shown severe suppurative inflammation in all the above organs. FIP was confirmed by detected FCoV antigen in the cytoplasm of macrophages in the kidney and lung tissue by immunohistochemistry staining.
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OBJECTIVE: To systematically describe the outcomes of patients with COVID-19-associated pulmonary aspergillosis (CAPA). METHODS: All of the researches covering the clinical outcomes of CAPA were retrieved from databases such as ScienceDirect, PubMed, CNKI and MEDLINE (OVID) from Dec 31, 2019 to Dec 1, 2021. The literatures were screened out based on inclusion and exclusion criteria by 2 writers, the data were extracted, the quality of the literatures was evaluated, and meta-analysis was performed. RESULTS: Totally 14 cohort studies were included in this study, with 2 056 severe COVID-19 patients involved, including 338 CAPA patients and 1 718 non-CAPA patients. The incidence rate of CAPA was 16.4% among the ICU patients. As compared with the non-CAPA patients, the mortality rate of the CAPA patients was increased by 21% [risk difference (RD)]=0.21, 95% CI:0.15-0.27, (I-2=0%). No heterogeneity or publication bias was detected (t=1.98, P=0.069). Among the patients with underlying diseases, the patients with chronic obstructive pulmonary disease (COPD) were 2.37 times the risk of CAPA as high as the patients of the non-CAPA group (95% CI: 1.15-4.88, P=0.020). The creatinine level of the CAPA patients was higher than that of the non-CAPA patients (33.32 micro mol/L, 95% CI: 6.81-59.83, P=0.014). As compared with the non-CAPA patients, the patients who received renal replacement therapy were 2.33 times the risk of CAPA (95% CI: 1.43-3.80, P=0.001). CONCLUSION: 16.4% of the severe COVID-19 patients have CAPA, the mortality rate is high. COPD, serum creatinine and renal replacement therapy may remarkably increase the risk of CAPA, and it is suggested that a prospective screening of CAPA should be carried out for the severe COVID-19 patients.
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Minmin, a 1-year-old male local cat weighing 4.3 kg has decreased appetite and an enlarged abdominal cavity. Based on physical examination, there was abdominal distension. Routine hematology and blood biochemical examinations were performed which showed chronic inflammation and abnormal liver and kidney function. Radiographic examination and abdominocentesis showed fluid accumulation in the abdominal cavity (ascites) with pale yellow fluid and thickened liquid consistency. The results of the rivalta test showed a positive accumulation of exudate which was characterized by a jellyfish-like formation. The cat was diagnosed with effusive feline infectious peritonitis. The therapies given are diuretic furosemide 5 mg/kg BW (twice a day) intravenously, antibiotic cefotaxime sodium 30 mg/kg BW (twice a day) intravenously, anti-inflammatory dexamethasone 0,5 mg/kg BW (twice a day) subcutaneously, hepato-protector betaine 2.5 mg/kg BW (every two days) subcutaneously, and keto acid 11 mg/kg BW orally (every two days). The results of treatment for one week only provide temporary results in reducing the degree of abdominal distension. The cat died in the sixth month after therapy.