The 3'UTR region of the DNA repair gene PARP-1 May increase the severity of COVID-19 by altering the binding of antiviral miRNAs.

COVID-19 may cause the release of systemic inflammatory cytokines resulting in severe inflammation. PARP-1 has been identified as a nuclear enzyme that is activated by DNA strand breaks. It has been suggested that PARP-1 has a role in the cytokine storm shown as a cause of mortality in COVID-19, and its inhibition may adversely affect the replication of SARS -CoV-2. We aimed to investigate the relationship between PARP-1 gene polymorphisms and the clinical severity of COVID-19. rs8679 TT genotype was found to increase with the COVID-19 disease severity. The 3'UTR polymorphism rs8679 may cause PARP-1 activity as a result of viral replication increase by changing the binding site of antiviral or anti-inflammatory miRNAs. PARP-1 may affect the severity of COVID-19 by cytokine release and maybe a possible treatment target.

Healthcare providers' compliance with guidelines for catheter-associated urinary tract infections in a rural teaching and referral hospital / Cumplimiento de las pautas para las infecciones del tracto urinario asociadas con el catéter por parte de los proveedores de atención médica en un hospital rural docente y de referencia

Introduction: Healthcare professionals (HCPs) play a key role in the prevention of catheter-associated urinary tract infections (CAUTI). This study aims to determine the compliance of healthcare personnel with urethral catheterisation standards and the factors affecting it. Materials and Methods: This study is a prospective survey and was conducted between February and March 2021 after ethical approval and patient consent. An internet-based, structured 39-item questionnaire was sent via email to all HCPs at Zonguldak Bulent Ecevit University Hospital, Zonguldak, Turkey. A to evaluate their knowledge and attitudes towards the prevention of CAUTI. The questionnaire was completed by 156 health professionals. For categorical parameters Fisher’s exact test, though for scale parameters student t-test, Mann–Whitney U and Kruskal–Wallis tests were used. All statistical analysis was done using SPSS 17.0. Results: The average years of experience of the HCPs who participated in the survey was 12.5 years. The level of knowledge of the doctors and the nurses about the indication of catheter insertion was similar, whereas the level of knowledge about CAUTI prevention was higher among the doctors. However, none of the participants could fully describe how to prevent CAUTI. Conclusions: The level of knowledge of CAUTI preventive measures among the participants was insufficient. To effectively preventing CAUTI, there is a need to change HCPs’ perspective on this issue, which can be achieved through training, and advantage current technologies. (AU)

Introducción: Los profesionales de la salud (PS) juegan un papel clave en la prevención de infecciones del tracto urinario asociadas al catéter (ITUAC). Este estudio tiene como objetivo determinar el cumplimiento de las normas de sondaje uretral por parte del personal sanitario y los factores que lo afectan. Materiales y métodos: Este estudio es una encuesta prospectiva y se realizó entre febrero y marzo de 2021 después de la aprobación ética y el consentimiento del paciente. Se envió un cuestionario estructurado de 39 ítems basado en Internet por correo electrónico a todos los HCP en el Hospital Universitario Zonguldak Bulent Ecevit, Zonguldak, Turquía. A para evaluar sus conocimientos y actitudes hacia la prevención de la ITUAC. El cuestionario fue completado por 156 profesionales de la salud. Para los parámetros categóricos se utilizó la prueba exacta de Fisher, aunque para los parámetros de escala se utilizaron la prueba t de Student, la U de Mann-Whitney y la de Kruskal-Wallis. Todos los análisis estadísticos se realizaron con SPSS 17.0. Resultados: El promedio de años de experiencia de los profesionales de la salud que participaron en la encuesta fue de 12,5 años. El nivel de conocimiento de los médicos y las enfermeras sobre la indicación de la inserción del catéter fue similar, mientras que el nivel de conocimiento sobre la prevención de las ITUAC fue mayor entre los médicos. Sin embargo, ninguno de los participantes pudo describir completamente cómo prevenir ITUAC. Conclusiones: El nivel de conocimiento de las medidas preventivas de ITUAC entre los participantes fue insuficiente. Para prevenir CAUTI de manera efectiva, es necesario cambiar la perspectiva de los profesionales de la salud sobre este tema, lo que se puede lograr a través de la capacitación y aprovechar las tecnologías actuales. (AU)

Pulmonary Embolism Severity Index Predicts Adverse Events in Hospitalized COVID-19 Patients: A Retrospective Observational Study.

OBJECTIVES: Pulmonary embolism is one of the leading causes of death in patients with COVID-19. Autopsy findings showed that the incidence of thromboembolic events was higher than clinically suspected. In this study, the authors investigated the relationship between pulmonary embolism severity index (PESI) and simplified PESI (sPESI) on admission to the hospital, as well as adverse events in hospitalized COVID-19 patients without clinically documented venous and/or pulmonary embolism. The adverse events investigated were the development of acute respiratory distress syndrome, the need for intensive care unit admission, invasive or noninvasive mechanical ventilation, and in-hospital mortality. DESIGN: A retrospective and observational study. SETTING: Two large-volume tertiary hospitals in the same city. PARTICIPANTS: A total of 720 hospitalized COVID-19 patients with a positive polymerase chain reaction were evaluated. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Of the study population, 48.6% (350) were women, and the median age was 66 years (19-96). The overall in-hospital mortality rate was 20.5%. In the multivariate logistic regression analysis, a significant relationship was found between the whole adverse events considered and PESI, as well as sPESI (p < 0.001). According to the results, sPESI ≥2 predicts in-hospital mortality with a sensitivity of 61.4% and specificity of 83.3% (area under the curve = 0.817, 95% confidence interval 0.787-0.845, p < 0.001). Similarly, PESI classes IV and V also were found as independent risk factors for in-hospital mortality (for PESI class IV, odds ratio = 2.81, p < 0.017; for PESI class V, odds ratio = 3.94, p < 0.001). CONCLUSIONS: PESI and sPESI scoring systems were both found to be associated with adverse events, and they can be used to predict in-hospital mortality in hospitalized COVID-19 patients without documented venous and/or pulmonary embolism.

Treatment of Candida sternal infection following cardiac surgery - a review of literature.

BACKGROUND: Candida sternal wound infections (SWIs) following cardiac surgery are rare but are associated with a high mortality rate. Guidelines on this topic either propose no suggestions for management or offer recommendations based on a small number of reports. METHODS: This paper presents a case of a Candida SWI and its successful treatment with debridement using a burr, negative pressure vacuum therapy (NPVT) and dermal grafting. To investigate different methods of treating Candida SWIs following cardiac surgery, a review was completed using the MEDLINE database. Reports without English abstracts and without defined outcomes of therapy for individual patients were excluded. RESULTS: Seventy-seven cases of Candida SWIs following cardiac surgery were identified in 20 articles published since 1999, including our case. Treatment strategies are identified: omentum flap; muscle flap; debridement and secondary wound healing with or without NPVT; debridement and primary closure; incision and drainage; only medical therapy. Patients documented in the articles were classified based on the following outcomes: cured (n = 41 patients [including the present case]), relapse infection (n = 25 patients) and death (n = 11 patients). The various methods used to treat patients were analysed. CONCLUSIONS: Delayed closure reoperation with surgical debridement and NPVT have favourable outcomes. In the presence of widespread osteomyelitis, the use of omental flaps is advocated. Treatment with muscle flaps has a high rate of relapse. Debridement and secondary healing or conservative management with antifungals alone can be considered in the treatment of relapsing infection.