The potential therapeutic effect of metformin in type 2 diabetic patients with severe COVID-19.

OBJECTIVE: Type 2 diabetes mellitus (T2DM) is regarded as a chief risk factor for(coronavirus disease 2019 (COVID-19) owing to dysregulation of the expression of angiotensin-converting enzyme 2 (ACE2) and chronic low-grade inflammatory disorders. Metformin, an insulin-sensitizing agent for managing T2DM, has pleiotropic anti-inflammatory and oxidant potentials, which may lessen the risk of diabetic complications. So, we aimed to reveal the potential role of metformin monotherapy in treating T2DM patients with COVID-19. PATIENTS AND METHODS: In this prospective cohort study, 60 hospitalized T2DM patients with COVID-19 on metformin plus standard anti-COVID-19 treatments compared to 40 hospitalized T2DM patients with COVID-19 on other diabetic pharmacotherapy like insulin and sulfonylurea, were recruited. Inflammatory and oxidative stress biomarkers and radiological and clinical outcomes were assessed at admission time and at the time of discharge. RESULTS: The results of this study illustrated that metformin treatment in T2DM patients with COVID-19 was more effective in reducing inflammatory and oxidative stress biomarkers with significant amelioration of radiological scores and clinical outcomes compared to T2DM patients with COVID-19 on another diabetic pharmacotherapy. CONCLUSIONS: Our findings highlighted that metformin efficiently managed T2DM patients with COVID-19 by reducing inflammatory and oxidative stress with mitigating effects on the radiological scores and clinical outcomes.

Immunotherapy for Alzheimer's Disease: Current Scenario and Future Perspectives.

Alzheimer's disease (AD) is a global health concern owing to its complexity, which often poses a great challenge to the development of therapeutic approaches. No single theory has yet accounted for the various risk factors leading to the pathological and clinical manifestations of dementia-type AD. Therefore, treatment options targeting various molecules involved in the pathogenesis of the disease have been unsuccessful. However, the exploration of various immunotherapeutic avenues revitalizes hope after decades of disappointment. The hallmark of a good immunotherapeutic candidate is not only to remove amyloid plaques but also to slow cognitive decline. In line with this, both active and passive immunotherapy have shown success and limitations. Recent approval of aducanumab for the treatment of AD demonstrates how close passive immunotherapy is to being successful. However, several major bottlenecks still need to be resolved. This review outlines recent successes and challenges in the pursuit of an AD vaccine.

Clinical complications after transvaginal oocyte retrieval: a retrospective analysis.

There are little systematic data reported in the literature on complications observed after transvaginal oocyte retrieval (OR) guided by ultrasound. We report our experience in 542 in vitro fertilisation cycles. The frequency of severe complications in our patients was 0.72%; of these, two cases were bronchospasm during anaesthesia (0.36%) and two were cases of intraperitoneal bleeding (0.36%); minor vaginal bleeding was the most frequent complication (18.08%), which was treated easily. Through this retrospective analysis, it is evident that clinical suspicion is of particular importance in detecting post-OR complications on one hand, but on the other these complications are rare and most are treated conservatively.

An investigation into the effects of social evaluation on cardiovascular and endocrine responses to the CO2 stress test in humans.

The present study examined whether social evaluation could heighten individuals' physiological responses to the CO(2) stress test, and the hypothalamic-pituitary-adrenal (HPA) response in particular. Twenty-five healthy volunteers undertook the CO(2) test under three conditions: (i) standard CO(2) protocol, (ii) standard CO(2) protocol conducted in front of a full-length mirror (mirror) and (iii) standard CO(2) protocol conducted in front of a video camera deemed to be transmitting live images of the procedure to investigators evaluating participant performance (video). Despite counterbalancing for task order, there were significant differences in anger and depression among the conditions. Repeated measures analysis of variances (ANOVAs), controlling for these mood indices, revealed that salivary cortisol, heart rate and systolic blood pressure responses to the CO(2) test were not affected by social evaluation (i.e. mirror or video). Although the data provide no evidence that endocrine and cardiovascular responses to the CO(2) test are affected by social evaluation, the potency of the social evaluation manipulation in this study is in question. Thus, further research is warranted which includes evidence of, or instructions suggesting negative social evaluation.

Intestinal obstruction due to an anomalous congenital band.

We report a case of a 20-year-old male who presented with symptoms and signs of intestinal obstruction. The patient reported no previous history of abdominal surgery or trauma while clinical and radiographic examinations were not diagnostic. An open laparotomy was subsequently performed and the intraoperative findings were consistent with a congenital band extending from the antimesenteric wall of the jejunum to the root of mesentery. The band was ligated and divided with an uneventful postoperative course. Congenital bands are extremely rare. Their exact incidence is still unknown and usually observed in childhood. This case, therefore, represents an unusual surgical problem in an older individual in which the diagnosis was clinically unexpected.

[Prevalence of nosocomial infections in a university hospital: distribution, predisposing factors and diagnostic indices]. / Prévalence des infections nosocomiales dans un hôpital universitaire: distribution, facteurs prédisposants et indices diagnostiques.

Nosocomial infections are a major challenge for modern medicine and contribute to increased resource use in health care systems. The first hospital-wide prevalence survey of nosocomial infections was conducted at the University of Geneva Hospitals in 1994. At the time of the study, 16.9% of admitted patients had nosocomial infections (168/994). Leading infection sites were: urinary tract (30%), respiratory tract (17%), surgical wounds (12%) and bloodstream (9.6%). Rates of infection varied between hospital wards: intensive care (21%), surgery (19%), rehabilitation (18%), internal medicine (13%). However, the distribution of nosocomial infections varied according to surveillance and attribution rules. Optimal detection of nosocomial infections requires ward surveillance, including revision of microbiology, nursing (Kardex) and medical records; the combination of fever above 38 degrees C, prescription of antimicrobial agent(s), and positive microbiological records suggested the diagnosis of nosocomial infections in 95% of situations. Priorities for infection control were derived from these results.

Herpes simplex virus types 1 and 2 and cytomegalovirus in peptic ulcer disease and non-ulcer dyspepsia.

The prevalence and the serum levels of IgG antibody to Herpes simplex virus type 1 or 2 (HSV1, HSV2) and to cytomegalovirus (CMV) were studied by ELISA in patients with active peptic ulcer -- duodenal and gastric -- and non-ulcer dyspepsia. Two hundred and forty-two consecutive patients with endoscopically confirmed active peptide ulcer -- 170 duodenal ulcers, 72 gastric ulcers -- and 95 consecutive patients who fulfilled the criteria for the diagnosis of non-ulcer dyspepsia were included in the study. The patients, aged 17-80 years, were well matched for age and sex. Antibody to cytomegalovirus was found in 83% of duodenal ulcer, 85% of gastric ulcer and 75% of non-ulcer dyspepsia patients; differences were not significant. The prevalence of HSV1 antibody was significantly higher in patients with duodenal ulcer than in those with non-ulcer dyspepsia (p < 0.025); the prevalence of HSV2 antibody was significantly higher in patients with duodenal or gastric ulcer, than in those with non-ulcer dyspepsia (p < 0.05, p < 0.01, respectively); however, antibody levels (mean optical density) to the viruses studied were similar for all groups of patients. These results provide some evidence that HSV might be implicated in the pathogenesis of peptic ulcer disease.

The synergistic effect of drought and light stresses in sorghum and pearl millet.

The effects of drought stress and high irradiance and their combination were studied under laboratory conditions using young plants of a very drought-resistant variety, ICMH 451, of pearl millet (Pennisetum glaucum) and three varieties of sorghum (Sorghum bicolor)-one drought-resistant from India, one drought-tolerant from Texas, and one drought-sensitive variety from France. CO(2) assimilation rates and photosystem II fluorescence in leaves were analyzed in parallel with photosynthetic electron transport, photosystem II fluorescence, and chlorophyll-protein composition in chloroplasts isolated from these leaves. High irradiance slightly increased CO(2) assimilation rates and electron transport activities of irrigated plants but not fluorescence. Drought stress (less than -1 megapascal) decreased CO(2) assimilation rates, fluorescence, and electron transport. Under the combined effects of drought stress and high irradiance, CO(2) assimilation rates and fluorescence were severely inhibited in leaves, as were the photosynthetic electron transport activities and fluorescence in chloroplasts (but not photosystem I activity). The synergistic or distinctive effect of drought and high irradiance is discussed. The experiments with pearl millet and three varieties of sorghum showed that different responses of plants to drought and light stresses can be monitored by plant physiological and biochemical techniques. Some of these techniques may have a potential for selection of stress-resistant varieties using seedlings.

Rapid method for total iron determination in iron ores, sinter and related materials without use of mercury compounds.

A rapid method for determining total iron in iron ores, sinter and related materials without use of mercury compounds is described. Fusion of the sample with sodium peroxide in a zirconium crucible and subsequent treatment with acid yields total decomposition and a solution amenable to direct reduction to ferrous iron with a silver reductor and subsequent titration with dichromate. Results for NBS, BCS and ISO reference standard ores demonstrate the universal applicability of the method both for routine and referee analysis. There is no interference from vanadium and two samples can be analysed in 30 min.