Aggravating Factor Research Articles

Anxiety among undergraduate Nursing students with mandatory curricular internship during the COVID-19 pandemic

Objective: to compare the average anxiety among undergraduate Nursing students during the COVID-19 pandemic. Methods: it was a cross-sectional study conducted with 101 undergraduate Nursing students. Data collection took place through WhatsApp®, by sending a link containing a consent form, a Google Forms® instrument and State-Trait Anxiety Inventory. The analysis was carried out through central tendency, absolute and relative frequency, and analytical tests. Results: trait anxiety and state anxiety presented medium (52.5%) and high (67.3%) levels, respectively, with mean state anxiety (48.1) higher than the mean trait anxiety (42.3) and positive correlation (r=0.479) between the two scales (p<0.000). They were high among students who lived with family members with risk factors for COVID-19 aggravation, underwent social isolation, without confirmatory tests for the disease, and performed an internship in internal medicine. Conclusion: significant percentages of anxiety levels were identified among undergraduate Nursing students in mandatory internship during the COVID-19 pandemic, thus revealing the need for preventive actions for this public. Contributions to practice: based on these findings, proposals to prevent mental health problems in this public can be developed seeking to change the current mental health scenario.

Mediation Effect of Maladaptive Coping between Work-to-Family Conflict and Cardiovascular Health Behaviors.

Work-to-family conflicts (WFC), an aggravating factor of stress, may affect cardiovascular health. However, the link between WFC and cardiovascular health behaviors is not fully defined. This study intends to identify the mediating effect of coping strategy on the relation between WFC with cardiovascular health behaviors, such as smoking, stress management, increased physical activity, and healthy diet habits. The study is a cross-sectional online survey with 358 call center counselors. We adopted a linear regression to confirm the relationship between WFC, coping strategy, and cardiovascular health behavior, which are the main variables of the study. Maladaptive coping partially mediated the relationship between WFC and cardiovascular health behavior. Based on the results, we insist that a support system to reduce WFC is necessary, as well as increasing the availability of resources and policies to reduce WFC in the workplace and find ways to improve maladaptive coping to promote healthy behaviors of call center workers.

The Issue of Using Ordinal Quantities to Estimate the Vulnerability of Seabirds to Wind Farms

The article is a follow-up study to research on analysing methodological approaches to estimate anthropogenic impacts on marine biota. The work examines relevant publications about the vulnerability of seabirds to the effects of offshore wind farms, relying upon the provisions of the measurement theory and the median theorem for ordinal quantities. It has been shown that the final ranking of sensitivity of certain bird species to wind farms, or indices of a risk of collisions with turbine blades and indices of a risk of birds’ displacement by wind farms, can vary at permissible monotonic transformations of the values of initial factors since all of these are estimated on ordinal scales. We conclude such estimates are incorrect. The summation of the two indices (exposure to collisions with turbine blades and to habitat change) of the birds’ species vulnerability in the context of the proposed models is incorrect. It has been demonstrated that the model based on dividing factors into primary and aggravation, when the latter are incorporated into the formula of computation through the exponent of primary factors, is incorrect: when primary factors have maximum values (equal to 1), the effect of aggravation factors is no longer taken into account; with some values of factors in the model, infinite vulnerability values can be obtained. The models are to operate within the entire presented range of initial data, but that is not fulfilled. Thus, none of the analysed models are correct, and an approach is needed, based on the use of metric values. Considering that the bird flight altitude primarily determines the impact of wind farms on birds, the proposals have been formulated to take into account the impact of various factors on the flight altitude.

Severe Gastro-Intestinal Complications of Radiation Therapy in Rectal Cancer: Modeling the Influence of Age Based upon Population Level Data

<h3>Purpose/Objective(s)</h3> Gastro-intestinal (GI) side effects are dose limiting for pelvic & abdominal radiation therapy (RT). Advanced-age is hypothesized to be an aggravating factor in severe radiation toxicity, but this has not been well defined. We sought to quantify the effect of age on grade IV / V gastro-intestinal complications of RT by combining information from two US population-based databases. <h3>Materials/Methods</h3> The absolute number of complications was obtained by querying the National Inpatient Database (NIS) of the Healthcare Cost and Utilization Project, which contains discharge data from a 20% stratified sample of all US non-federal hospitals. Inclusion criteria were inpatient episodes between 2015-18, with listed diagnoses of both ‘Malignant neoplasm of rectum' (ICD-10-CM Code C20), and ‘Gastroenteritis and colitis due to radiation' (ICD-10-CM Code K52.0). A grade IV complication was defined as a hospitalization, alive on discharge; whereas grade V was defined as a hospitalization culminating in death. The relative age-distribution of patients with rectal cancer treated with RT was obtained from the SEER database. Relative toxicity incidence by age group was obtained by normalizing the absolute number of toxic events obtained from NIS with the age-distribution treatment data from SEER. Statistical techniques included best-fit linear regression and multivariate logistic regression. <h3>Results</h3> Within the NIS database there were 31,878 hospitalizations with a listed diagnosis of rectal cancer (median age 63 years), of whom 290 had grade IV (median age 66) and 10 grade V (median age 76.5) radiation gastroenteritis / colitis. There were no grade 4 toxicities under the age of 20, and no grade 5 toxicities under the age of 70. After adjusting for the baseline age distribution of rectal cancer patients receiving radiation derived from SEER data, the relative risk (RR) of grade IV toxicity was 0.44 for subjects aged 20-39, and 0.53 for subjects aged 40-59 and 1.0 for 60-79 (the comparator). The RR for grade V toxicity was zero for <60, 1.0 for 60-79 (the comparator), and 1.26 for subjects aged 80-99. Best-fit linear regression line for grade IV toxicity was defined by [0.0084* age(yrs)* + 0.2], and for grade V toxicity by [0.024* age(yrs)* - 0.87]. On multivariate logistic regression, amongst all those with grade 4-5 radiation gastroenteritis / colitis, age was the only clinical predictor of death (dosimetric factors were not available). <h3>Conclusion</h3> We demonstrate that the risk of acute severe radiation-induced bowel toxicity in rectal cancer patients rises linearly with age. Modelling demonstrates that the gradient is far steeper for grade V toxicity than grade IV toxicity. Importantly, our results facilitate the incorporated of age into existing NTCP models of bowel toxicity. Age-adjusted radiation dose constraints for the bowel should be adopted.

Two-dimensional simulation of the seismic response of the Santiago Basin, Chile

Results from an ambient noise tomography, gravimetric studies, and local geophysical surveys are combined to develop three representative cross-sections of the Santiago Basin, Chile, that include the main geological features and the wave velocities of the materials. One-dimensional (1D) and two-dimensional (2D) seismic responses were simulated for each cross-section, considering input seismic signals polarized in different directions. Amplification factors calculated in the surface of the cross-sections highlight the larger amplitudes and durations of the strong-ground motions in the softer deposits of the Basin due to surface waves generated at the boundaries of the rock outcrops. 2D over 1D aggravation factors for several earthquake ground motion characteristics indicate that 2D effects are negligible in the stiff gravel deposits and that the 1D simulations cannot capture the basin edge effects in the fine-grained soils. Numerical predictions are confirmed using the analyses of earthquake records of the 2015 Mw 8.3 Illapel Earthquake.

FREQUENCY OF MUTATIONS IN ABCB1 AND ABCB11 GENES IN PATIENTS WITH CHRONIC HEPATITIS C (HCV) IN RIO DE JANEIRO

The post-COVID-19 syndrome is characterized by the appearance of symptoms and sequelae up to four weeks after the acute symptoms of COVID-19 and can affect various systems, such as respiratory, hematological and hepatic. Cases of chronic fatigue, thromboembolism events, myalgia and the increase in enzymes associated with liver damage have been reported. It is known that individuals with chronic liver disease, cirrhosis and/or hepatocellular carcinoma are more likely to develop post-COVID-19 syndrome. In addition, mutations in the ABCB1 gene (G2677T, C3435T and C1236T) that encode the drug-export pump (P-glycoprotein) are associated with drug resistance and hepatotoxicity. The T1331C mutation in the ABCB11 gene encodes the bile salt-exporting pump and is associated with cholestasis. Therefore, these mutations may be an aggravating factor for the post-COVID-19 syndrome, especially in hepatocompromised individuals. The aim of this study was to assess the frequencies of mutations in the ABCB1 and ABCB11 genes and to monitor the post-COVID-19 syndrome in patients with liver disease. We analyzed 197 samples from patients with chronic hepatitis C from the Liver Disease Outpatient Clinic of the Gaffrée and Guinle University Hospital. Extraction and mutation analysis by qPCR was performed using TaqMan Assays. In the ABCB1 gene, the most frequent mutation was C3435T (rs1045642) in 13.7% (TT), in this group 40.1% were wild-type (CC) and 46.2% were heterozygous (CT). For the C1236T (rs1128503) the frequency of wild-type (CC) was 45.2%, of heterozygotes (CT) 43.6% and mutants (TT) 11.2%. The lowest frequency of mutations in the ABCB1 gene was G2677T (rs2032582) in 8.6% of patients, 52.8% are wild-type (GG) and 38.6% are heterozygous (GT). As for the T1331C (rs2287622) in the ABCB11 gene, most individuals were heterozygotes ‒ TC (51.8%), followed by wild-type ‒ TT (34.0%) and mutants ‒ CC (14.2%). This is the first study to evaluate the association of cases and severity of post-COVID-19 syndrome with mutations in the ABCB1 and ABCB11. So far, there are only reports in the literature of the association of this mutations with liver damage and resistance to drugs used in the treatment of COVID-19, such as lopinavir and dexamethasone. Therefore, the presence of these mutations could influence the presence of the post-COVID-19 syndrome. We observed a greater presence of heterozygous individuals than the other genotypes in the population studied. It is necessary to investigate its association with cases of post-COVID-19 syndrome in hepatocompromised patients, in order to establish the risks associated with the syndrome in these individuals and to understand the influence of these polymorphisms on the clinical picture and evolution of these individuals. CAPES and FAPERJ.

Statistical calibration of two-dimensional seismic aggravation effects for homogeneous basins

Two-dimensional basin effects often play a relevant role in defining earthquake ground motion at sites with deep morphologies. The quantitative estimation of two-dimensional effects requires a numerical approach which is typically complex and computationally demanding. Due to modelling complexities, basin effects are not routinely accounted for and have not received significant attention in seismic design codes. One-dimensional seismic response can be modeled with greater ease but does not allow their confident investigation. The use of simplified approaches which allow the estimation of two-dimensional effects from one-dimensional analyses is thus warranted. Past studies have defined and investigated aggravation factors, which can be applied as multiplicative coefficients to one-dimensional ground response outputs to account for two-dimensional basin effects. This paper proposes a novel framework for estimating basin effects by assigning aggravation factors for a vast range of symmetric basins overlain by a single-layer, homogeneous soil deposit and for varying basin sizes, dynamic geotechnical properties, and seismic inputs. In the study, aggravation factors are defined with reference to pseudo-acceleration response spectrum (5% of critical damping) and are calibrated statistically using a large set of dimensionless parameters from the outputs of an extensive set of one-dimensional and two-dimensional numerical analyses. The calibration process is described along with notable observations regarding the spatial variability of the magnitude of two-dimensional aggravation along the surface of the deposit. The proposed method is amenable to current design code formats involving tabulated partial factors. In principle, aggravation factors obtained in this study can be applied to 1D response spectra developed either from the provisions of the design codes themselves or from site-specific ground response analyses. A discussion focusing on the validation of the proposed approach using experimental and empirical measurements is provided. An example application attests to the simplicity of use of the method.

The impact of maternal smoking during pregnancy on hemostatic profile of neonates using thromboelastometry (ROTEM). A pilot observational study

IntroductionIn adults, the negative effect of smoking on hemostasis has been well established. Contrarily, data regarding the hemostatic status of neonates exposed to tobacco during pregnancy are limited. This study aimed to investigate the influence of antenatal tobacco exposure on the hemostatic profile of neonates using Thromboelastometry (ROTEM). MethodsThis observational study included 92 healthy full-term neonates born in the maternity department of our hospital over a 5-year period. The neonates were categorized in 2 groups: neonates born to mothers who reported smoking during the entire pregnancy and neonates born to non-smoking mothers. Neonates were matched 1:1 with regards to gestational age, delivery mode, and gender. ROTEM EXTEM assay was performed on the 2nd-3rd day of life and clotting time (CT); clot formation time (CFT); clot amplitude recorded at 10 and 30 min (A10, A30); a angle (ao); maximum clot firmness (MCF, mm); lysis index at 30 and 60 min (LI30, LI60, %); maximum clot elasticity (MCE), were measured. ResultsNeonates with antenatal exposure to tobacco had shorter CT (p < 0.001) and CFT (p = 0.035), higher A10 (p = 0.043), A30 (p = 0.028) and MCE (p = 0.028) compared to those not exposed to tobacco during pregnancy. The multivariable regression analysis adjusted for gestational age, gender, birth weight and delivery mode showed that maternal tobacco use during pregnancy is associated with an accelerated activation of coagulation in neonates expressed by shorter EXTEM CT values (coefficient: −8.68, 95%,CI: −13.51–-3.85, p = 0.001) while no association was found with the remaining ROTEM parameters. DiscussionSmoking during pregnancy results in a hypercoagulable profile of neonates, expressed by shorter ROTEM CT. Antenatal exposure to tobacco appears to be an aggravating factor for the hemostatic status of neonates.

'Powering through': A qualitative descriptive study of nurses working while in pain.

To describe the experience of nurses working while in pain and the potential impact on work performance. Pain is described more broadly and inclusive of musculoskeletal injuries, psychological and emotional pain. Nurse have been recognised as developing pain and injuries; however, the experience of nurses working while in pain and its impact is not well-described. A qualitative descriptive analysis of interviews from an explanatory mixed methods study. Twenty direct care nurses who experienced pain in the past week participated in the semi-structured interviews. Transcripts were analysed using content analysis. Guidelines for reporting following the COREQ checklist. Categories identified: (1) pain provocation, quality of pain, refers, severity, and time (PQRST); (2) Avoiding pain at work; (3) Hiding pain's impact; (4) Tools at Work; (5) Pain recovery at home; (6) Career consequences; and (7) 'Supernurse' culture; (8) Stigma and its impact on pain management; and (9) Dream work environment. Pain was described as part of nursing and impacted nurses' career plans and performance. Nurses described minimising the direct impact on their patient care but admitted that there was an impact on teamwork and thinking which have been linked to negative patient outcomes. Clinical practice was an aggravating factor for all nurses in the study and impacted their performance and career trajectory. Workplace tools to decrease nurse injury and pain exist; however, tools were not used often due to lack of resources and training. The culture of nursing that accepts pain as part of the job needs to be addressed.

Emotional and Environmental Factors Aggravating Dream Enactment Behaviors in Patients with Isolated REM Sleep Behavior Disorder.

ObjectiveTo identify emotional and environmental factors that aggravate dream enactment behaviors (DEBs) in isolated rapid eye movement (REM) sleep behavior disorder (iRBD).MethodsIn this cross-sectional study, a total of 96 polysomnography-confirmed iRBD patients (mean age, 68.5 years; men, 68%) and their caregivers completed questionnaires regarding potential aggravating factors related to DEBs, including emotion/feelings (stress, anger, anxiety, depressive mood, fatigue, pain), food (alcohol, caffeine, overeating in the evening, fasting/hunger), activities and sleep patterns (strenuous exercise, sex before bed, conflict/fighting, sleep deprivation, oversleeping, sleeping away from home, watching TV before bed), weather/environmental factors (cloudy or rainy weather, heat, cold, noise) and medication (skipping medication, taking hypnotics).ResultsThe patients reported that stress (61%) was the most aggravating factor for DEBs, followed by anxiety (56%), anger (51%), fatigue (49%), and watching TV before bed (46%). Similarly, the caregivers reported that these factors were most relevant to the aggravation of DEBs in the patients, although some factors were ranked differently. In the subgroup analyses, aggravating factors for DEBs did not differ by RBD symptom severity. Interestingly, the proportion of patients experiencing DEB aggravation by stress, anxiety and depressive mood was significantly higher in women than in men. Furthermore, depressed patients reported that stress and cloudy or rainy weather made DEBs worse than nondepressed patients.ConclusionOur results suggest that DEBs in iRBD patients may be mainly aggravated by emotional factors. These negative effects appeared to be more prominent in female and depressed patients.

Functional performance of the upper limb and the most common boxing-related injuries in male boxers: a retrospective, observational, comparative study with non-boxing population

BackgroundTo investigate the functional status and recording the most common injuries of the upper limb in male Greek boxing squad in comparison to the general population.MethodsA retrospective injury surveillance study using an electronic questionnaire was performed in 2021. The questionnaire was sent to male members of the Greek Boxing Federation and consisted of three parts. Demographic data, functional status scales, training conditions, hours of training, the location and description of upper limb injuries and whether the injury occurred during competition or training and also whether it was a new or a recurrent one were gathered. The same questionnaire was sent to non-boxer males (military recruits), but without asking them to report any training parameters. Inclusion criteria were age < 35 years-old for all participants and no involvement in martial arts for the control group. Also, all participants (boxers and non-boxers) completed the Patient Rated Wrist Evaluation (PRWE) scale and the Quick Disabilities of Arm, Shoulder and Hand (quick-DASH) score.ResultsThe final study cohort was consisted of 62 elite or amateur boxers and 75 non-boxer males, less than 35 years old. The quick-DASH score was found to be significantly lower (better) in boxers in comparison to the general population (15.65 ± 10.25 vs. 12.55 ± 8.62; p = 0.020) whereas the PRWE score was similar in both groups (9.25 ± 14.96 vs. 8.61 ± 13.05; p = 0.843). Physical therapy sessions, thumb injuries and boxer’s knuckle were also found to be significantly higher in the boxers group. On the other hand, upper limb surgeries were significantly less in the boxers group. Finally, the size of boxing gloves was associated to the number of finger fractures, thumb injuries and ulnar sided wrist pain in boxers.ConclusionsAlthough a controversial sport, boxing appears to have no long-term consequences to the upper limb function, especially regarding hand performance. The size of gloves during heavy bag training was found to be an aggravating factor for hand injuries.

Long-term analysis of the effects of COVID-19 in people with epilepsy: Results from a multicenter on-line survey across the pandemic waves

PurposeThe worldwide pandemic caused by SARS-CoV-2 virus posed many challenges to the scientific and medical communities, including the protection and management of fragile populations. People with epilepsy (PWE) are a heterogenous group of subjects, with different treatment regimens and severity of symptoms. During the National lockdown, in Italy many patients with chronic conditions lost their regular follow-up program. The aim of this study was to investigate the impact of COVID-19 on their health status, from the start of the pandemic (March 2020) to July 2021 and one year later. MethodsWe proposed an online questionnaire to subjects followed up at different epilepsy centers located in Milano, Monza & Lodi, three of Lombardy, Northern Italy, the most affected areas by the pandemic. Survey evaluated age, sex, characteristics of patients, type of epilepsy and therapies, COVID-19 diagnosis, vaccines, sleep quality, and anxiety status. ResultsAmong 178 analyzed surveys, 37 individuals reported symptoms of COVID-19 in closed contacts, including 9 with molecular diagnosis and 16 PWE performing the nasopharyngeal swab with 3 positive cases. One year later, 35 individuals reported at least one symptom overlapping with those typical of COVID-19, 8 received COVID-19 diagnosis, among which 6 were positive for SARS-CoV-2 infection. According to the sleep quality scale assessment, most PWE (52.3%) had poor sleep quality. Assessing anxiety status, 32 (38.1%) had a pathological score. ConclusionIn this multicenter study, we observed that PWE do not appear to be at a higher risk of severe COVID-19. It will be fundamental monitoring this group to assess possible differences in long-COVID-19 and/or neuro-COVID-19 prevalence. On the other hand, our survey confirmed the impact of the pandemic on anxiety and quality of sleep in PWE. Thus, it is important to promptly recognize and treat psychological distress in PWE, because it could be a risk factor in seizure aggravation and quality-of-life deterioration. Telemedicine appears to be a useful tool to support patients with chronic diseases, such as epilepsy.

INFLUÊNCIAS PSICOSSOMÁTICAS DA COVID-19 EM PACIENTES FIBROMIÁLGICOS: UMA REVISÃO

Fibromyalgia (FM) is understood as a psychosomatic disease characterized by widespread pain throughout the body. In the current context, the COVID-19 pandemic has brought new difficulties, including, among its own symptoms, increased pain sensitivity. The objective of this work is to investigate the impacts of this new reality on people with FM. The methodology used was a systematic literature review. As a result, 10 articles were found, with two main thematic groups as an outcome: post-infection aggravating factors and aggravating factors resulting from sanitary measures. From this, we realized that the coronavirus disease both brought aggravating factors in relation to the pain condition of fibromyalgic patients, and became an aggravating factor for comorbidities of the disease, such as depression and anxiety.

The Female Face of COVID-19: Burnout in Working Women and the Quest for Resilience

Gender inequity seems to have worsened during the COVID-19 contingency. Work-life conflict and burnout were preexisting conditions when the pandemic started, but the increment in job demands as well as household and maternal responsibilities resulted in an increase in burnout in working women. The present study was developed to understand how the COVID-19 pandemic impacted burnout among working women. The theoretical background was based on the Job Demand-Control-Support (JDCS) conceptual framework and considered the model of support and resilience in which organizational and family involvement act as moderators. As part of our online survey, the Maslach Burnout Inventory was applied to a universe of 704 working women in Mexico during the pandemic in 2021. Our results revealed an increase in burnout for working women, reflected in the levels of exhaustion, depersonalization, and the self-perception of personal efficacy. As the findings show, the COVID-19 pandemic was an aggravating factor, and the development of resilience as a moderator required organizational and structural support to mediate the effect of burnout. This study provides evidence for the variable of structural support in the conceptual model, introduced to reflect the influence of external aid, which differs from family support, and the results show its relevance.

Characteristics of X-ray pattern of lung lesion in COVID-19 in adult patients with cystic fibrosis

Background. Patients with cystic fibrosis (CF) fall into the risk group of breathing passages infection as a result of clinical features of the disease. During the period of COVID-19 pandemic,the necessity of understanding how infection affects the course of the main disease has appeared, taking into account that viability of patients is essentially determined by the degree of lung lesion. Early diagnostics and complex therapy of coronavirus infection increase the lifespan of CF patients and improve quality of life. X-ray examinations play the leading role in solving this problem.&#x0D; Purpose – to establish risk factors of the main pathological process aggravation by determining diagnostic significance of roentgen sings of lung lesion in COVID-19 in CF adult patients.&#x0D; Materials and methods. Theanalysis of radiography and computed tomography results of 11 adult patients with CF of moderate and severe degree who were also diagnosed with coronavirus infection.&#x0D; Results. The main X-ray symptoms in observed patients with CF with confirmed diagnosis of coronavirus infection was pneumonic infiltration of different degrees in the setting of diffuse changes of lung pattern and features of pulmonary emphysema. Besides symptoms of the main disease, computed tomography allowed us to find the signs, which we consider to be the signs of pneumonia caused by COVID-19 infection – induration of lung tissue in the form of ground-glass opacity, presence of ground-glass areas of different shapes with reticular changes and consolidation of lung tissue, bilateral localization of pathological changes, predominantly in basal and subpleural areas.&#x0D; Conclusions. Lung lesion conditioned by COVID-19 in radiography of CF patients may be disguised by the features of the main disease manifestations. Therefore, any X-ray evidence of inflammatory lung changes in CF patients during the epidemic period must be regarded as COVID-19 suspected, and polymerase chain reaction and computed tomography must be performed.

HbA1c measurement may save COVID-19 inpatients from overlooked diabetes.

ABSTRACTAims/IntroductionTo investigate overlooked diabetes in patients with coronavirus disease 2019 (COVID‐19).Materials and MethodsIn total, 462 COVID‐19 inpatients were included in this retrospective study. The presence of diabetes before COVID‐19 admission, and the HbA1c and blood glucose levels at admission were examined.ResultsOf the 462 patients, 116 had diabetes. Seventy‐six patients had been diagnosed with diabetes before COVID‐19 admission, and 40 patients were diagnosed for the first time. Of the patients with diabetes 72% required insulin. Patients with diabetes were significantly (P < 0.05) older, more likely to be male, heavier, and showed a lower eGFR. Patients with overlooked diabetes showed a lower HbA1c (average 7.1% vs 7.5%), a lower casual blood glucose (average 157 vs 179 mg/dL), and they used less insulin per day during hospitalization (average 16.0 units vs 34.5 units) than patients with previously diagnosed diabetes. Patients with overlooked diabetes tended to have more severe COVID‐19 than those with pre‐diagnosed diabetes. Multivariable logistic regression analyses showed that the increased odds ratios (ORs) of aggravation in all patients with COVID‐19 were associated with age [OR 1.04], BMI [OR 1.05], and diabetes [OR 2.15]. The risk factors for aggravation in patients with COVID‐19 and diabetes were age [OR 1.05] and HbA1c [OR 1.45].ConclusionsDiabetes is a predictor of COVID‐19 aggravation. Furthermore, in COVID‐19 patients with diabetes, high HbA1c levels are a risk factor for severe COVID‐19. A total of 8.7% of COVID‐19 inpatients were diagnosed with diabetes after HbA1c was measured on admission. Therefore, it is important to measure HbA1c in COVID‐19 patients.

A computational study of metal ions interaction with amyloid-β 1–42 peptide structure in hyperpyrexia: Implications for Alzheimer disease

Given the current context of the SARS-CoV-19 pandemic, among the interfering risky factors with the Aβ peptide aggregation in the brains of Alzheimer’s disease (AD) patients can be hyperpyrexia and increased intracranial pressure (ICP). According to our hypothesis on the relationship between hyperpyrexia and cognitive decline in AD, two models of Aβ peptides were used in this study: the structure of AD amyloid beta-peptide and near-atomic resolution fibril structures of the Aβ peptide. Therefore, the binding templates were constructed for Aβ peptide regions able to bind 9 different metal ions. The fragment transformation method was used for the structural comparison between Aβ chains. Molecular dynamics simulation (MDS) was applied using the Nose-Poincare-Anderson equation to generate a theoretically correct NPT (isothermal–isobaric ensemble). The smallest dissimilarities were observed in the case of Cu+ binding potential followed by Co2+, both with similar variation. Structural changes have also occurred as a result of the dynamic simulation. All these changes suggest an aggravating factor in both hyperpyretic and AD conditions. Our findings suggest that elevated temperature and increased intracranial pressure rise the effect of peptide aggregation, by converting α-helix motif to β-sheet and random coil conformation, which are related to the formation of senile plaques in AD brains.

Sleeve Gastrectomy with Pyloroplasty in Wistar Rats: Assessment of Gastric Emptying, Intestinal Transit, and Possible Duodenogastric Alkaline Reflux.

Studies indicate sleeve gastrectomy (SG) as a factor of aggravation or even emergence of symptoms of gastroesophageal reflux disease. Accelerated gastric emptying is described as a mitigating factor. SG may be potentiated by adding a pyloroplasty, although with the potential risk of resulting in duodenogastric alkaline reflux. The objective was to standardize sleeve gastrectomy with pyloroplasty in rats, analyze the complementation in terms of mortality and weight evolution, and conduct assessments on gastric emptying, intestinal transit, and genesis of possible duodenogastric reflux. Ninety-three male Wistar rats were divided into a pilot study (standardization of the surgical technique and the scintigraphic study), and the main study. They were then subdivided into the SHAM group, the sleeve gastrectomy (SG) group, and the sleeve gastrectomy with pyloroplasty (SGP) group. After 3months, the animals were submitted to two scintigraphic experiments and histological analysis of gastric biopsies. The surgical groups (SG and SGP) lost initially more weight than the SHAM group, and the gastric emptying and intestinal transit in the first were more accelerated. However, no difference was found between the SG and SGP groups. Scintigraphic and histological analyses did not reveal statistical differences among the SG and SGP groups regarding gastroesophageal and duodenogastric refluxes. Pyloroplasty did not affect weight reduction or increase duodenogastric reflux, after three postoperative months in this animal model of sleeve gastrectomy.

Fisheries assessment of the Albanian lagoon fisheries

Abstract The present study uses fisher knowledge to outline the basic socio-economic framework of Albanian lagoon fisheries based on on-the-spot interviews conducted with fishers operating in the most important Albanian lagoons. The results indicated that Albanian lagoon fisheries were family-based, with spatial differences observed in vessels from the northern lagoon that were older, larger in size, with more powerful engines, and involved more persons in comparison with corresponding vessels from the southern lagoon. The results also indicated that lagoon fisheries were in decline, ageing fishers, and encountering problems with illegal fishery and invasive species. Most of the fishers were aware that protected areas existed in Albanian waters, whereas severe contradictions among fishers existed about the need to establish new Marine Protected Areas (MPAs). An aggravating factor that threatened the viability of the lagoon fisheries and coastal ecosystems was high incidental catches of the Blue crab, Callinectes sapidus. These issues revealed the increased marginalization of the Albanian lagoon fisheries that might be able to be generalized beyond this case study to other Mediterranean lagoons. The present work also highlighted the need to establish a decent stratified statistical survey to monitor the highly complex nature of lagoon fisheries.

Factors aggravating the course of atrial fibrillation in comorbid hypertension and type 2 diabetes mellitus

Atrial fibrillation (AF) is quite a common problem, and its frequency increases with age. The course of this rhythm disturbance in comorbid conditions of hypertension and diabetes mellitus (DM) may depend on many pathophysiological factors. Therefore, the study on factors of AF development and aggravation in these comorbidities remains relevant. Aim. The work aimed at determining the factors of development and aggravation of AF in patients with hypertension and type 2 DM. Materials and methods. 214 patients with AF, hypertension and type 2 DM were examined. They were distributed into groups: 1) isolated AF – 7.5 %; 2) AF and hypertension – 51.9 %; 3) AF, hypertension and DM – 25.2 %; 4) isolated hypertension – 5.1 %; 5) hypertension and DM – 10.3 %. The paroxysmal form of AF was revealed in 34.3 %, persistent – in 46.4 % and constant – in 19.3 %. Results. It was revealed that persons with taller stature experienced arrhythmia symptoms more frequently (P = 0.01). Sex, Quetelet index, height, duration of hypertension, SBP, glucose, glycated Hb, urea, fibrinogen, triglycerides, interventricular septum and left ventricular posterior wall thickness, LV ejection fraction, concentric type of remodeling influenced the development of next AF episode in conditions of comorbid hypertension and DM. Quetelet index (P = 0.03), duration of AH (P = 0.03), and glycated Hb level (P = 0.002) were the most significant factors for frequent AF recurrences. A history of at least one AF episode increased the risk of developing a subsequent one by 5.56 times (Р = 0.01). An increase in LA was significantly influenced by AF. Hypertension also contributed to cardiac remodeling, namely, its hypertrophy, while the presence of DM only enhanced this effect. The increase in LА over 4.43 cm (P = 0.0001) and RV over 2.59 cm (P = 0.02) significantly increased the risk of АF conversion to the permanent form. Conclusions. A special attention should be paid to such parameters as Quetelet index, duration of AH, elevated BP, daily SBP variability, glycated Hb level and fasting glycemia, echocardiography indexes (EF, size of LA and RV) to prevent the occurrence of AF and its chronicity in patients with hypertension and DM.