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Later, neutrophile, platelet, and lymphocyte counts were obtained through the medical database. We categorized the error reports on the basis of the vaccine error type described by the Centres for Disease Control and Prevention CDC. The International Society of Pharmacovigilance ISoP aims to develop its activities on a worldwide basis towards supporting safer use of medicines in clinical practice.❿
Suplement 3 – Annals of Clinical and Analytical Medicine. Windows 10 1703 download iso italy covid symptoms – windows 10 1703 download iso italy covid symptom
COVID TANISI ALAN ÇOCUKLARIN B LENFOSİT HÜCRELERİNİN VE ALT GRUPLARININ AKIŞ SİTOMETRİK 10 minutes and analyzed for routine biochemistry tests. Patients with coronavirus disease (COVID) may have symptoms of anosmia or partial loss of the sense of smell, often accompanied by. The COVID pandemic has created not only major economic and social The Italian recommendations revolve around the norms ISO – The coronavirus disease (Covid) causes fever, cough, sore throat, and in severe cases shortness of breath and death. trol of the disease in many countries, including Italy and. Portugal,11 In a recent large survey including almost patients with COPD selected by the.
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The coronal postcontrast fat-suppressed T1WI in 3 patients with COVID A—C ; cases 2—4 shows that both olfactory bulbs long arrows are small oval images that are hyperintense with contrast, having signal intensity higher than the intensity of the cortex. D , A patient case 5 with COVID shows hyperintensity only on the left bulb long arrow , the right olfactory bulb being normal short arrow.
In a healthy year-old man, the coronal T2WI E and the postcontrast fat-suppressed T1WI F demonstrate normal olfactory bulbs long arrows , which are isointense to the cortex and normally hypointense on postgadolinium sequence F. This finding was suggestive of a small area of methemoglobin in the left olfactory bulb in this patient with anosmia.
In the 4 patients who did not have a pregadolinium sequence, we did not have information about anosmia in 1 patient Fig 2 A ; case 2 , and 2 of them with anosmia Fig 2 B , – C ; Cases 3 and 4 showed hyperintensity suggestive of enhancement of both olfactory bulbs following gadolinium injection.
However, only in the patient with COVID without clinical anosmia case 5 was there a suggestive enhancement in the left olfactory bulb Fig 2 D. The differential diagnosis in these cases is mainly microbleeding methemoglobin because the pregadolinium sequence was not performed. Coronal STIR of the anterior cranial fossa did not show any abnormality in the olfactory bulbs in these 4 patients.
MR imaging of a healthy individual was used as a comparative control Fig 2 E , – F to demonstrate that the normal olfactory bulbs do not enhance and are isointense to the cerebral cortex. This case series demonstrates abnormal intensity of the olfactory bulbs in 5 adult patients with COVID, three of whom had anosmia.
In 1 patient case 1 , the abnormal intensity could represent microbleeding methemoglobin. However, in the other 4 patients, it could represent abnormal enhancement or microbleeding methemoglobin because they only underwent the sequence after injection of gadolinium in fat-suppressed T1WI. Previously, it was demonstrated, using an experimental mouse model, that the SARS-CoV could travel from the nose to the olfactory bulb. The literature has already reported that some other viruses can use the olfactory nerve as a shortcut into the CNS, such as influenza A virus, herpesviruses, poliovirus, paramyxoviruses, vesicular stomatitis virus, rabies virus, parainfluenza virus, adenoviruses, Japanese encephalitis virus, West Nile virus, chikungunya virus, La Crosse virus, mouse hepatitis virus, and bunya viruses.
Clinical consequences range from nervous dysfunction in the absence of histopathological changes to severe meningoencephalitis and neurodegenerative disease. Probably, the impairment of olfactory function is much more frequent in COVID because, strictly speaking, unilateral anosmia can only be detected through a detailed physical examination.
The patient hardly perceives unilateral anosmia. This feature will be more important in cases of refractory headache associated or not with other symptoms and signs such as fever and anosmia.
The weakness of this work is that it is a retrospective study with only a few cases in which it was possible to evaluate the olfactory bulbs.
Brain MR imaging of patients with COVID has not been routinely scheduled to adequately evaluate the olfactory bulbs because other neurologic complications were being investigated. The distortion at the air-tissue interface in fat-suppressed T1WI makes the findings somewhat difficult to interpret, but it seems that the images are true abnormal lesions along the olfactory bulbs. Future prospective studies geared to evaluating the olfactory bulbs with a larger sample size will be needed to confirm our findings.
This seems to be the first time that a neuroimaging study has documented this type of olfactory bulb injury in patients with COVID Cartaxo Filho , c T. Fonseca , c and M. Find articles by M.
Find articles by O. Cartaxo Filho. Find articles by T. Author information Article notes Copyright and License information Disclaimer. Corresponding author. Received May 20; Accepted Jun 1. Indicates open access to non-subscribers at www.
Open in a separate window. FIG 1. FIG 2. References 1. SARS-CoV-2 receptor and entry genes are expressed by sustentacular cells in the human olfactory neuroepithelium. AIT is a treatment modality that continues at gradually increasing doses, for a long period of time, modifies T-cell-mediated immune responses and provides an improvement in symptoms and clinical course []. Patients receiving SCIT should be administered immunotherapy at regular intervals and the COVID pandemic adversely affects access to treatment for this patient group that needs to be treatedt at week intervals.
Such a case may also adversely influence adherence to treatment in patients receiving SCIT []. Files of the patients who admitted to the allergy outpatient clinic between June and March 1, and were administered SCIT regularly with diagnoses of AR, SAR, asthma, and venom allergy that were established in accordance with clinical history, skin prick tests, allergen-specific IgE results and international guidelines [14, 15] were retrospectively reviewed.
Adult patients over the age of 18 were included in the study. Patients who did not regularly attend SCIT treatment between June and March 1, , whose treatment was terminated due to SCIT for a sufficient time, and whose files did not have sufficient data, were excluded from the study.
In addition, patients who were diagnosed with allergic diseases in our center and continued their SCIT follow-up in other centers were excluded from the study. Age, gender, education level, history of comorbid diseases, presence of individual atopy, type of IT received and frequency of administration of patients included in the study were obtained from their files.
At first outpatient clinic visits during the so-called period of normalization process June, July-August , the patients were asked to fill out a mini questionnaire developed by us about the March-April-May period, when the first SARS-CoV-2 case in Turkey was identified and some restrictions were imposed due to risk of transmission.
Patients who had been administered AIT regularly before the pandemic but did not come for outpatient clinic visits during this period were asked to fill out a mini questionnaire by phone calls.
The patients who did not come to at least one outpatient clinic visit during March-April-May were considered not adherent to treatment. This mini questionnaire asked whether they admitted to the hospital for AIT during March-April-May , and, if they came late or did not come, the reasons were investigated. Government-related reasons curfew, intercity travel restriction, failure to get an outpatient clinic appointment, disability and pregnancy status etc.
Each patient was asked to fill the validated coronavirus anxiety questionnaire [16]. Additionally, the patients were investigated about whether they experienced an increase in allergic complaints and, if present, the types of complaints, the need for additional anti-allergic medication, admission to the emergency department, additional drug supplement in addition to on-going treatments and use of food or herbal supplements. Descriptive data were presented as frequencies and percentages and compared using the Chi- square test.
In addition, the ethics committee approval was obtained from Karatay University Ethics Committee with a decision dated Informed consent was obtained from the participants of the study. A total of patients receiving SCIT in our clinic were included in the study. The median age of the patients was 31 years and The mean duration of allergic diseases was 5 years and the duration of immunotherapy was 20 months.
When adherence to treatment of the patients was evaluated, overall adherence to treatment during a 3-month period from March to April-May was determined to be On a monthly basis, adherence to treatment was observed to be lowest in April in ascending order, During the pandemic, The most commonly used additional treatment was oral antihistamines The treatment switch was performed in 60 patients In 28 patients When the patients adherent and non-adherent to SCIT treatment were compared, no significant difference was determined between both groups in regard to age, gender, education level, duration of allergic diseases, type of immunotherapy administered, presence of an additional comorbid disease and admission to emergency department p: 0.
However, the duration of immunotherapy, increased allergic symptoms, the need for an additional treatment and treatment switching in SCIT because of the pandemic were significantly higher in non-adherent to SCIT treatment patients compared to adherent ones p: 0. There was a statistically significant difference between the patients adherent and non-adherent to SCIT in regard to their responses in the anxiety questionnaire Table In our study, the COVID pandemic was determined to hinder the treatment process in patients receiving allergen immunotherapy, leading to an increase in allergic complaints and, hence, to the need for additional treatment and treatment switch in AIT.
In addition, it was shown that it may lead to the impaired mental and psychological status of the patients. AIT is a treatment method, which has been used for a long period of time, providing symptomatic and clinical improvement by modifying Th2-induced immune responses against bee venom and aeroallergens [14]. It requires physician visits at long-term and regular intervals For allergy clinics, the guidelines offer several recommendations for patient follow-up and procedures to be performed.
These recommendations include suspension of the vaccines in the build-up phase of AIT and prolongation of intervals between the shots in the maintenance phase []. Other recommendations include examining patients at regular intervals in the clinic, procurement of social distancing, injecting one patient at once and ventilating the room for immunotherapy for a certain period of time after each patient [6, , 17].
In our current study, the overall adherence to treatment of patients receiving AIT was determined to be reduced by half Ojetti et al. In our current study, the duration of immunotherapy was higher in patients adherent to AIT, compared to the patients nonadherent to AIT. This may be due to the fact that some patients who are aware of the need for at least 3 years of immunotherapy may consider the received immunotherapy sufficient, leading to hindering of the treatment.
In a study from Spain, 6. An increase in the number of allergic complaints and, hence, the need for additional treatment in patients nonadherent to AIT may be related to nonadherence to AIT, as well as to pollen dispersal that increases during March-April-May when the study was interested in.
The idea that steroids may increase the risk of SARS-CoV-2 transmission during the pandemic has led to a reduction in the use of intranasal steroids, although there are opposite recommendations, and this reduction, in turn, may have caused an increase in complaints of rhinitis [23]. Some restrictions like curfews may have led to an increase in complaints of rhinitis by causing the patients to spend more time at home and be exposed to domestic allergens for a longer period of time.
AIT is a treatment method that is administered at regular intervals with particular standard doses. When the treatment is suspended, the dose of AIT should be readjusted. Therefore, in our current study, it is unsurprising that patients nonadherent to AIT had a higher rate of treatment termination and switching. Martinez-Lourido et al. Ozturk et al. Access to AIT, the applicability, and maintenance of the immunotherapy should be a priority during this period.
Considering both patient- related and government-related factors in the administration of AIT, the process of AIT should be continued, minimizing the risk of SARS-CoV-2 transmission in accordance with the recommendations by the guidelines and science councils. J Zhejiang Univ Sci B. Physiol Genomics. Asthma Allergy Immunol. Curr Opin Allergy Clin Immunol. J Investig Allergol Clin Immunol.
Allergy Asthma Immunol Res. Pediatr Allergy Immunol. Allergen immunotherapy for allergic asthma: A systematic review and meta-analysis. Int Arch Allergy Immunol. N Engl J Med. Medicina Kaunas. Allergol Select.
Effect of COVID pandemic on the treatment process and adherence to treatment of the patients receiving allergen-specific immunotherapy. E-mail: serefdokcu hotmail. Aim: Many studies nowadays increasingly enlighten the nature of relationship between cancer and inflammation. NLR and PLR are proinflammatory indicators that are related to many clinicopathological characteristics of many types of cancer.
In this study, we aimed to find out the relationship between NLR and PLR values and tumor characteristics in patients with breast cancer that are operated with help of basic and inexpensive peripheral blood test results. Material and Methods: A database of 94 female patients who were operated in the Department of Surgical Oncology of the Medical School of Ankara Uni- versity was studied.
All blood sample tests, pathology reports, immunohistochemical staining results of the patients were retrospectively scanned. Patient demographics and pathological properties of tumor obtained from the database. Later data were analyzed. It has been seen that this differentiation is between T1 and T2; T1 and T3 statistically.
Discussion: The NLR value is significantly related to the tumor size. But further research is needed to see the clinical reflection and added value to the clinical practice of these results. Nowadays, breast cancer is the most common cancer among women and the second most common reason for cancer- associated women deaths [1]. Therefore, some diagnostic biomarkers such as free-floating tumor cells in serum, DNA, miRNA, lncRNA, and exosome have been developed to screen and detect cancer in the early stages.
However, their clinical use is still limited because of the uncertainty and high cost of these biomarkers [4]. Lately, PLR and NLR parameters, which are determined from peripheral venous blood tests, are closely related to poor prognosis, relapse, and mortality in solid tumors as prognostic indicators [5,2].
Even if their numbers are limited, similar studies have been carried out comparatively on breast cancer subtypes [6], in elderly patient groups [7] and in healthy control groups, and similar results were obtained [7]. It is now accepted that cancer dependent chronic inflammatory process is closely related to cancer development course.
It is increasingly accepted that as components of the systemic inflammatory response, lymphocytes, neutrophils, and platelets have an essential role in carcinogenesis and tumor progression [9, 10]. Many authors recommend inflammation- based scoring systems. However, clinical applications are not at a level that can be used in routine practice, and there is no consensus on optimal limit levels.
The Glasgow prognostic score is an inflammation-based prognostic scoring like NLR and PLR obtained from peripheral blood-based inflammatory components [5,6]. Neutrophils are known to support the potential of circulating tumor cells to metastasize to distant organs by secreting circulating growth factors such as vascular endothelial growth factor VEGF and proteases [11]. Studies have shown that cytokines and chemokines produced by inflammatory cells and tumor cells can contribute to metastasis development [12 ].
Lymphocytes that infiltrate the tumor are related to a better response to cytotoxic treatment and a better prognosis in patients with breast cancer [14]. Lymphocytes usually increase apoptosis through the cytokine microenvironment that they provide. They symbolize the immune response in the fight against cancer [15]. It is found that neutrophile-lymphocyte ratio NLR is an independent factor for negative outcomes in many solid tumors, including breast cancer.
These tests can be obtained easily in all routine clinics, and they do not require additional costs. As these parameters obtained from peripheral blood tests are cheap and easily accessible, their predictive value is important for clinicians. Studies like this, which are carried on with breast cancer patients, will help the clinicians diagnose, treat, and predict overall survival.
In this study, we aimed to show the relationship between the NLR and PLR values obtained from the peripheral blood test results at the diagnosis and the characteristics of the tumor, and the clinical reflections of this relationship. In this study, the database of 94 patients with breast cancer who were operated at the Surgical Oncology Clinic was examined retrospectively.
Included data were obtained from preoperative routine blood tests, postoperative follow-up, and pathology reports. In this study, newly diagnosed primary or metastatic breast cancer cases that did not use any medication that can affect hematological parameters were included. Therefore patients who are using steroids have hematological diseases, they have previously been diagnosed with malignancies, had acute or chronic inflammation signs before the operation, have recently received a blood transfusion, and were diagnosed with autoimmune disease.
Patients with missing data in the database were also excluded. Clinical characteristics including age, menopause status, diagnosis, TNM stage, pathological type, receptors estrogen, progesterone, HER2 were gathered. Recent preoperative neutrophile, platelet, and lymphocyte counts were obtained from medical blood test records.
The absolute neutrophile number was divided by the total lymphocyte number to calculate the NLR, and the final platelet number was divided by the whole lymphocyte number to calculate the PLR.
When patients were admitted to the hospital, peripheral blood tests were done to prepare for surgery. Later, neutrophile, platelet, and lymphocyte counts were obtained through the medical database. Pathology reports and immunohistochemical staining results were analyzed to obtain tumor size, lymph nodes, estrogen, progesterone, HER2 receptors, and Ki percentages. All patients involved in this study were female. Demographic and clinicopathological features of the patients are shown in Table Written informed consent was obtained from all participants.
Parametric test assumptions were examined before performing the difference analysis. Normality was checked with the Shapiro-Wilk test skewness and kurtosis. If the assumptions were satisfied, the difference analysis was performed using one-way analysis of variance ANOVA ; otherwise,, the Kruskal-Wallis test was used.
Paired comparisons were made using the Mann-Whitney U test. A P -value of less than 0,05 is considered statistically significant. As a result, it is seen that the NLR value increases significantly as the tumor size increases.
Our study showed that the NLR value statistically differs according to tumor diameter T stage. This differentiation was evident, especially in between T1 and T2; T1 and T3 tumor sizes. This finding was invalid for PLR values. Likewise, no significant findings were obtained when comparing PLR and NLR values with the clinical pathology of the tumor and the demographic characteristics of the patients.
Inflammation and cancer; platelets play an essential role in tumor growth by increasing angiogenesis through VEGF vascular endothelial growth factor in cancer progression [17]. There is a direct relationship between platelet count and VEGF levels. While angiogenesis may contribute to metastasis through thrombocytosis, some studies have found that most VEGF levels are due to neutrophils.
Neutrophils may also support tumor growth and metastasis by releasing reactive oxygen radicals ROS , nitric oxide NO , and arginase [18]. In contrast, lymphocytes represent the host immune response against malignancy by inducing cancer cell death and inhibiting tumor cell proliferation and migration [2,11]. A positive relationship was found between tumor diameter and NLR value in our study. Besides, NRL is an indicator of impaired cell- mediated immunity associated with systemic inflammation [12].
This shows that the cytokine microenvironment provided by neutrophils contributes to tumor growth. Consequently, the numerators of NLR and PLR values, neutrophile, and platelet counts are considered negative outcome determinants, and their denominator, lymphocyte count, is considered a positive predictor of outcome.
Koh et al. This outcome is coherent with the outcomes of the study by Azab et al. This finding is consistent with the findings of Azab et al. Azab et al. The study was evaluating the prognostic significance of the NLR value in breast cancer patients.
Patients with high NLR values were older. They also had more lymph node involvement and metastasis rates [19]. However, they could not define a significant correlation with relapse. Dirican et al. The study correlated the NLR value with disease-free survival and overall survival at 6-year follow-up in approximately patients using a cut-off value of 4 for NLR [20].
On the other hand, Yersal et al. But they found that PLR values in patients with lymph node metastasis were higher than in others [21]. Breast cancer is divided into subgroups according to receptor types. Yersal et al. Yao et al. Liu et al. In summary, these results show that inflammation components are important triggers of tumor growth.
The most significant limitation of our study is that it is observational and single-centered, and the comparison of clinicopathological features of the tumor requires a more extensive patient series.
Before considering the clinical application of PLR and NLR values as cancer markers, further prospective research is needed. It must evaluate particular cut-off values and required optimal cut-off levels. NLR value has the potential of becoming an accurate prognostic indicator. Mechanisms underlying the high NLR value and response to anticancer treatment in breast cancer need further investigation. Clearer findings on NLR and its association with breast cancer prognosis will facilitate selecting patients who are more likely to benefit from medical and specific surgical approaches [24].
Breast cancer statistics, CA Cancer J Clin. Effectiveness of four inflammatory markers in predicting prognosis in women with breast cancer. Decoding the usefulness of non- coding RNAs as breast cancer markers.
J Transl Med. Gene profiling and circulating tumor cells as biomarker to prognostic of patients with locoregional breast cancer. Tumor Biol.
Utility of pre-treatment neutrophil-lymphocyte ratio and platelet-lymphocyte ratio as prognostic factors in breast cancer. Br J Cancer. Usefulness of neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio in hormone- receptor-negative breast cancer. Onco Targets Ther. Clin Transl Oncol. Utility of peripheral blood parameters in predicting breast cancer risk.
Asian Pacific J Cancer Prev. Platelet-lymphocyte ratio acts as an indicator of poor prognosis in patients with breast cancer. Increased neutrophil-lymphocyte ratio is a poor prognostic factor in patients with primary operable and inoperable pancreatic cancer. Balkwill FR, Mantovani A. Cancer-related inflammation: Common themes and therapeutic opportunities.
Semin Cancer Biol. McMillan DC. Systemic inflammation, nutritional status and survival in patients with cancer. Prognostic role of platelet to lymphocyte ratio in solid tumors: A systematic review and meta-analysis. Cancer Epidemiol Biomarkers Prev. Tumor- associated lymphocytes as an independent predictor of response to neoadjuvant chemotherapy in breast cancer. J Clin Oncol.
Med Oncol. The platelet contribution to cancer progression. J Thromb Haemost. Avraham H BN. Modulation of megakaryocytopoiesis by human basic fibroblast growth factor. J BUON. Do the derived neutrophil to lymphocyte ratio and the neutrophil to lymphocyte ratio predict prognosis in breast cancer?
Int J Clin Oncol. Prognostic value of preoperative inflammatory markers in Chinese patients with breast cancer. A derived neutrophil to lymphocyte ratio predicts survival in patients with cancer. The neutrophil-to-lymphocyte ratio: A narrative review.
The relationship between the neutrophil-lymphocyte ratio and platelet-lymphocyte ratio and tumor characteristics in patients with breast cancer. B Dakhla Agadir, Morocco. E-mail: abderrahmane. The objective of this work is to study the prevalence and clinical features of constipation symptoms. Material and Methods: A cross-sectional descriptive study was conducted on a selected cohort of patients, previously diagnosed with PD.
Clinically, most patients suffer from the motoric disorder, including bradykinesia, rest tremor, rigidity, and postural and gait impairment. However, a number of patients also suffer from non-motor disorders, including olfactory, cognitive impairment dysfunction, anxiety, depression, sleep disorders, autonomic disturbances, pain, fatigue, and dementia [3, 4].
They are associated with neuropathological lesions commencing in the dorsal vagus nucleus, in the bulb and in the anterior olfactive nucleus, and will progressively propagate in the overlying structures [6, 7]. Early screening for such symptoms may constitute an important approach for early pre-clinical diagnosis. Patients were recruited from both private and public neurology centers in the city of Agadir in South-western Morocco.
All the selected patients gave their written consent, according to the recommendation of the Ethics Committees of the Faculty of Medicine and Pharmacy of Marrakech. The data were collected between January and July using a detailed clinical questionnaire filled up by the clinicians through an interview with the patients.
Independent sample t-tests, non-parametric test and Variance test were used. Variations in the distribution of categorical data were evaluated using the Chi-square test or Fisher exact test. A p-value below 0. The mean age of the patients included in the cohort was estimated to be around The results showed that the age at the onset of the disease, in the sample ranged between 35 and 80 years old.
The mean age at the onset of symptoms for male and female population was Among the participants in the current clinical investigation, To compare the characteristics of patients with constipation, PD patients were divided into two groups: constipated group constipation group and non-constipated group non-constipation group. The maincharacteristicsofthecohortinrelationtoconstipation are presented in Table 1. There was no significant difference in Body Mass Index, and gender between the two groups.
The age of PD patients in the constipation group The duration of the illness in the PD group with constipation 8. This result showed that the initial symptom differed from that of the non-constipation group.
There was a correlation between the constipation group and the severity of motor symptoms of PD. Indeed, the comparison between the two groups in relation to the initial symptom showed that the non-constipation group experienced more significant symptoms of bradykinesia compared to the constipation group. The clinical profile of the patients differed slightly between the two groups. Both groups presented three disease phenotypes, however, the percentage of patients with a mixed phenotype in the constipation group The mean daily dose of levodopa was similar in the constipation group However, this result remains insignificant.
The H-Y stages in the PD group with constipation 3. A cluster analysis with a two-cluster solution revealed two profiles. Pre-motor constipation appeared in over half of the patients with a delay of 2 to 10 years for a significant proportion The average duration of onset of premotor constipation was 4.
In the present study, Our results also suggest that constipation in our population had an average of 4 or more years delay before the onset of motor symptoms, which was consistent with previous reports that showed that the prevalence of constipation as a pre-motor sign ranged from This finding indicates constipation as a prodromal symptom of PD.
Our results also showed that patients with constipation had significantly longer duration of disease and more advanced stages of the Hoehn and Yahr scale. This restricts the physical activity and mobilization of patients. In contrast, in this study, the PD group with constipation received a daily dose of levodopa similar to the PD group without constipation, which is inconsistent with the results of other studies suggesting that autonomic symptom alterations were associated with dopaminergic treatment.
This difference may be partially explained because dopaminergic treatment was not initially used to treat patients in our study. Our study has certain limitations.
This is a historical clinical investigation of the onset of premotor symptoms, in which information about the chronology of constipation and other symptoms was collected through patient reminders. Therefore, the subjective bias of the responses could not be ignored and may partially influence the precision of our results.
The diagnosis of constipation may allow clinicians to identify PD in their patients at an earlier stage, especially if it is associated with other pre-motor symptoms including sleep and olfactory disorders.
Projected number of people with Parkinson disease in the most populous nations, through J Neurology. Tysnes OB, Storstein A. J Neural Transm. Nat Neuroscience. Meta-analysis of early nonmotor features and risk factors for Parkinson disease. Ann Neurol. Pfeiffer RF. Parkinsonism Relat Disord. Verny M. Non-motor symptoms in Parkinson Disease. J European Geriatric Medicine. Jost WH. J Neurol Sci. J Neurogastroenterol Motil.
J Clin Neurosci. Parkinson symptoms and health related quality of life as predictors of costs: a longitudinal observational study with linear mixed model analysis. J PLoS One. BMC Neurol. Medical records documentation of constipation preceding Parkinson disease: A case-control study. J Neurol Neurosurg. A report on the clinical experience in Morocco. E-mail: drnilaygun gmail. Material and Methods: The levels of OH vitamin D in patients who applied to our outpatient clinic between April and April were examined retrospectively.
Discussion: In our study, widespread vitamin D deficiency and insufficiency were found in patients who applied to our hospitals. Emphasizing that this situation can be seen at a high rate even in sunny regions such as Adana, we think that it will be appropriate to inform people about benefiting from sunlight enough, proper nutrition and vitamin D supplementation when necessary.
Vitamin D has important effects on calcium homeostasis and bone metabolism in the body [1, 2]. For the positive effects of vitamin D to occur, adequate exposure to sunlight or the active form of vitamin D, which is the active form of 1,Dihydroxy D, must be kept at normal levels.
While the half-life of 1,25 dihydroxy vitamin D, which is the active form of vitamin D, is hours, the half-life of OH D3 is approximately weeks, so OH D3 levels are generally measured in the body [].
Subclinical vitamin D deficiency and insufficiency affect most men and women in all age groups in many geographical regions. This situation arises as a result of a diet poor in calcium, together with insufficient exposure to sunlight [8].
Despite the uncertainty about the ideal level of vitamin D, many studies accept vitamin D deficiency as a common problem, especially in winter, even in areas with plenty of sunshine [9, 10]. Vitamin D deficiency and insufficiency in Turkey pregnant women, babies, adults, and is one of the major health problems affecting the elderly. In this study, it was aimed to determine the frequency of vitamin D deficiency in individuals who applied to our physical therapy outpatient clinics and to investigate if there is a significant difference between OH D3 levels considering age, gender and seasonal differences.
The data of the patients whose outpatient clinic records were examined and who had chronic renal failure, chronic liver disease and who had dialysis unit registration were not included in the study. The patients were grouped according to age and gender. The distribution of vitamin D levels by months was examined. Statistical analysis was done using the SPSS Mean, standard deviation, median, min-max, ratio and frequency values were used in the complementary statistics of the data.
The distribution of variables was checked with the Kolmogorov- Smirnov test. The Chi-square test was used in the analysis of qualitative data. P-values less than 0. The research was conducted on patients; of the patients were female While OH vitamin D levels in The difference between vitamin D levels in both sexes was not statistically significant.
The average OH vitamin D level was No such relationship was found in men. It increases the absorption of calcium and phosphate from the intestine and is an important factor in bone mineralization.
Vitamin D deficiency causes secondary hyperparathyroidism, bone resorption and increases the risk of fracture formation. There are also publications showing that it is associated with cardiovascular diseases and type 2 diabetes [11, 12]. Vitamin D deficiency is common, especially among the elderly. However, seasonal changes have a significant effect on OH Vitamin D levels because cholecalciferol is synthesized in the skin under the influence of ultraviolet UV light [13, 14].
However, this is generally not the case in more southern countries [16]. Studies have found that vitamin D deficiency has a high prevalence not only in the risk group, but also in the Middle East and Asian countries [15]. Vitamin D levels also have been investigated in several studies conducted in Turkey []. In studies conducted in the last twenty years, Turkey, India, China, Saudi Arabia and Iran, even in a tropical climate and sunny countries such as high rates of vitamin D deficiency have been reported [15, 22].
In the study conducted by Ucar et al. In a study conducted by Levis et al. In the study conducted by Bozkurt et al. In our study, OH D3 levels were found to be significantly lower in winter than in summer, in line with the literature.
Similarly, in the study by Ono et al. Many factors, such as cultural factors, geography, race, as well as personal characteristics affect vitamin D levels and may vary depending on the population in which studies are conducted [6, 22].
Although our study was conducted in a sunny region, a high level of vitamin D deficiency was detected. In conclusion, a high rate of vitamin D deficiency and insufficiency was detected in patients who applied to our hospital in Antalya, and we think that it would be appropriate to supplement the person with vitamin D, bearing in mind that even in areas with abundant sunny and tropical climates, there may be high rates of OH vitamin D deficiency.
In addition, patient education about the importance of sunbathing and dietary content can also contribute to treatment. Karahan S, Katkat F. J Nutr Health Aging. Moy FM, Bulgiba A.
High prevalence of vitamin D insufficiency and its association with obesity and metabolic syndrome among Malay adults in Kuala Lumpur, Malaysia. Prevalence of vitamin D deficiency among Turkish, Moroccan, Indian and sub-Sahara African populations in Europe and their countries of origin: an overview.
Osteoporos Int. Correlates and prevalence of insufficient hydroxyvitamin D status in black and white older adults: the health, aging and body composition study. J Am Geriatr Soc. Plasma concentrations of hydroxyvitamin D among Jordanians: Effect of biological and habitual factors on vitamin D status. BMC Clin Pathol. Serum vitamin D levels in office workers in a subtropical climate. Photochem Photobiol. Serum hydroxyvitamin d concentrations and season-specific correlates in Japanese adults.
J Epidemiol. Prevalence of hypovitaminosis D and folate deficiency in healthy young female Austrian students in a health care profession. Eur J Nutr. Prevalence and determinants of vitamin D deficiency and insufficiency among three immigrant groups in Finland: evidence from a population-based study using standardised hydroxyvitamin D data.
Public Health Nutr. Vitamin D-fortified foods improve wintertime vitamin D status in women of Danish and Pakistani origin living in Denmark: a randomized controlled trial. J Diabetes Res. Adv Skin Wound Care. High frequency of vitamin D deficiency in current pregnant Japanese women associated with UV avoidance and hypo-vitamin D diet.
J Steroid Biochem Mol Biol. Lips P. Worldwide status of vitamin D nutrition. Vitamin D deficiency and secondary hyperparathyroidism in the elderly: consequences for bone loss and fractures and therapeutic implications. Endocr Rev. Frequency of vitamin D insufficiency in healthy children between 1 and 16 years of age in Turkey. Pediatr Int. Age, sex, and seasonal variations in the serum vitamin D3 levels in a local Turkish population. Arch Rheumatol.
Subclinical vitamin D deficiency is increased in adolescent girls who wear concealing clothing. J Nutr. The frequency of vitamin D insufficiency in healthy female adolescents. The risk of misinterpreting tests results by patients when rapid kits are used for self-diagnosis is another aspect that must be considered.
This was mostly due to objective difficulties encountered by the patients in reading and interpreting the results of the strips.
Important considerations for implementing point-of-care serology testing thus include i usage of well-validated tests, evaluated against a gold standard; ii performance characteristics – thus encompassing sensitivity, specificity, positive and negative predictive values or cross-reaction with other coronaviruses – shall be tested using serum samples collected from patients infected with SARS-CoV-2, with other respiratory viruses including seasonal coronaviruses and also from healthy controls; iii adequate training of healthcare workers is needed iv and, finally, IV provisions must be in place, encompassing the capture of testing data for individual patient records and surveillance purposes, and the participation to external quality assessment schemes, to systematically monitor the quality of this type of testing.
At the heart of society 4. It is in these sectors that, lately, the greatest investments have been made in digital transformation aimed at exploiting -through data-all the new present and emerging technologies, from the Internet of Things IoT to Artificial Intelligence AI. The exploitation of Big Data, in fact, constitutes the starting point and the indispensable resource for the development of innovative and precision medicine, providing scientific, organizational and infrastructural support to promote research and accelerate preclinical and clinical studies.
However, this development, having increased the number of subjects holding health-related data, the speed of transmission of such data and the quantity of information electronically stored often not on national territory , has determined an exponential increase in the danger of data processing from the point of view of confidentiality and an increased possibility of damaging the dignity and fundamental freedoms of the individual.
This has led to an increased sensitivity of the European legislator and, subsequently, of the national legislator, towards the protection of such data and related protections. In addition to the General Data Protection Regulation, which has revolutionized the way of conceiving the data economy, it is, in fact, being evaluated by European institutions the first draft of the Artificial Intelligence Act, which will be the real springboard for the massive and regulated use of algorithms, especially in healthcare.
To be precise, this last mentioned regulation will only define the limits to the use of algorithmic systems already widely in use. AIFA, through this guide, has described some case studies, showing some workflows that represent the regulations impacted depending on the type of system used and paying particular attention to the compliance related to the treatment of data and the related profiles of cybersecurity.
Ad oggi sono operativi circa 72 Drive-Through-Difesa. I contributi, forniti da ciascuna Forza Armata, sono diretti e coordinati fin dalla prima ora dal Comando Operativo di vertice Interforze COI per mezzo di una Sala Operativa dedicata, composta da personale interforze.
In the last couple of decades, Laboratory Medicine has made giant steps forward in terms of innovative technology and has made major scientific breakthroughs in the medical field as a whole.
Indeed, a plethora of both in vitro and in vivo assays and tests in biological fluids of the human hydrodynamic system are now available. The importance, for clinical purposes, of novel metabolic processes and protein cross-talk mechanisms is being increasingly recognized. The increased survival period of sick, elderly people, plus the therapeutic aspects of precision medicine, in which the drugs selected resulted in a series of direct approaches to altered target molecules, have made it difficult to identify the most effective molecules to use as biomarkers in most of this population scenario.
Therefore, it seems that Laboratory Medicine does not need to increase further value in the contribution to the care of fragile individuals, and in people affected by chronic degenerative diseases. Notwithstanding all these premises, and the increase in Clinical Laboratory testing, which is, and will continue in the future to be an indispensable ally of medical care, the correct diagnosis of a single or of multiple diseases occurring in a single individual will benefit enormously from this Discipline, if some steps forward will be made.
I believe that the enormous amount of knowledge now accumulating in the field of Laboratory Medicine will revolutionize, not only the medical care of people, but, in the various areas of the medical scenario, also the field of Laboratory Medicine Science itself and the practice deriving from it. In other words, we should all begin to be mindful of our state of health as early as about 20—25 years of age, when most auxological aspects have been reached, and sexual maturity completed.
Therefore, also healthy people should be monitored as well as patients, which should be one of the tenets of preventive medicine. Having said that, I must now say that chronological age is practically meaningless in calculating health status. This, of course, applies much more to multimorbidity; in fact, once identified them, measures can be made to eradicate or to delay the start or the progression of each illness, therefore determining a better state of health during the progression of chronological age.
The revolution I am talking about is to look at each individual when they are enjoying still normal health, as mentioned above. This approach may be considered too costly, but in effect it is much less costly than waiting for the appearance of an overt disease, which must then be treated for decades, frequently with very expensive drugs and tests laboratory and imaging.
This will also support the joining of Preventive Medicine to effective Individualized Medicine. Salvatore F. The shift of the paradigm between ageing and diseases. Clin Chem. Lab Med. During the second wave, the validation of SARS-CoV-2 antigen rapid diagnostic tests RDT has substantially changed testing strategies globally, since results were available within 30 min, reducing turnaround time and therefore exposure risk.
Recently, validated self-tests for SARS-CoV-2 based on the nasopharyngeal swab NPS or saliva have prompted for the empowerment of the general population in the fight against the spread of infectious. Swabbing is a complex task requiring training and competency assessment, and thus they are performed by trained nurses or physicians.
Recently, Tsang et al. The Authors concluded that saliva and nasal swabs are clinically acceptable alternatives to commonly used nasopharyngeal swabs. Saliva is a matrix elective for self-collection, and molecular testing is reliable but require laboratory instrumentation to be performed.
Indeed, antigen determination on salivary samples is still under debate [2]. Most of the errors occur in the preanalytical phase, with relatively few analytical and post-analytical errors. Some issues arising during the pre-analytical phase of SARS-CoV-2 diagnostics regards: the time of swab, swabbing practice, sample handling and conservation and RNA extraction.
NPS should be taken at the time of symptom onset when the highest viral load occurs in COVID, thus not the day immediately before and not too far from possible close contact with positive subjects. Differently, sample preparation is a crucial factor for antigen testing, and centrifuged vs. In conclusion, self-testing could be of aid in the screening programs for reducing viral spread, but other alternatives are possible, such as self-collection of samples with analytical tests performed in clinical laboratories.
These required the optimization of pre-analytical steps to reduce the impact on results. Woloshin, S. Basso, D. In a broad and complex territory such as that of ULSS 6 Euganea, composed of five local health districts with a population of about Information is sent in real time to central laboratory using IT middleware, where data are validated and historicized.
Historicized data can be consulted and downloaded like other laboratory exams. Results: the project involved patients. From January 1st to June 30th the average frequency of determinations per patient was about 30 days, while the average number of determinations per patient was about 7,5. This model simplifies management of both patients in IHC and followed by RMC, allowing easier access to the determination of PT-INR, with more constant therapy control and significant improvement of life quality.
Ovarian cancer is the seventh most frequent malignancy in the female population worldwide and the leading cause of death among gynecological cancers. In Italy, about new cases were registered in The availability of a guide in the diagnostic paths is a requirement for general practitioners and specialists of other disciplines that arises from the need to guarantee the most appropriate, less demanding, more useful and less expensive diagnostic path.
The purpose of PDTAs is to increase the quality of perceived and effectively delivered care, improving outcomes and promoting patient safety through the use of the right resources needed. The surgical approach plays a fundamental and essential role in the treatment program and the absent tumor residue has been defined as the only tumor residue associated with optimal survival curves and also the antiblastic chemotherapy, that always follows surgery in advanced ovarian cancer, gets better results after optimal surgery.
The first network of reference and dissemination of PDTAs is constituted by general medicine. Indeed, we cannot ignore sharing with the entire regional network of general practitioner, who will thus know who to send the patient with suspicion or already ascertained diagnosis of ovarian cancer, for an adequate diagnostic and therapeutic path, allowing feedback on the conditions and clinical-therapeutic pathways for individual patients.
In addition, information and reference relationships with voluntary associations and patient associations must be encouraged. They constitute a fundamental asset in the creation and development of information, health culture of primary and secondary prevention and support in home care or in assistance facilities even to the terminally ill. Scarone , V. Dovere, C. Traverso, F. Background: The emergency caused by the Covid pandemic has forced the reformulation of the operating methods of the Health System, turning the spotlight on the need for greater interaction between hospital and territory.
This aspect is even more evident in patients needing for a more strict followup as those under antithrombotic therapy TAO , making clear the essential usefulness of digital tools and of new organizative models. Each patient was asked for an email address and signed consent to the computerized management of TAO therapy and forwarding of health documents.
Results: In order to monitor the expected results, the following indicators were evaluated: number of incoming phone calls; number of treatment plans issued for DOAC; time in range for patients in AVK; number of complications recorded in the period under review April —April Conclusions: The new organization, based on digital support of clinical monitoring, has received high appreciation from patients and consequently a greater compliance with the therapy protocol.
This management model has allowed an effective control both of the number and severity of adverse events, while the reduction of outpatient access has allowed to drastically reduce the infectious risk. In addition, e-mailing of reports and treatment plans allowed an optimization of human resources.
Lorubbio 1 , F. Baldelli 1 , E. Bromo 5 , G. Caldarelli 4 , C. Donnini 1 , S. Fabbroni 1 , A. Fanelli 1 , M. Fantacci 2 , L. Gasbarri 1 , M.
Mazzi 4 , A. Periccioli 3 , P. Pugliano 4 , C. Rapini 2 , A. Rebuffat 3 , A. Sereni 1 , M. Sorini 1 , E.
Tripodo 1 , A. Ognibene 1. The use of information and communication technologies ICT and E-Health can contribute to a reorganization by moving the focus of health care from the hospital to the territory. The aim of the present project is to evaluate of the complete blood count CBC test and the peripheral blood smear through digital images, shared and available to the team of the 12 TSE laboratories.
During implementation, the image analyzers and the staining adopted were compared, together with the quality indicators QI to support the new flows implemented between the peripheral laboratories and the Hub laboratory. The Passing-Bablok and Bland-Altman plot analysis performed for comparison of all elements of the blood count test, provided excellent results between the technologies and the different cell staining used data not shown.
The organization proposed in the project improves the analytical quality, harmonises the reporting and interpretation of analytical data, promotes uniform training, preparing for continuous professional comparison. Pelagalli 1,2 , A. Giovannelli 1,2 , C. Calabrese 1,2 , S. Sarubbi 1,2 , M. Minieri 1,2 , M. Nuccetelli 1,2 , M. Pieri 1,2 , S. Bernardini 1,2. Sepsis is an infectious disease the etiology can be viral or bacterial with hight mortality, threatening human health.
The aim of this study is to use leucocyte counts neutrophils and monocytes that are activated from pathogenic virus or bacteria and others morphological change with Mindray BCplus platform to diagnose sepsis early, quickly, conveniently and at low cost.
A total EDTA-k2 anticoagulant venous whole blood samples were collected: 70 control patients blood donors with a normal complete count blood and negative VES, and samples hospitalized at the emergency department with symptoms attributable to sepsis with PCT request.
All data was divided in 4 groups: control group, group where sepsis cannot be confirmed, group with confirmed sepsis diagnosis and a group with sepsis from SARS-CoV-2 infection. The roc curves highlight acceptable sensitivity and specificity values for some haematological parameters and suggest a possible cut-off. The BC plus can help the diagnosis of sepsis upon the admission to the emergency department using some morphological positional parameters.
Pecoraro 1 , T. Pirotti 1 , T. Trenti 1 , M. Plebani 2. However, their immunological significance are currently undefined. There are many methods available for the detection of specific Abs whit suboptimal diagnostic accuracy and relatively high throughput capacity and less stringent specimen requirements compared to RNA-based assays.
We conduct a retrospective study analyzing with a big data analysis all samples collected between 11 March and 30 September All serum samples received at the laboratory were processed using qualitative and commercially available rapid lateral flow immunoassay tests for nCoV IgG and IgM.
Positive results were confirmed using a chemiluminescent method. Subjects with a positive result were contacted from the Department of Public Health for further tests viral RNA research or subsequent serological tests for definitive diagnosis.
A total of 69, serological tests in 42, subjects and , oropharyngeal or nasopharyngeal swabs in 88, subjects were performed. Of the subjects with IgG negative and IgM positive results, a positivity was confirmed in 1. Subsequent serological testing confirmed IgG positivity in 8 subjects 1. Conversely, in subjects with IgG positive and IgM negative results, a positivity was confirmed in 7. Scaglione , C. Nardelli, M. Setaro, E. The impairment of this pathway is a common characteristic of many tumors and it is frequently observed in breast and ovarian cancer.
Samples were then pooled and sequenced on NextSeq Dx platform Illumina. Sequencing files were quality checked, analyzed and processed using our dedicated bioinformatics pipeline. In this workflow, LGAs profiles were calculated using whole genome sequencing data at low coverage 0. The HRD score was then estimated by measuring the level of agreement in the segmentation profiles of each samples.
Cosma 1 , A. Padoan 1 , C. Di Chiara 2 , D. Rinaldi 1 , D. Gastaldi 3 , D. Basso 1 , C. Giaquinto 2 , M. Plebani 1. For 9 HCW, salivary samples were collected at three different times within the same day before breakfast, at 10 am, and after lunch. A serum sample was also collected for all individuals. Time post symptoms onset or time from the first vaccine were also recorded. Passing-Bablok regressions showed that sar-IgG and ser-IgG comparability was assessable only when ser-IgG values were divided by , being slope and intercept 0.
Conclusions: Salivary IgG is efficiently detectable both in COVID and in vaccinated individuals and analyses appeared to be not influenced by the daytime of collection. The analyses performed showed that, overall, sal-IgG were lower than ser-IgG, and thus comparability with serum levels needs to be better explored.
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The type of selected sport is affected by either genotype or chronotype, and it is not clear how much the chronotype is affected by the sporting environment. Epub Aug This led to a series of parliamentary investigations, traditional and social media misinformation and disinformation vilifying the health decision makers and the company, and criminal charges filed against over 20 individuals by the state over alleged unproven vaccine caused deaths. Aim: This study determines the anxiety levels of health workers by evaluating their anxiety status in the challenging process of the pandemic. It was performed at five departments of children hospital of rabat in Morocco : Neonatal intensive care, General intensive care, Hemato-oncology, Respiratory and Infectious Diseases, endocrinology and metabolic diseases departments. Normality was checked with the Shapiro-Wilk test skewness and kurtosis.
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