PathophysiologyPub Date : 2023-07-11DOI: 10.3390/pathophysiology30030023
Hadi Askarifirouzjaei, Leila Khajoueinejad, Elena Wei, Sruti Cheruvu, Carlos Ayala, Ning Chiang, Thomas Theis, Dongming Sun, Mehdi Fazeli, Wise Young
{"title":"Sex Differences in Immune Cell Infiltration and Hematuria in SCI-Induced Hemorrhagic Cystitis.","authors":"Hadi Askarifirouzjaei, Leila Khajoueinejad, Elena Wei, Sruti Cheruvu, Carlos Ayala, Ning Chiang, Thomas Theis, Dongming Sun, Mehdi Fazeli, Wise Young","doi":"10.3390/pathophysiology30030023","DOIUrl":"10.3390/pathophysiology30030023","url":null,"abstract":"<p><p>Rats manifest a condition called hemorrhagic cystitis after spinal cord injury (SCI). The mechanism of this condition is unknown, but it is more severe in male rats than in female rats. We assessed the role of sex regarding hemorrhagic cystitis and pathological chronic changes in the bladder. We analyzed the urine of male and female Sprague-Dawley and Fischer 344 rats after experimental spinal cord contusion, including unstained microscopic inspections of the urine, differential white blood cell counts colored by the Wright stain, and total leukocyte counts using fluorescent nuclear stains. We examined bladder histological changes in acute and chronic phases of SCI, using principal component analysis (PCA) and clustered heatmaps of Pearson correlation coefficients to interpret how measured variables correlated with each other. Male rats showed a distinct pattern of macroscopic hematuria after spinal cord injury. They had higher numbers of red blood cells with significantly more leukocytes and neutrophils than female rats, particularly hypersegmented neutrophils. The histological examination of the bladders revealed a distinct line of apoptotic umbrella cells and disrupted bladder vessels early after SCI and progressive pathological changes in multiple bladder layers in the chronic phase. Multivariate analyses indicated immune cell infiltration in the bladder, especially hypersegmented neutrophils, that correlated with red blood cell counts in male rats. Our study highlights a hitherto unreported sex difference of hematuria and pathological changes in males and females' bladders after SCI, suggesting an important role of immune cell infiltration, especially neutrophils, in SCI-induced hemorrhagic cystitis.</p>","PeriodicalId":19852,"journal":{"name":"Pathophysiology","volume":"30 3","pages":"275-295"},"PeriodicalIF":0.0,"publicationDate":"2023-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10366728/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10233454","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
PathophysiologyPub Date : 2023-06-16eCollection Date: 2023-06-01DOI: 10.2478/jvetres-2023-0028
Mariola Bochniarz, Przemysław Błaszczyk, Marek Szczubiał, Iosif Vasiu, Łukasz Adaszek, Katarzyna Michalak, Dorota Pietras-Ożga, Marco Wochnik, Roman Dąbrowski
{"title":"Comparative analysis of total protein, casein, lactose, and fat content in milk of cows suffering from subclinical and clinical mastitis caused by <i>Streptococcus</i> spp.","authors":"Mariola Bochniarz, Przemysław Błaszczyk, Marek Szczubiał, Iosif Vasiu, Łukasz Adaszek, Katarzyna Michalak, Dorota Pietras-Ożga, Marco Wochnik, Roman Dąbrowski","doi":"10.2478/jvetres-2023-0028","DOIUrl":"10.2478/jvetres-2023-0028","url":null,"abstract":"<p><strong>Introduction: </strong>The aim of the study was to analyse the total protein (TP), casein (CAS), lactose (LAC), and fat content of milk from cows with subclinical (SCM) and clinical mastitis (CM) caused by <i>Streptococcus</i> spp.</p><p><strong>Material and methods: </strong>A total of 60 milk samples from diseased cows and 30 milk samples from healthy cows were included in the study. Milk samples were taken from Holstein-Friesian cows from four dairy farms in Lublin Province. The bacteriological examination of the milk was performed and the somatic cells count in 1 mL of milk was determined using a SomaCount FC automatic cell counter. Determination of TP, CAS, LAC, FAT and FA levels in milk was carried out using a DairySpec FT automated Fourier transform infrared spectrometer.</p><p><strong>Results: </strong>Total protein in milk from HE was significantly higher than in milk from cows with mastitis (4.04% <i>vs</i> 3.57% in milk from SCM cows and 3.7% in milk from CM cows, P = 0.001). The CAS level was 2.73% in milk from CM cows and 2.92% in milk from SCM cows <i>vs</i> 3.30% in milk from HE cows, P = 0.001. The changes in CAS and TP in milk resulted in a significant difference in the CAS/TP ratio (81.7% in milk from HE cows <i>vs</i> 73.8% in milk from CM cows). A decrease in levels was also recorded for LAC (4.8% in milk from HE cows <i>vs</i> 4.51% in milk from SCM cows and 4.01% in milk from CM cows, P = 0.001). The fat level was significantly higher in milk from healthy cows than in milk from cows with mastitis (4.0% <i>v</i>s 2.3% in milk from SCM cows and 1.64% in milk from CM cows, P = 0.001).</p><p><strong>Conclusion: </strong>It should be emphasised that the decrease in the levels of TP, LAC and FAT was significant not only in milk from CM cows but also in milk from SCM cows. This is very unfavourable, because the reduction in the main milk components results in poor quality dairy products and impairs line processes.</p>","PeriodicalId":19852,"journal":{"name":"Pathophysiology","volume":"1 1","pages":"251-257"},"PeriodicalIF":2.7,"publicationDate":"2023-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10740323/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75524008","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
PathophysiologyPub Date : 2023-06-15DOI: 10.3390/pathophysiology30020022
Alexandra Nikolaeva, Maria Pospelova, Varvara Krasnikova, Albina Makhanova, Samvel Tonyan, Yurii Krasnopeev, Evgeniya Kayumova, Elena Vasilieva, Aleksandr Efimtsev, Anatoliy Levchuk, Gennadiy Trufanov, Mark Voynov, Maxim Shevtsov
{"title":"Elevated Levels of Serum Biomarkers Associated with Damage to the CNS Neurons and Endothelial Cells Are Linked with Changes in Brain Connectivity in Breast Cancer Patients with Vestibulo-Atactic Syndrome.","authors":"Alexandra Nikolaeva, Maria Pospelova, Varvara Krasnikova, Albina Makhanova, Samvel Tonyan, Yurii Krasnopeev, Evgeniya Kayumova, Elena Vasilieva, Aleksandr Efimtsev, Anatoliy Levchuk, Gennadiy Trufanov, Mark Voynov, Maxim Shevtsov","doi":"10.3390/pathophysiology30020022","DOIUrl":"https://doi.org/10.3390/pathophysiology30020022","url":null,"abstract":"<p><p>Vestibulo-atactic syndrome (VAS), which represents a combination of motor and vestibular disorders, can be manifested as a clinical complication of breast cancer treatment and has a significant impact on patients' quality of life. The identification of novel potential biomarkers that might help to predict the onset of VAS and its progression could improve the management of this group of patients. In the current study, the levels of intercellular cell adhesion molecule 1 (ICAM-1), platelet/endothelial cell adhesion molecule 1 (PECAM-1), NSE (neuron-specific enolase), and the antibodies recognizing NR-2 subunit of NMDA receptor (NR-2-ab) were measured in the blood serum of BC survivor patients with vestibulo-atactic syndrome (VAS) and associated with the brain connectome data obtained via functional magnetic resonance imaging (fMRI) studies. A total of 21 patients were registered in this open, single-center trial and compared to age-matched healthy female volunteers (control group) (<i>n</i> = 17). BC patients with VAS demonstrated higher serum levels of ICAM-1, PECAM-1, and NSE and a lower value of NR-2-ab, with values of 654.7 ± 184.8, 115.3 ± 37.03, 49.9 ± 103.9, and 0.5 ± 0.3 pg/mL, respectively, as compared to the healthy volunteers, with 230.2 ± 44.8, 62.8 ± 15.6, 15.5 ± 6.4, and 1.4 ± 0.7 pg/mL. According to the fMRI data (employing seed-to-voxel and ROI-to-ROI methods), in BC patients with VAS, significant changes were detected in the functional connectivity in the areas involved in the regulation of postural-tonic reflexes, the coordination of movements, and the regulation of balance. In conclusion, the detected elevated levels of serum biomarkers may reveal damage to the CNS neurons and endothelial cells that is, in turn, associated with the change in the brain connectivity in this group of patients.</p>","PeriodicalId":19852,"journal":{"name":"Pathophysiology","volume":"30 2","pages":"260-274"},"PeriodicalIF":0.0,"publicationDate":"2023-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10305185/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9717621","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
PathophysiologyPub Date : 2023-06-12DOI: 10.3390/pathophysiology30020021
Anastasia Sklifasovskaya, Mikhail Blagonravov, Madina Azova, Vyacheslav Goryachev
{"title":"Myocardial Glutathione Synthase and TRXIP Expression Are Significantly Elevated in Hypertension and Diabetes: Influence of Stress on Antioxidant Pathways.","authors":"Anastasia Sklifasovskaya, Mikhail Blagonravov, Madina Azova, Vyacheslav Goryachev","doi":"10.3390/pathophysiology30020021","DOIUrl":"https://doi.org/10.3390/pathophysiology30020021","url":null,"abstract":"<p><p>Antioxidant protection is one of the key reactions of cardiomyocytes (CMCs) in response to myocardial damage of various origins. The thioredoxin interacting protein (TXNIP) is an inhibitor of thioredoxin (TXN). Over the recent few years, TXNIP has received significant attention due to its wide range of functions in energy metabolism. In the present work, we studied the features of the redox-thiol systems, in particular, the amount of TXNIP and glutathione synthetase (GS) as markers of oxidative damage to CMCs and antioxidant protection, respectively. This study was carried out on 38-week-old Wistar-Kyoto rats with insulin-dependent diabetes mellitus (DM) induced by streptozotocin, on 38- and 57-week-old hypertensive SHR rats and on a model of combined hypertension and DM (38-week-old SHR rats with DM). It was found that the amount of TXNIP increased in 57-week-old SHR rats, in diabetic rats and in SHR rats with DM. In 38-week-old SHR rats, the expression of TXNIP significantly decreased. The expression of GS was significantly higher compared with the controls in 57-week-old SHR rats, in DM rats and in the case of the combination of hypertension and DM. The obtained data show that myocardial damage caused by DM and hypertension are accompanied by the activation of oxidative stress and antioxidant protection.</p>","PeriodicalId":19852,"journal":{"name":"Pathophysiology","volume":"30 2","pages":"248-259"},"PeriodicalIF":0.0,"publicationDate":"2023-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10302676/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9722870","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Risk Factors and Clinical Characteristics of Acute Kidney Injury in Patients with COVID-19: A Systematic Review and Meta-Analysis.","authors":"Amal Arifi Hidayat, Vania Azalia Gunawan, Firda Rachmawati Iragama, Rizky Alfiansyah, Decsa Medika Hertanto, Artaria Tjempakasari, Mochammad Thaha","doi":"10.3390/pathophysiology30020020","DOIUrl":"https://doi.org/10.3390/pathophysiology30020020","url":null,"abstract":"<p><p>Acute kidney injury (AKI) is associated with a worse prognosis in coronavirus disease 2019 (COVID-19) patients. Identification of AKI, particularly in COVID-19 patients, is important for improving patients' management. The study aims to assess risk factors and comorbidities of AKI in COVID-19 patients. We systematically searched PubMed and DOAJ databases for relevant studies involving confirmed COVID-19 patients with data on risk factors and comorbidities of AKI. The risk factors and comorbidities were compared between AKI and non-AKI patients. A total of 30 studies involving 22385 confirmed COVID-19 patients were included. Male (OR: 1.74 (1.47, 2.05)), diabetes (OR: 1.65 (1.54, 1.76)), hypertension (OR: 1.82 (1.12, 2.95)), ischemic cardiac disease (OR: 1.70 (1.48, 1.95)), heart failure (OR: 2.29 (2.01, 2.59)), chronic kidney disease (CKD) (OR: 3.24 (2.20, 4.79)), chronic obstructive pulmonary disease (COPD) (OR: 1.86 (1.35, 2.57)), peripheral vascular disease (OR: 2.34 (1.20, 4.56)), and history of nonsteroidal anti-inflammatory drugs (NSAID) (OR: 1.59 (1.29, 1.98)) were independent risk factors associated with COVID-19 patients with AKI. Patients with AKI presented with proteinuria (OR: 3.31 (2.59, 4.23)), hematuria (OR: 3.25 (2.59, 4.08)), and invasive mechanical ventilation (OR: 13.88 (8.23, 23.40)). For COVID-19 patients, male gender, diabetes, hypertension, ischemic cardiac disease, heart failure, CKD, COPD, peripheral vascular disease, and history of use of NSAIDs are associated with a higher risk of AKI.</p>","PeriodicalId":19852,"journal":{"name":"Pathophysiology","volume":"30 2","pages":"233-247"},"PeriodicalIF":0.0,"publicationDate":"2023-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10204466/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9568949","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
PathophysiologyPub Date : 2023-05-12DOI: 10.3390/pathophysiology30020019
Carolina Ochoa, Phillip C S R Kilgore, Nadejda Korneeva, Eric Clifford, Steven A Conrad, Marjan Trutschl, Jacquelyn M Bowers, Thomas Arnold, Urska Cvek
{"title":"Trends in Drug Tests among Children: A 22-Year Retrospective Analysis.","authors":"Carolina Ochoa, Phillip C S R Kilgore, Nadejda Korneeva, Eric Clifford, Steven A Conrad, Marjan Trutschl, Jacquelyn M Bowers, Thomas Arnold, Urska Cvek","doi":"10.3390/pathophysiology30020019","DOIUrl":"10.3390/pathophysiology30020019","url":null,"abstract":"<p><p>There are several pathophysiological outcomes associated with substance abuse including metabolic disbalance, neurodegeneration, and disordered redox. Drug use in pregnant women is a topic of great concern due to developmental harm which may occur during gestation and the associated complications in the neonate after delivery. We sought to determine what the trajectory of drug use is like in children aged 0-4 years and mothers of neonates. Urine drug screen (UDS) results were obtained of our target demographic during 1998-2011 and 2012-2019 from LSU Health Sciences Center in Shreveport (LSUHSC-S). Statistical analysis was performed using R software. We observed an increase in cannabinoid-positive UDS results in both Caucasian (CC) and African American (AA) groups between 1998-2011 and 2012-2019 periods. Cocaine-positive UDS results decreased in both cohorts. CC children had higher UDS positive results for opiates, benzodiazepines, and amphetamines, while AA children had a higher percentage for illicit drugs such as cannabinoids and cocaine. Neonate's mothers had similar UDS trends to that in children during 2012-2019. Overall, while percentage of positive UDS results for both AA and CC 0-4 year old children started to decline for opiate, benzodiazepine, and cocaine during 2012-2019, cannabinoid- and amphetamine (CC)-positive UDS steadily increased. These results suggest a shift in the type of drug use by mothers from opiates, benzodiazepines, and cocaine to cannabinoids and/or amphetamines. We also observed that 18-year-old females who tested positive for opiates, benzodiazepine, or cocaine had higher than average chances of testing positive for cannabinoids later in life.</p>","PeriodicalId":19852,"journal":{"name":"Pathophysiology","volume":"30 2","pages":"219-232"},"PeriodicalIF":2.7,"publicationDate":"2023-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10204533/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9870977","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
PathophysiologyPub Date : 2023-05-10DOI: 10.3390/pathophysiology30020018
Liudmila Gerasimova-Meigal, Alexander Meigal, Maria Gerasimova, Anna Sklyarova, Ekaterina Sirotinina
{"title":"Cerebral Circulation and Brain Temperature during an Ultra-Short Session of Dry Immersion in Young Subjects.","authors":"Liudmila Gerasimova-Meigal, Alexander Meigal, Maria Gerasimova, Anna Sklyarova, Ekaterina Sirotinina","doi":"10.3390/pathophysiology30020018","DOIUrl":"https://doi.org/10.3390/pathophysiology30020018","url":null,"abstract":"<p><p>The primary aim of the study was to assess cerebral circulation in healthy young subjects during an ultra-short (45 min) session of ground-based microgravity modeled by \"dry\" immersion (DI), with the help of a multifunctional Laser Doppler Flowmetry (LDF) analyzer. In addition, we tested a hypothesis that cerebral temperature would grow during a DI session. The supraorbital area of the forehead and forearm area were tested before, within, and after a DI session. Average perfusion, five oscillation ranges of the LDF spectrum, and brain temperature were assessed. Within a DI session, in the supraorbital area most of LDF parameters remained unchanged except for a 30% increase in respiratory associated (venular) rhythm. The temperature of the supraorbital area increased by up to 38.5 °C within the DI session. In the forearm area, the average value of perfusion and its nutritive component increased, presumably due to thermoregulation. In conclusion, the results suggest that a 45 min DI session does not exert a substantial effect on cerebral blood perfusion and systemic hemodynamics in young healthy subjects. Moderate signs of venous stasis were observed, and brain temperature increased during a DI session. These findings must be thoroughly validated in future studies because elevated brain temperature during a DI session can contribute to some reactions to DI.</p>","PeriodicalId":19852,"journal":{"name":"Pathophysiology","volume":"30 2","pages":"209-218"},"PeriodicalIF":0.0,"publicationDate":"2023-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10204427/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9568951","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
PathophysiologyPub Date : 2023-05-09DOI: 10.3390/pathophysiology30020017
Nhi Dao, Colette Cozean, Oleg Chernyshev, Clete Kushida, Jonathan Greenburg, Jonathan S Alexander
{"title":"Retrospective Analysis of Real-World Data for the Treatment of Obstructive Sleep Apnea with Slow Maxillary Expansion Using a Unique Expansion Dental Appliance (DNA).","authors":"Nhi Dao, Colette Cozean, Oleg Chernyshev, Clete Kushida, Jonathan Greenburg, Jonathan S Alexander","doi":"10.3390/pathophysiology30020017","DOIUrl":"https://doi.org/10.3390/pathophysiology30020017","url":null,"abstract":"<p><p>In addition to mandibular advancement devices, dental expansion appliances are an important clinical approach for achieving an increased intra-oral space that promotes airflow and lessens the frequency or severity of apneic events in patients diagnosed with obstructive sleep apnea (OSA). It has been thought that dental expansion in adults must be preceded by oral surgery; however, in this paper, we examine the results of a new technique for slow maxillary expansion without any surgical procedures. The palatal expansion device, DNA (Daytime-Nighttime Appliance), was reviewed in this retrospective study, particularly regarding its effects on measurements of transpalatal width, airway volume, and apnea-hypopnea indices (AHI) as well as its common modalities and complications. The DNA effectively reduced AHI by 46% (<i>p</i> = 0.00001) and significantly increased both airway volume and transpalatal width (<i>p</i> < 0.00001). After DNA treatment, 80% of patients showed some improvement in AHI scores with 28% of patients having their OSA symptoms completely resolved. Compared to the use of mandibular appliances, this approach is intended to create a sustained improvement in airway management that can reduce or eliminate dependence on continuous positive airway pressure (CPAP) or other OSA treatment devices.</p>","PeriodicalId":19852,"journal":{"name":"Pathophysiology","volume":"30 2","pages":"199-208"},"PeriodicalIF":0.0,"publicationDate":"2023-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10204354/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9870976","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
PathophysiologyPub Date : 2023-05-04DOI: 10.3390/pathophysiology30020016
Muhammad Vitanata Arfijanto, Tri Pudy Asmarawati, Bramantono Bramantono, Musofa Rusli, Brian Eka Rachman, Bagus Aulia Mahdi, Nasronudin Nasronudin, Usman Hadi
{"title":"Duration of SARS-CoV-2 RNA Shedding Is Significantly Influenced by Disease Severity, Bilateral Pulmonary Infiltrates, Antibiotic Treatment, and Diabetic Status: Consideration for Isolation Period.","authors":"Muhammad Vitanata Arfijanto, Tri Pudy Asmarawati, Bramantono Bramantono, Musofa Rusli, Brian Eka Rachman, Bagus Aulia Mahdi, Nasronudin Nasronudin, Usman Hadi","doi":"10.3390/pathophysiology30020016","DOIUrl":"https://doi.org/10.3390/pathophysiology30020016","url":null,"abstract":"<p><p>Severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2) ribonucleic acid (RNA) shedding is an important parameter for determining the optimal length of isolation period required for coronavirus disease 2019 (COVID-19) patients. However, the clinical (i.e., patient and disease) characteristics that could influence this parameter have yet to be determined. In this study, we aim to explore the potential associations between several clinical features and the duration of SARS-CoV-2 RNA shedding in patients hospitalized with COVID-19. A retrospective cohort study involving 162 patients hospitalized for COVID-19 in a tertiary referral teaching hospital in Indonesia was performed from June to December 2021. Patients were grouped based on the mean duration of viral shedding and were compared based on several clinical characteristics (e.g., age, sex, comorbidities, COVID-19 symptoms, severity, and therapies). Subsequently, clinical factors potentially associated with the duration of SARS-CoV-2 RNA shedding were further assessed using multivariate logistic regression analysis. As a result, the mean duration of SARS-CoV-2 RNA shedding was found to be 13 ± 8.44 days. In patients with diabetes mellitus (without chronic complications) or hypertension, the duration of viral shedding was significantly prolonged (≥13 days; <i>p</i> = 0.001 and <i>p</i> = 0.029, respectively). Furthermore, patients with dyspnea displayed viral shedding for longer durations (<i>p</i> = 0.011). The multivariate logistic regression analysis reveals that independent risk factors associated with the duration of SARS-CoV-2 RNA shedding include disease severity (adjusted odds ratio [aOR] = 2.94; 95% CI = 1.36-6.44), bilateral lung infiltrates (aOR = 2.79; 95% CI = 1.14-6.84), diabetes mellitus (aOR = 2.17; 95% CI = 1.02-4.63), and antibiotic treatment (aOR = 3.66; 95% CI = 1.74-7.71). In summary, several clinical factors are linked with the duration of SARS-CoV-2 RNA shedding. Disease severity is positively associated with the duration of viral shedding, while bilateral lung infiltrates, diabetes mellitus, and antibiotic treatment are negatively linked with the duration of viral shedding. Overall, our findings suggest the need to consider different isolation period estimations for specific clinical characteristics of patients with COVID-19 that affect the duration of SARS-CoV-2 RNA shedding.</p>","PeriodicalId":19852,"journal":{"name":"Pathophysiology","volume":"30 2","pages":"186-198"},"PeriodicalIF":0.0,"publicationDate":"2023-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10204499/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9568952","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
PathophysiologyPub Date : 2023-04-26DOI: 10.3390/pathophysiology30020015
Elena Zelikovna Golukhova, Inessa Viktorovna Slivneva, Inga Yur'evna Farulova, Ivan Ivanovich Skopin, Damir Ildarovich Marapov, Dar'ya Vladimirovna Murysova, Yuliya Dmitrievna Pirushkina, Irina Vasilyevna Volkovskaya
{"title":"Advantages of Multiposition Scanning in Echocardiographic Assessment of the Severity of Discordant Aortic Stenosis.","authors":"Elena Zelikovna Golukhova, Inessa Viktorovna Slivneva, Inga Yur'evna Farulova, Ivan Ivanovich Skopin, Damir Ildarovich Marapov, Dar'ya Vladimirovna Murysova, Yuliya Dmitrievna Pirushkina, Irina Vasilyevna Volkovskaya","doi":"10.3390/pathophysiology30020015","DOIUrl":"10.3390/pathophysiology30020015","url":null,"abstract":"<p><strong>Aim of the study: </strong>The aim of this study was to perform a comparative analysis of severity of discordant aortic stenosis (AS) assessment using multiposition scanning and the standard apical window.</p><p><strong>Materials and methods: </strong>All patients (<i>n</i> = 104) underwent preoperative transthoracic echocardiography (TTE) and were ranked according to the degree of AS severity. The reproducibility feasibility of the right parasternal window (RPW) was 75.0% (<i>n</i> = 78). The mean age of the patients was 64 years, and 40 (51.3%) were female. In 25 cases, low gradients were identified from the apical window not corresponding to the visual structural changes in the aortic valve, or disagreement between the velocity and calculated parameters was detected. Patients were divided into two groups: concordant AS (<i>n</i> = 56; 71.8%) and discordant AS (<i>n</i> = 22; 28.2%). Three individuals were excluded from the discordant AS group due to the presence of moderate stenosis.</p><p><strong>Results: </strong>Based on the comparative analysis of transvalvular flow velocities obtained from multiposition scanning, the concordance group showed agreement between the velocity and calculated parameters. We observed an increase in the mean transvalvular pressure gradient (ΔP<sub>mean</sub>) and peak aortic jet velocity (V<sub>max</sub>), ΔP<sub>mean</sub> in 95.5% of patients, velocity time integral of transvalvular flow (VTI AV) in 90.9% of patients, and a decrease in aortic valve area (AVA) and indexed AVA in 90.9% of patients after applying RPW in all patients with discordant AS. The use of RPW allowed the reclassification of AS severity from discordant to concordant high-gradient AS in 88% of low-gradient AS cases.</p><p><strong>Conclusion: </strong>Underestimation of flow velocity and overestimation of AVA using the apical window may lead to misclassification of AS. The use of RPW helps to match the degree of AS severity with the velocity characteristics and reduce the number of low-gradient AS cases.</p>","PeriodicalId":19852,"journal":{"name":"Pathophysiology","volume":"30 2","pages":"174-185"},"PeriodicalIF":2.7,"publicationDate":"2023-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10204481/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9870975","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}