Journal of clinical medicine research最新文献

{"title":"Botulinum Toxin Type A and Hyaluronic Acid Dermal Fillers in Dentistry: A Systematic Review of Clinical Application and Indications.","authors":"Marta Maci, Carlotta Fanelli, Mauro Lorusso, Donatella Ferrara, Marino Caroprese, Michele Laurenziello, Michele Tepedino, Domenico Ciavarella","doi":"10.14740/jocmr5202","DOIUrl":"10.14740/jocmr5202","url":null,"abstract":"<p><strong>Background: </strong>Botulinum toxin type A (BoNT-A) and hyaluronic acid (HA) dermal fillers are increasingly utilized in dentistry for therapeutic and aesthetic purposes. However, a comprehensive synthesis of their clinical applications and indications in dentistry is lacking. This systematic review aimed to analyze the clinical application and indications of BoNT-A and HA dermal fillers in dentistry, providing insights into their efficacy, safety profiles, and limitations.</p><p><strong>Methods: </strong>A systematic search was conducted in PubMed/MEDLINE databases to identify relevant studies published between 2018 and 2024. Medical Subject Headings (MeSH) terms and keywords related to BoNT-A, HA dermal fillers, dentistry, clinical applications, and indications were used. Study selection criteria included randomized controlled trials (RCTs) and non-RCTs involving human participants of any age group. Data extraction and synthesis followed established guidelines, focusing on study characteristics, participant demographics, intervention details, outcome measures, and key findings related to BoNT-A and HA dermal fillers' clinical application in dentistry.</p><p><strong>Results: </strong>Systematic searches across electronic databases and grey literature identified 857 records, with an additional 73 from hand searches. After screening titles and abstracts, 542 records were excluded, leaving 374 full-text publications for evaluation. Ultimately, 12 RCTs and 13 non-RCTs were included. The systematic review encompassed diverse geographic locations: Brazil, Italy, Spain, Syria, India, Egypt, Korea, and the Netherlands, involving samples sizes ranging from 14 to 143 participants. The review synthesized findings on HA's efficacy in various areas, including bone repair, gingivitis management, temporomandibular joint disorders, postoperative swelling reduction, periodontal defect treatment, chin and check projection and lips augmentation. BoNT-A exhibited promising efficacy in managing orofacial pain conditions, gummy smile treatment and neuromodulation of the lower third muscles. Safety profiles varied among studies, with some reporting minimal adverse effects while others noted dose-related concerns.</p><p><strong>Conclusion: </strong>BoNT-A and HA dermal fillers offer a wide array of clinical applications in dentistry, ranging from therapeutic interventions to aesthetic enhancements. Despite promising efficacy, careful consideration and monitoring of safety outcomes are essential when integrating these interventions into clinical practice. Further research addressing methodological limitations and safety concerns is warranted to optimize their utilization and improve patient care in dentistry.</p>","PeriodicalId":94329,"journal":{"name":"Journal of clinical medicine research","volume":"16 6","pages":"273-283"},"PeriodicalIF":1.6,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11254312/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141725466","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":"Clinically Evident Cardiopulmonary Congestion Does Not Significantly Impact the Prognosis of Patients With Septic Acute Kidney Injury.","authors":"Charlotte Mund, Katharina Asmus, Wajima Safi, Oliver Ritter, Dominique Petrus, Susann Patschan, Daniel Patschan","doi":"10.14740/jocmr5190","DOIUrl":"10.14740/jocmr5190","url":null,"abstract":"<p><strong>Background: </strong>Acute kidney injury (AKI) is a common issue among in-hospital patients, with high mortality rates. Sepsis is a primary cause of AKI, particularly in the intensive care unit. Patients with septic AKI often experience cardiovascular congestion, leading to the formal classification of cardiorenal syndrome type 5. The study aimed to evaluate the prognosis of septic AKI patients with and without clinical evidence of cardiovascular congestion.</p><p><strong>Methods: </strong>This was a retrospective observational study. AKI patients were identified using the in-hospital AKI alert system. Sepsis was diagnosed based on laboratory, clinical, and hemodynamic characteristics, with additional consideration of the quickSOFA score. Cardiovascular congestion was diagnosed by assessing clinical (edema), radiographic (pulmonary congestion), echocardiographic (e.g., wall motion abnormalities), and laboratory variables (e.g., N-terminal pro-B-type natriuretic peptide). Endpoints included in-hospital survival, the need for kidney replacement therapy (KRT), and recovery of kidney function (ROKF).</p><p><strong>Results: </strong>In total, 102 patients were included, and cardiopulmonary congestion was diagnosed in 78.4%. Individuals with congestion did not differ from patients without congestion in any of the pre-defined endpoints.</p><p><strong>Conclusions: </strong>It is justified not to consider clinically apparent cardiovascular congestion in septic AKI patients as a risk factor for death <i>per se</i>. Rather, especially in the case of sepsis, clinically apparent positive fluid balance does not seem to be a disadvantage in terms of survival, KRT, and ROKF.</p>","PeriodicalId":94329,"journal":{"name":"Journal of clinical medicine research","volume":"16 6","pages":"302-309"},"PeriodicalIF":1.6,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11254307/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141725467","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":"Battle of the Blocks: Which Pain Management Technique Triumphs in Gender-Affirming Bilateral Mastectomies?","authors":"Sengottaian Sivakumar, Aron Kressel, Roni Mendonca, Michael Girshin","doi":"10.14740/jocmr5159","DOIUrl":"10.14740/jocmr5159","url":null,"abstract":"<p><strong>Background: </strong>Gender-affirming mastectomy, performed on transgender men and non-binary individuals, frequently leads to considerable postoperative pain. This pain can significantly affect both patient satisfaction and the overall recovery process. The study examines the efficacy of four analgesic techniques pectoral nerve (PECS) 2 block, erector spinae plane (ESP) block, thoracic wall local anesthesia infiltration (TWI), and systemic multimodal analgesia (SMA) in managing perioperative pain, with special consideration for the effects of chronic testosterone therapy on pain thresholds.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on patients aged 18 - 45 who underwent gender-affirming bilateral mastectomies at a New York City community hospital. The study compared intraoperative and post-anesthesia care unit (PACU) opioid consumption, postoperative pain scores, the interval to first rescue analgesia, and total PACU duration among the four analgesic techniques.</p><p><strong>Results: </strong>The study found significant differences in intraoperative and PACU opioid consumption across the groups, with the PECS 2 block group showing the least opioid requirement. The PACU morphine milligram equivalent (MME) consumption was highest in the SMA group. Postoperative pain scores were significantly lower in the PECS and ESP groups at earlier time points post-surgery. However, by postoperative day 2, pain scores did not significantly differ among the groups. Chronic testosterone therapy did not significantly impact intraoperative opioid requirements.</p><p><strong>Conclusion: </strong>The PECS 2 block is superior in reducing overall opioid consumption and providing effective postoperative pain control in gender-affirming mastectomies. The study underscores the importance of tailoring pain management strategies to the unique physiological responses of the transgender and non-binary community. Future research should focus on prospective designs, standardized block techniques, and the complex relationship between hormonal therapy and pain perception.</p>","PeriodicalId":94329,"journal":{"name":"Journal of clinical medicine research","volume":"16 6","pages":"284-292"},"PeriodicalIF":1.6,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11254309/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141725465","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":"The Use of Remimazolam During Awake Craniotomy for Seizure Foci Resection in Adolescents: A Case Series.","authors":"Ashley Smith, Sidhant Kalsotra, Joseph D Tobias","doi":"10.14740/jocmr5175","DOIUrl":"10.14740/jocmr5175","url":null,"abstract":"<p><p>Remimazolam is a novel benzodiazepine with sedative, anxiolytic, and amnestic properties similar to midazolam. Metabolism by tissue esterases results in a short clinical half-life of 5 - 10 min and a limited context sensitive half-life. We present initial retrospective clinical experience with the use of remimazolam as an intraoperative adjunct to sedation during awake craniotomy in a cohort of three adolescent patients. A remimazolam infusion was added to a combination of dexmedetomidine and remifentanil to deepen the level of sedation during surgical incision, craniotomy, duraplasty, and surgical dissection for exposure of the seizure foci. The remimazolam infusion was discontinued 30 min prior to the planned awake assessments and electrophysiology testing. The patients emerged calmly and were able to follow commands for intraoperative testing. Our anecdotal experience supports the efficacy of remimazolam for awake craniotomy and tumor resection using a standard asleep-awake-asleep technique. We noted adequate sedation, maintenance of spontaneous respiration, rapid awakening, and no limitations to intraoperative neuromonitoring or awake assessment in our three patients.</p>","PeriodicalId":94329,"journal":{"name":"Journal of clinical medicine research","volume":"16 6","pages":"319-323"},"PeriodicalIF":1.6,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11254310/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141725470","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":"Comparison Between Twenty-Four-Hour Collection and Single Spot Urines for the Detection of Biogenic Amines by High-Performance Liquid Chromatography Tandem Mass Spectrometry.","authors":"Chiara Rosato, Marilena Greco, Giovanni Marciante, Roberta Assunta Lazzari, Floriano Indino, Giambattista Lobreglio","doi":"10.14740/jocmr5070","DOIUrl":"10.14740/jocmr5070","url":null,"abstract":"<p><strong>Background: </strong>Pheochromocytomas and paragangliomas (PPGL) are neuroendocrine tumors that originate from adrenal medulla or extra-adrenal chromaffin cells, respectively. They produce an excess of catecholamines and their metabolites. Abnormal levels of these biomolecules have been also found in pediatric patients with neuroblastoma (NB). Due to the diurnal fluctuation, the laboratory practice recommends the determination of biogenic amines in acidified 24-h urine samples. However, the collection and acidification of specimens cannot be performed easily, especially for children. Spot urines represent an attractive alternative for the detection of catecholamines and corresponding metabolites.</p><p><strong>Methods: </strong>In our study, we enrolled 50 patients with symptoms related to PPGL and we determined the concentration values for both spot and 24-h urine samples using high-performance liquid chromatography tandem mass spectrometry (HPLC/MS-MS). Since day variations of the urinary concentration are due to fluctuations in renal excretion rather than in production, we normalized the concentration of biogenic amines in spot urine and in 24-h urine collection to urinary creatinine concentration. A correlation study between the normalized levels of biogenic amines was performed using a linear regression analysis model and Pearson's correlation coefficients.</p><p><strong>Results: </strong>We obtained a good correlation of values which suggests an interchangeability of the 24-h and random urine samples. Only for epinephrine a weak correlation was determined.</p><p><strong>Conclusions: </strong>Our findings suggest that the sample collection as single spot urine may replace 24-h collection for the detection of urinary biogenic amines by HPLC/MS-MS.</p>","PeriodicalId":94329,"journal":{"name":"Journal of clinical medicine research","volume":"16 6","pages":"293-301"},"PeriodicalIF":1.6,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11254308/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141725468","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":"Mapping the Grounds for Mortalities in Acute Myeloid Leukemia Through Registry Analyses: A Retrospective Cohort Study of Children, Adolescents, and Young Adults Patients.","authors":"Anas Elgenidy, Mohammed Al-Mahdi Al-Kurdi, Hoda Atef Abdelsattar Ibrahim, Eman F Gad, Ahmed K Awad, Rebecca Caruana, Sheriseane Diacono, Aya Sherif, Tasneem Elattar, Islam E Al-Ghanam, Asmaa M Eldmaty, Tareq M Abubasheer, Ahmed M Afifi, Amira Elhoufey, Hamad Ghaleb Dailah, Amira M Osman, Mohamed Ezzat, Doaa Ali Gamal, Rady Elmonier, Ahmed El-Sayed Hammour, Maged T Abougabal, Khaled Saad","doi":"10.14740/jocmr5205","DOIUrl":"10.14740/jocmr5205","url":null,"abstract":"<p><strong>Background: </strong>Our objective was to identify non-malignant factors that contribute to mortality in children, adolescents and young adults, aiming to improve patient follow-up and reduce mortality rates to achieve better survival outcomes.</p><p><strong>Methods: </strong>We analyzed 8,239 acute myeloid leukemia (AML) cases diagnosed between 2000 and 2019 in the USA. Using version 8.4.0.1 of the Surveillance, Epidemiology, and End Results (SEER)*Stat software, we calculated the standardized mortality ratios (SMRs) and 95% confidence intervals (CIs) for each cause of death.</p><p><strong>Results: </strong>Out of the 3,165 deaths observed in the study population, the majority (2,245;70.9%) were attributed to AML itself, followed by non-AML cancers (573; 18.1%) and non-cancerous causes (347; 10.9%).</p><p><strong>Conclusions: </strong>Patients with AML are at a higher risk of developing other types of cancer and granulocyte deficiencies, which increases the risk of death from non-cancerous causes such as infections. Moreover, treatment for AML carries the risk of cardiac problems. AML is commoner in males than females.</p>","PeriodicalId":94329,"journal":{"name":"Journal of clinical medicine research","volume":"16 6","pages":"310-318"},"PeriodicalIF":1.6,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11254311/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141725469","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":"Efficacy and Safety of Upadacitinib Plus Intensive Granulocyte and Monocyte Adsorptive Apheresis as Induction for Intractable Ulcerative Colitis.","authors":"Satoshi Tanida, Shun Sasoh, Takahiro Otani, Yoshimasa Kubota, Tesshin Ban, Tomoaki Ando, Makoto Nakamura, Takashi Joh","doi":"10.14740/jocmr5165","DOIUrl":"10.14740/jocmr5165","url":null,"abstract":"<p><p>Monotherapy with a selective Janus kinase (JAK) inhibitor or intensive granulocyte and monocyte adsorptive apheresis (GMA) has been limited to patients with intractable ulcerative colitis (UC). No previous reports have described the efficacy including histopathological evaluations and the safety of combination therapy with upadacitinib (UPA) plus intensive GMA (two sessions per week) for intractable UC showing resistance to conventional agents and adalimumab. This retrospective study evaluated the 10-week clinical and histopathological efficacy of induction combination therapy with UPA plus intensive GMA in patients with intractable UC. Among eight patients (moderate UC, n = 1; severe UC, n = 7) who received combination therapy with UPA plus intensive GMA, 50.0% had achieved clinical remission by 10 weeks. Percentages of patients with histological-endoscopic mucosal improvement and mucosal healing at 10 weeks were 62.5% and 12.5%, respectively. After excluding one patient who discontinued treatment by week 10 because of intolerance for UPA, mean full Mayo score, endoscopic subscore and C-reactive protein concentration at baseline were 11.43 ± 0.37, 3 ± 0 and 1.29 ± 0.70 mg/dL, respectively. Corresponding values at 10 weeks were 2.28 ± 0.77 (P < 0.03), 1.14 ± 0.34 (P < 0.03) and 0.03 ± 0.008 mg/dL (P < 0.05), respectively. Adverse events of herpes zoster, temporary increase in creatinine phosphokinase and anemia were observed in one patient each. One patient discontinued combination therapy at week 4 because of temporary taste abnormality due to UPA. Combination comprising UPA plus intensive GMA appears likely to achieve satisfactory induction of clinical remission and histopathological improvement for patients with intractable UC for whom conventional agents and anti-tumor necrosis factor-α antibody have failed.</p>","PeriodicalId":94329,"journal":{"name":"Journal of clinical medicine research","volume":"16 5","pages":"256-263"},"PeriodicalIF":0.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11161188/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141297709","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":"Immune Checkpoints Receptors Expression of Macrophage/Monocytes in Response to Acute Viral Respiratory Infection.","authors":"Asmaa Zahran, Hosni A Hussein, Ali A Thabet, Mohamed R Izzaldin, Ahmed A Wardany, Ali Sobhy, Mohamed A Bashir, Magdy M Afifi, Wageeh A Ali, Amal Rayan, Khaled Saad, Mohammad Gamal Khalaf, Mahmoud Elsaeed Ahmed, Noha G Sayed","doi":"10.14740/jocmr5098","DOIUrl":"10.14740/jocmr5098","url":null,"abstract":"<p><strong>Background: </strong>We aimed to monitor the phenotypic changes in macrophages and their polarization in patients with acute viral respiratory diseases, including coronavirus disease diagnosis, focusing on the variations in the percentages of macrophages and monocytes and their sub-populations in those patients compared to healthy control. Moreover, we defined the correlation between macrophage subtypes and some inflammatory indices.</p><p><strong>Methods: </strong>Twenty-seven patients with clinical and radiologic diagnosis of acute viral respiratory infection admitted in Al-Azhar and Assiut University hospitals were recruited. Fresh peripheral blood samples were collected from all patients and healthy controls for flow cytometric analysis using BD FACSCanto II analyzer equipped with three lasers.</p><p><strong>Results: </strong>Compared to healthy controls, accumulation of cluster of differentiation (CD)11B⁺CD68⁺ macrophages (M) (P = 0.018), CD274⁺ M1 (P = 0.01), CD274⁺ M2 (P < 0.001), and CD80^-CD206⁺ M2 (P = 0.001) was more evident in patients. Moreover, CD273⁺ M2 (P = 0.03), CD80⁺CD206^- M1 (P = 0.002), and CD80⁺CD86⁺ M1 (P = 0.002) were highly expressed in controls compared with patients.</p><p><strong>Conclusion: </strong>The examination of clinical specimens obtained from patients with signs of acute respiratory viral infection showed the role of the macrophage in the immune response. Dysfunction in macrophages results in heightened immune activity and inflammation, which plays a role in the progression of viral diseases and the emergence of accompanying health issues. This malfunction in macrophages is a common characteristic seen in various viruses, making it a promising focus for antiviral therapies with broad applicability. The immune checkpoint could be a target for immune modulation in patients with severe symptoms.</p>","PeriodicalId":94329,"journal":{"name":"Journal of clinical medicine research","volume":"16 5","pages":"232-242"},"PeriodicalIF":0.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11161185/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141297710","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":"Predicting Dropout From Cognitive Behavioral Therapy for Panic Disorder Using Machine Learning Algorithms.","authors":"Sei Ogawa","doi":"10.14740/jocmr5167","DOIUrl":"10.14740/jocmr5167","url":null,"abstract":"<p><strong>Background: </strong>Attrition is an important problem in clinical practice and research. However, the predictors of dropping out from cognitive behavioral therapy (CBT) for panic disorder (PD) are not fully understood. In this study, we aimed to build a dropout prediction model for CBT for PD using machine learning (ML) algorithms.</p><p><strong>Methods: </strong>We treated 208 patients with PD applying group CBT. From baseline data, the prediction analysis was carried out using two ML algorithms, random forest and light gradient boosting machine. The baseline data included five personality dimensions in NEO Five Factor Index, depression subscale of Symptom Checklist-90 Revised, age, sex, and Panic Disorder Severity Scale.</p><p><strong>Results: </strong>Random forest identified dropout during CBT for PD showing that the accuracy of prediction was 88%. Light gradient boosting machine showed that the accuracy was 85%.</p><p><strong>Conclusions: </strong>The ML algorithms could detect dropout after CBT for PD with relatively high accuracy. For the purpose of clinical decision-making, we could use this ML method. This study was conducted as a naturalistic study in a routine clinical setting. Therefore, our results in ML approach could be generalized to regular clinical settings.</p>","PeriodicalId":94329,"journal":{"name":"Journal of clinical medicine research","volume":"16 5","pages":"251-255"},"PeriodicalIF":0.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11161187/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141297712","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":"Predictors of Premature Ventricular Contractions Development in Patients With SARS-CoV-2 Infection.","authors":"Aida I Tarzimanova, Anna E Bragina, Ekaterina E Sokolova, Tatiana S Vargina, Anna E Pokrovskaya, Tatiana A Safronova, Irakli Zh Loriya, Igor V Cherkesov, Alexander G Cherepanov, Liubov A Ponomareva, Daria D Vanina, Kseniya E Krylova, Nadezhda K Ziskina, Valery I Podzolkov","doi":"10.14740/jocmr5160","DOIUrl":"10.14740/jocmr5160","url":null,"abstract":"<p><strong>Background: </strong>Epidemiological studies have demonstrated that severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-positive patients often develop atrial fibrillation, premature ventricular contractions (PVCs), and conduction disorders. The manifestation of ventricular cardiac arrhythmias accentuates the risk of sudden cardiac death.</p><p><strong>Methods: </strong>A retrospective study was conducted on the cohort of 1,614 patients admitted for coronavirus disease 2019 (COVID-19). Patients were categorized into two groups based on the occurrence of PVCs. Group I comprised 172 patients diagnosed with PVCs of Lown-Wolf class II - IV upon hospital admission; group II (control group) consisted of 1,442 patients without this arrhythmia. Each patient underwent comprehensive clinical, laboratory, and instrumental evaluations.</p><p><strong>Results: </strong>The emergence of PVCs in individuals afflicted with COVID-19 was associated with a 5.879-fold heightened risk of lethal outcome, a 2.904-fold elevated risk of acute myocardial infarction, and a 2.437-fold increased risk of pulmonary embolism. Upon application of diagnostic criteria to evaluate the \"cytokine storm\", it was discovered that the occurrence of the \"cytokine storm\" was notably more frequent in the group with PVCs, manifesting in six patients (3.5%), compared to 16 patients (1.1%) in the control group (P < 0.05). The mean extent of lung tissue damage in group I was significantly greater than that of patients in group II (P < 0.05). Notably, the average oxygen saturation level, as measured by pulse oximetry upon hospital admission was 92.63±3.84% in group I and 94.20±3.50% in group II (P < 0.05).</p><p><strong>Conclusions: </strong>The presence of PVCs in COVID-19 patients was found to elevate the risk of cardiovascular complications. Significant independent predictors for the development of PVCs in patients with SARS-CoV-2 infection include: age over 60 years (risk ratio (RR): 4.6; confidence interval (CI): 3.2 - 6.5), a history of myocardial infarction (RR: 3.5; CI: 2.6 - 4.6), congestive heart failure (CHF) with reduced left ventricular ejection fraction (RR: 5.5; CI: 3.9 - 7.6), respiratory failure (RR: 2.3; CI: 1.7 - 3.1), and the presence of a \"cytokine storm\" (RR: 4.5; CI: 2.9 - 6.0).</p>","PeriodicalId":94329,"journal":{"name":"Journal of clinical medicine research","volume":"16 5","pages":"243-250"},"PeriodicalIF":0.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11161186/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141297713","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}