• 【与人类神经胶质瘤细胞系SNB-19获得性替莫唑胺抗性相关的遗传改变。】 复制标题 收藏 收藏
    DOI:10.1158/1535-7163.MCT-05-0428 复制DOI
    作者列表:Auger N,Thillet J,Wanherdrick K,Idbaih A,Legrier ME,Dutrillaux B,Sanson M,Poupon MF
    BACKGROUND & AIMS: :Gliomas are highly lethal neoplasms that cannot be cured by currently available therapies. Temozolomide is a recently introduced alkylating agent that has yielded a significant benefit in the treatment of high-grade gliomas. However, either de novo or acquired chemoresistance occurs frequently and has been attributed to increased levels of O6-methylguanine-DNA methyltransferase or to the loss of mismatch repair capacity. However, very few gliomas overexpress O6-methylguanine-DNA methyltransferase or are mismatch repair-deficient, suggesting that other mechanisms may be involved in the resistance to temozolomide. The purpose of the present study was to generate temozolomide-resistant variants from a human glioma cell line (SNB-19) and to use large-scale genomic and transcriptional analyses to study the molecular basis of acquired temozolomide resistance. Two independently obtained temozolomide-resistant variants exhibited no cross-resistance to other alkylating agents [1,3-bis(2-chloroethyl)-1-nitrosourea and carboplatin] and shared genetic alterations, such as loss of a 2p region and loss of amplification of chromosome 4 and 16q regions. The karyotypic alterations were compatible with clonal selection of preexistent resistant cells in the parental SNB-19 cell line. Microarray analysis showed that 78 out of 17,000 genes were differentially expressed between parental cells and both temozolomide-resistant variants. None are implicated in known resistance mechanisms, such as DNA repair, whereas interestingly, several genes involved in differentiation were down-regulated. The data suggest that the acquisition of resistance to temozolomide in this model resulted from the selection of less differentiated preexistent resistant cells in the parental tumor.
    背景与目标: : 神经胶质瘤是高度致命的肿瘤,目前可用的疗法无法治愈。替莫唑胺是最近引入的烷基化剂,在治疗高级别神经胶质瘤方面具有显着益处。然而,从头开始或获得的化学抗性经常发生,并且归因于O6-methylguanine-DNA甲基转移酶水平的升高或失配修复能力的丧失。然而,很少有神经胶质瘤过表达O6-methylguanine-DNA甲基转移酶或错配修复缺陷,这表明其他机制可能与替莫唑胺的耐药性有关。本研究的目的是从人神经胶质瘤细胞系 (SNB-19) 产生替莫唑胺抗性变体,并使用大规模基因组和转录分析来研究获得性替莫唑胺抗性的分子基础。两个独立获得的抗替莫唑胺的变体对其他烷基化剂 [1,3-双 (2-氯乙基)-1-亚硝基脲和卡铂] 没有交叉抗性,并且具有共同的遗传改变,例如2p区域的丢失和丢失染色体4和16q区域的扩增。核型改变与亲本SNB-19细胞系中先存的抗性细胞的克隆选择兼容。微阵列分析表明,17,000个基因中有78个在亲本细胞和替莫唑胺抗性变体之间差异表达。没有一个与已知的抗性机制 (例如DNA修复) 有关,而有趣的是,参与分化的几个基因被下调。数据表明,在该模型中获得对替莫唑胺的耐药性是由于在亲本肿瘤中选择了分化较少的耐药细胞。
  • 【Ro 19-3704通过独立于其血小板活化因子拮抗剂特性的机制直接抑制免疫球蛋白E依赖性介质的释放。】 复制标题 收藏 收藏
    DOI:10.1016/0014-2999(90)90018-2 复制DOI
    作者列表:Gilfillan AM,Wiggan GA,Hope WC,Patel BJ,Welton AF
    BACKGROUND & AIMS: :Rat basophilic leukemia (RBL 2H3) cells were passively sensitized by exposure to monoclonal anti-trinitrophenol mouse immunoglobulin E (anti-trinitrophenol IgE) (0.5 microgram/ml) and triggered by exposure to a sub-optimal concentration of trinitrophenol ovalbumin conjugate (5 ng/ml). At this concentration, trinitrophenol-ovalbumin increased histamine release from a basal rate of 4.8 +/- 0.5 to 28.5 +/- 4.6% and peptidoleukotrienes from less than 0.1 to 4.2 +/- 1.3 ng/10(6) cells in the activated cells. Ro 19-3704 and Ro 19-1400, platelet activating factor (PAF) antagonists which are structural analogs of PAF, potently inhibited both the IgE-dependent release of histamine (IC50 values of 3.0 and 3.6 microM, respectively) and LT release (IC50 values of 5.0 microM for both compounds) from the cells. These effects appeared to be independent to the ability of the compounds to act as PAF antagonists since PAF on its own had no effect on mediator release, and WEB 2086 and BN 52021, structurally distinct PAF antagonists, were relatively ineffective as inhibitors of mediator release. Ro 19-3704 and Ro 19-1400 were observed to be potent inhibitors of the soluble phospholipase A2 activity in synovial fluid from rheumatoid arthritic patients (IC50 values of 6.5 and 8.4 microM, respectively). In contrast, WEB 2086 and BN 52021 had no effect on this phospholipase A2. Ro 19-3704 significantly inhibited the IgE-dependent formation of inositol phosphates in RBL 2H3 cells (IC50 value of 7.0 microM). These data suggest that the mediator release inhibitory action of these compounds may be related to the ability of these compounds to inhibit phospholipase A2 and/or phospholipase C.
    背景与目标: : 大鼠嗜碱性白血病 (rbl2h3) 细胞通过暴露于单克隆抗三硝基酚小鼠免疫球蛋白E (抗三硝基酚IgE) (0.5微克/毫升) 而被动致敏,并通过暴露于次优浓度的三硝基酚卵白蛋白缀合物 (5 ng/毫升) 而触发。在该浓度下,三硝基苯酚-卵清蛋白在活化细胞中增加组胺释放,从4.8 +/- 0.5的基础速率增加到28.5 +/- 4.6%,肽白三烯从小于0.1增加到4.2 +/- 1.3 ng/10(6) 细胞。血小板活化因子 (PAF) 拮抗剂Ro 19-3704和Ro 19-1400是PAF的结构类似物,可有效抑制组胺的IgE依赖性释放 (3.0和3.6 microM的IC50值,分别) 和LT从细胞释放 (两种化合物的5.0微米的IC50值)。这些作用似乎与化合物作为PAF拮抗剂的能力无关,因为PAF本身对介质释放没有影响,并且结构上不同的PAF拮抗剂WEB 2086和BN 52021作为介质释放的抑制剂相对无效。观察到Ro 19-3704和Ro 19-1400是类风湿关节炎患者滑液中可溶性磷脂酶A2活性的有效抑制剂 (IC50值分别为6.5和8.4 microM)。相反,WEB 2086和BN 52021对该磷脂酶a2没有影响。Ro 19-3704显著抑制RBL 2H3细胞中肌醇磷酸盐的IgE依赖性形成 (7.0 microM的IC50值)。这些数据表明,这些化合物的介体释放抑制作用可能与这些化合物抑制磷脂酶A2和/或磷脂酶C的能力有关。
  • 【儿童犯罪的预测因素: 一项为期19年的男孩纵向流行病学研究的结果。】 复制标题 收藏 收藏
    DOI:10.1177/1087054712461934 复制DOI
    作者列表:Young S,Taylor E,Gudjonsson G
    BACKGROUND & AIMS: OBJECTIVE:To examine the relative contribution of hyperactivity, conduct, and emotional problems in predicting criminal offending. METHOD:In all, 173 boys aged 6 to 8 years (assessed for hyperactivity, conduct, and emotional problems) were followed up 19 years later by examining criminal offense histories. RESULTS:Significant main effects for total and violent convictions were found, the strongest being for violent criminal offenses. Conduct problems predicted general offending (irrespective of the type of conviction), whereas emotional problems were the single best predictor of violent convictions. Hyperactivity was not a significant predictor in the models. CONCLUSION:The findings provide insight into the developmental mechanisms that mediate criminal behavior by showing that childhood emotional problems independently contribute to the risk of violent offending in later life.
    背景与目标:
  • 【完整膜蛋白的氟-19 NMR与gpcr的研究有关。】 复制标题 收藏 收藏
    DOI:10.1016/j.sbi.2013.07.011 复制DOI
    作者列表:Didenko T,Liu JJ,Horst R,Stevens RC,Wüthrich K
    BACKGROUND & AIMS: :Fluorine-19 is a spin-½ NMR isotope with high sensitivity and large chemical shift dispersion, which makes it attractive for high resolution NMR spectroscopy in solution. For studies of membrane proteins it is further of interest that (19)F is rarely found in biological materials, which enables observation of extrinsic (19)F labels with minimal interference from background signals. Today, after a period with rather limited use of (19)F NMR in structural biology, we witness renewed interest in this technology for studies of complex supramolecular systems. Here we report on recent (19)F NMR studies with the G protein-coupled receptor family of membrane proteins.
    背景与目标: : 氟-19是一种自旋-½ NMR同位素,具有高灵敏度和大的化学位移分散性,这使其对溶液中的高分辨率NMR光谱具有吸引力。对于膜蛋白的研究,进一步令人感兴趣的是,在生物材料中很少发现 (19)F,这使得可以在背景信号干扰最小的情况下观察外部 (19)F标记。如今,在结构生物学中使用 (19)F NMR相当有限的时期之后,我们见证了对该技术对复杂超分子系统研究的新兴趣。在这里,我们报告了最近 (19)F NMR研究,其中包括膜蛋白的g蛋白偶联受体家族。
  • 【标准ISO 15189对CA 19-9/GI监视器测量的难题有用吗?】 复制标题 收藏 收藏
    DOI:10.1515/CCLM.2007.134 复制DOI
    作者列表:Dorizzi RM,Meneghelli S,Rocca M,Ferrari A
    BACKGROUND & AIMS: -2
    背景与目标: -2
  • 【关于制备用于COVID-19患者治疗的免疫血浆的立场论文。】 复制标题 收藏 收藏
    DOI:10.1016/j.transci.2020.102817 复制DOI
    作者列表:Accorsi P,Berti P,de Angelis V,De Silvestro G,Mascaretti L,Ostuni A,Italian Society for Transfusion Medicine Immunohaematology (SIMTI) Italian Society for Hemapheresis cell Manipulation (SIdEM).
    BACKGROUND & AIMS: :Passive immunotherapy with plasma derived from patients convalescent from SARS-CoV-2 infection can be a promising approach in the treatment of COVID-19 patients. It is important that Blood Establishments are prepared to satisfy requests for immune plasma by defining the requirements applicable to plasma donors and the standards for preparation, qualification, storage, distribution and control of use of the product. This position paper is aimed to give recommendations on biological characteristics of a plasma preparation from convalescent donors and to support the evaluation of this therapeutic approach in more rigorous investigations.
    背景与目标: : SARS-CoV-2感染恢复期患者血浆被动免疫治疗可能是新型冠状病毒肺炎患者的一种有前途的方法。重要的是,通过定义适用于血浆供体的要求以及产品的制备,鉴定,储存,分配和使用控制的标准,血液机构应准备满足免疫血浆的要求。本文旨在就恢复期供体血浆制剂的生物学特性提出建议,并支持在更严格的研究中对这种治疗方法的评估。
  • 【新型冠状病毒肺炎爆发期间沉浸在急诊科分诊中心: 列日大学医院经历的第一份报告。】 复制标题 收藏 收藏
    DOI:10.1080/17843286.2020.1778348 复制DOI
    作者列表:Gilbert A,Brasseur E,Petit M,Donneau AF,Diep A,Hetzel Campbell S,Servotte JC,Piazza J,Ancion A,Gensburger M,D'Orio V,Ghuysen A
    BACKGROUND & AIMS: OBJECTIVES:Since the beginning of the novel coronavirus outbreak, different strategies have been explored to stem the spread of the disease and appropriately manage patient flow. Triage, an effective solution proposed in disaster medicine, also works well to manage Emergency Department (ED) flow. The aim of this study was to describe the role of an ED Triage Center for patients with suspected novel coronavirus disease (Covid-19) and characterize the patient flow. METHODS:In March 2020, we established a Covid-19 triage center close to the Liège University EDs. From March 2 to March 23, we planned to analyze the specific flow of patients admitted to this triage zone and their characteristics in terms of inner specificities, work-up and management. During this period, all patients presented to the ED with symptoms suggestive of Covid-19 were included in the study. RESULTS:A total amount of 1071 patients presented to the triage center during the study period. 41.50% of the patients presented with flu-like symptoms. In 82.00% of the cases, no risk factor of virus transmission was found. The SARS-Cov2 positive patients represented 29.26% of the screened patients. 83.00% of patients were discharged home while 17.00% were admitted to the hospital. CONCLUSION:Our experience suggests that triage centers for the assessment and management of Covid-19 suspected patients is an essential key strategy to prevent the spread of the disease among non-symptomatic patients who present to the EDs for care. This allows for a disease-centered work-up and safer diversion of Covid-19 patients to specific hospital units.
    背景与目标:
  • 【新型冠状病毒肺炎和流感的合并感染是低报告还是低报告?一项观察性研究检查了当前已发表的文献,包括三个新的未发表的病例。】 复制标题 收藏 收藏
    DOI:10.1002/jmv.26167 复制DOI
    作者列表:Antony SJ,Almaghlouth NK,Heydemann EL
    BACKGROUND & AIMS: :As the coronavirus disease-2019 (COVID-19) pandemic continues, one major point of uncertainty is the impact this novel pathogen will have during the upcoming 2020 to 2021 flu season. While the influenza virus is a known contributor to human morbidity and mortality, the question of how a coinfection between COVID-19 and influenza might manifest is of utmost concern. The aim of this study was to review the limited cases of COVID-19/influenza coinfection currently available in the literature, along with cases in the community of El Paso, TX, to determine whether any patterns of clinical presentation and morbidity emerged. An international review of the literature was conducted. Six published articles describing COVID-19/influenza coinfection were identified, with a total of 13 patients described therein. Three additional patients were identified from the El Paso, TX data. The most common presenting symptoms were fever and cough. The most common laboratory findings were elevated C-reactive protein and lymphocytopenia. Thirteen patients presented with viral pneumonia findings on CT, and nine had findings of ground-glass opacity. Finally, complications were reported in six patients, with most common complication being acute respiratory distress syndrome. The results of the review indicate that, due to the similarity in presentation between COVID-19 and influenza, further analysis will be required to understand the effects of coinfection on morbidity and mortality. However, the limited number of coinfection cases in the literature indicates that the implementation of COVID-19 control measures may continue to play a role in limiting the spread of these human respiratory pathogens.
    背景与目标: : 随着冠状病毒病2019 (新型冠状病毒肺炎) 大流行的继续,一个主要的不确定性点是这种新型病原体在即将到来的2020 2021年流感季节将产生的影响。虽然流感病毒是人类发病率和死亡率的已知因素,新型冠状病毒肺炎和流感之间的共同感染如何表现的问题是最令人担忧的。这项研究的目的是回顾目前文献中有限新型冠状病毒肺炎/流感共感染病例,以及德克萨斯州埃尔帕索社区的病例,以确定是否出现任何临床表现和发病率模式。对文献进行了国际审查。确定了六篇描述新型冠状病毒肺炎/流感共感染的已发表文章,其中总共描述了13名患者。从德克萨斯州埃尔帕索的数据中发现了另外三名患者。最常见的症状是发热和咳嗽。最常见的实验室检查结果是C反应蛋白升高和淋巴细胞减少。13例患者在CT上表现为病毒性肺炎,9例出现毛玻璃混浊。最后,有6例患者报告了并发症,其中最常见的并发症是急性呼吸窘迫综合征。审查结果表明新型冠状病毒肺炎和流感在表现上的相似性,需要进一步分析以了解合并感染对发病率和死亡率的影响。然而,文献中合并感染病例的数量有限,这表明新型冠状病毒肺炎控制措施的实施可能继续在限制这些人类呼吸道病原体的传播方面发挥作用。
  • 【新型冠状病毒肺炎大流行: 增长模式、幂律缩放和饱和度。】 复制标题 收藏 收藏
    DOI:10.1088/1478-3975/ab9bf5 复制DOI
    作者列表:Singer HM
    BACKGROUND & AIMS: :More and more countries are showing a significant slowdown in the number of new COVID-19 infections due to effective governmentally instituted lockdown and social distancing measures. We have analyzed the growth behavior of the top 25 most affected countries by means of a local slope analysis and found three distinct patterns that individual countries follow depending on the strictness of the lockdown protocols: rise and fall, power law, or logistic. For countries showing power law growth we have determined the scaling exponents. For countries that showed a strong slowdown in the rate of infections we have extrapolated the expected saturation of the total number of infections and the expected final date. Three different extrapolation methods (logistic, parabolic, and cutoff power law) were used. All methods agree on the order of magnitude of saturation and end dates. Global infection rates are analyzed with the same methods. The relevance and accuracy of these extrapolations is discussed.
    背景与目标: : 由于政府制定的有效封锁和社会疏远措施,越来越多的国家显示出新新型冠状病毒肺炎感染人数显著放缓。我们通过局部斜率分析分析了受影响最严重的前25个国家的增长行为,并根据锁定协议的严格性发现了各个国家遵循的三种不同模式: 兴衰,幂律或逻辑。对于显示幂律增长的国家,我们已经确定了比例指数。对于感染率大幅放缓的国家,我们推断了感染总数的预期饱和度和预期的最终日期。使用了三种不同的外推方法 (逻辑,抛物线和截止幂定律)。所有方法都在饱和度和结束日期的数量级上达成一致。用相同的方法分析全球感染率。讨论了这些外推的相关性和准确性。
  • 【不同严重程度和过敏状态的182例新型冠状病毒肺炎患者的临床特征。】 复制标题 收藏 收藏
    DOI:10.1111/all.14452 复制DOI
    作者列表:Du H,Dong X,Zhang JJ,Cao YY,Akdis M,Huang PQ,Chen HW,Li Y,Liu GH,Akdis CA,Lu XX,Gao YD
    BACKGROUND & AIMS: BACKGROUND:The pandemic of coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection has made widespread impact recently. We aim to investigate the clinical characteristics of COVID-19 children with different severities and allergic status. METHODS:Data extracted from the electronic medical records, including demographics, clinical manifestations, comorbidities, laboratory and immunological results, and radiological images of 182 hospitalized COVID-19 children, were summarized and analyzed. RESULTS:The median age was 6 years, ranging from 3 days to 15 years, and there were more boys (male-female ratio about 2:1) within the studied 182 patients. Most of the children were infected by family members. Fever (43.4%) and dry cough (44.5%) were common symptoms, and gastrointestinal manifestations accounted for 11.0%, including diarrhea, abdominal discomfort, and vomiting. 71.4% had abnormal chest computed tomography (CT) scan images, and typical signs of pneumonia were ground-glass opacity and local patchy shadowing on admission. Laboratory results were mostly within normal ranges, and only a small ratio of lymphopenia (3.9%) and eosinopenia (29.5%) were observed. The majority (97.8%) of infected children were not severe, and 24 (13.2%) of them had asymptomatic infections. Compared to children without pneumonia (manifested as asymptomatic and acute upper respiratory infection), children with pneumonia were associated with higher percentages of the comorbidity history, symptoms of fever and cough, and increased levels of serum procalcitonin, alkaline phosphatase, and serum interleukins (IL)-2, IL-4, IL-6, IL-10, and TNF-α. There were no differences in treatments, duration of hospitalization, time from first positive to first negative nucleic acid testing, and outcomes between children with mild pneumonia and without pneumonia. All the hospitalized COVID-19 children had recovered except one death due to intussusception and sepsis. In 43 allergic children with COVID-19, allergic rhinitis (83.7%) was the major disease, followed by drug allergy, atopic dermatitis, food allergy, and asthma. Demographics and clinical features were not significantly different between allergic and nonallergic groups. Allergic patients showed less increase in acute phase reactants, procalcitonin, D-dimer, and aspartate aminotransferase levels compared with all patients. Immunological profiles including circulating T, B, and NK lymphocyte subsets, total immunoglobulin and complement levels, and serum cytokines did not show any difference in allergic and pneumonia groups. Neither eosinophil counts nor serum total immunoglobulin E (IgE) levels showed a significant correlation with other immunological measures, such as other immunoglobulins, complements, lymphocyte subset numbers, and serum cytokine levels. CONCLUSION:Pediatric COVID-19 patients tended to have a mild clinical course. Patients with pneumonia had higher proportion of fever and cough and increased inflammatory biomarkers than those without pneumonia. There was no difference between allergic and nonallergic COVID-19 children in disease incidence, clinical features, and laboratory and immunological findings. Allergy was not a risk factor for developing and severity of SARS-CoV-2 infection and hardly influenced the disease course of COVID-19 in children.
    背景与目标:
  • 【更正: 肺对比增强超声 (CEUS) 揭示新型冠状病毒肺炎患者的多个微血栓区域。】 复制标题 收藏 收藏
    DOI:10.1007/s00134-020-06148-6 复制DOI
    作者列表:Tee A,Wong A,Yusuf GT,Rao D,Sidhu PS
    BACKGROUND & AIMS: :The original version of this article unfortunately contained two mistakes.
    背景与目标: : 这篇文章的原始版本不幸包含两个错误。
  • 【新型冠状病毒肺炎的肺外和非典型临床表现。】 复制标题 收藏 收藏
    DOI:10.1002/jmv.26157 复制DOI
    作者列表:Abobaker A,Raba AA,Alzwi A
    BACKGROUND & AIMS: :The novel coronavirus (SARS-CoV2) has led to an outbreak of multiple cases of pneumonia in Wuhan city in December 2019. The disease caused by this virus was named coronavirus disease 2019 or "COVID-19", which was declared by the World Health Organization as a global pandemic in March 2020. It typically presents with respiratory symptoms and febrile illness. However, there are few reported extrapulmonary and atypical presentations, such as hemoptysis, cardiac, neurological, gastrointestinal, ocular, and cutaneous manifestations, as well as venous and arterial thrombosis. Lack of awareness of these presentations might lead to misdiagnosis, delayed diagnosis, and isolation of suspected patients which increases the risk of transmission of infection between patients and doctors. All these issues will be discussed in this review.
    背景与目标: : 新型冠状病毒 (SARS-CoV2) 导致2019年12月武汉市爆发多例肺炎。该病毒引起的疾病被命名为冠状病毒病2019或新型冠状病毒肺炎 ”,被世界卫生组织宣布为2020年3月全球大流行。它通常表现为呼吸道症状和发热性疾病。然而,很少有报道的肺外和非典型表现,例如咯血,心脏,神经,胃肠道,眼部和皮肤表现,以及静脉和动脉血栓形成。缺乏对这些表现的认识可能会导致误诊,延迟诊断和可疑患者的隔离,从而增加患者与医生之间传播感染的风险。所有这些问题都将在本次审查中讨论。
  • 【健康科学之外新型冠状病毒肺炎大流行: 对其社会决心的思考。】 复制标题 收藏 收藏
    DOI:10.1590/1413-81232020256.1.11532020 复制DOI
    作者列表:Souza DO
    BACKGROUND & AIMS: :This paper aims to perform a theoretical reflection on the historical-social foundations of the COVID-19 pandemic. The "capital worldization", "capital-imperialism", "space-time compression", and "structural crisis of capital" categories are conjured from the historical materialistic-theoretical matrix, outlining a course that transcends the limits of Health Sciences to understand global health, of which the COVID-19 pandemic is an expression. We then return to the field of health, when the category of "social determination of health" allows elucidating the bases of the pandemic studied. We show that, other elements typical of the current phase of contemporary capitalism have become universal besides the SARS-CoV-2 characteristics or the dynamics of the rapid movement of people and objects around the world, unifying the health social determination process. :Este artigo possui o objetivo de realizar uma reflexão teórica sobre os fundamentos histórico-sociais da pandemia de COVID-19. A partir da matriz teórica materialista histórica, evoca-se as categorias da “mundialização do capital”, “capital-imperialismo”, “compressão espaço-tempo” e “crise estrutural do capital” traçando um percurso que ultrapassa os limites das Ciências da Saúde a fim de entender a saúde global, da qual a pandemia de COVID-19 é expressão. Posteriormente, faz-se o retorno ao campo da saúde, quando a categoria da “determinação social da saúde” permite elucidar as bases da pandemia estudada. Demonstra-se que, para além das características próprias do SARS-CoV-2 ou da dinâmica de rápido trânsito de pessoas e objetos pelo mundo, há outros elementos típicos da atual fase do capitalismo contemporâneo que se tornaram universais, unificando o processo de determinação social da saúde.
    背景与目标:
  • 【在标准护理中添加羟氯喹是否对降低新型冠状病毒肺炎患者的死亡率有任何益处?: 系统评价。】 复制标题 收藏 收藏
    DOI:10.1007/s11481-020-09930-x 复制DOI
    作者列表:Patel TK,Barvaliya M,Kevadiya BD,Patel PB,Bhalla HL
    BACKGROUND & AIMS: :Hydroxychloroquine has been promoted for its use in treatment of COVID-19 patients based on in-vitro evidences. We searched the databases to include randomized and observational studies evaluating the effect of Hydroxychloroquine on mortality in COVID-19 patients. The outcome was summarized as odds ratios (OR) with a 95% confidence interval (CI).We used the inverse-variance method with a random effect model and assessed the heterogeneity using I2 test. We used ROBINS-I tool to assess methodological quality of the included studies. We performed the meta-analysis using 'Review manager software version 5.3'. We identified 6 observationalstudies satisfying the selection criteria. In all studies, Hydroxychloroquine was given as add on to the standard care and effect was compared with the standard care alone. A pooled analysis observed 251 deaths in 1331 participants of the Hydroxychloroquine arm and 363 deaths in 1577 participants of the control arm. There was no difference in odds of mortality events amongst Hydroxychloroquine and supportive care arm [1.25 (95% CI: 0.65, 2.38); I2 = 80%]. A similar trend was observed with moderate risk of bias studies [0.95 (95% CI: 0.44, 2.06); I2 = 85%]. The odds of mortality were significantly higher in patients treated with Hydroxychloroquine + Azithromycin than supportive care alone [2.34 (95% CI: 1.63, 3.34); I2 = 0%]. A pooled analysis of recently published studies suggests no additional benefit for reducing mortality in COVID-19 patients when Hydroxychloroquine is given as add-on to the standard care. Graphical Abstract.
    背景与目标: : 基于体外证据,羟氯喹已被推广用于新型冠状病毒肺炎患者。我们搜索了数据库,包括评估羟氯喹对新型冠状病毒肺炎患者死亡率影响的随机和观察性研究。结果总结为具有95% 置信区间 (CI) 的优势比 (OR)。我们使用具有随机效应模型的逆方差方法,并使用I2检验评估异质性。我们使用ROBINS-I工具评估纳入研究的方法学质量。我们使用 “审查管理器软件版本5.3” 进行了荟萃分析。我们确定了6项符合选择标准的观察性研究。在所有研究中,将羟氯喹作为标准护理的补充,并将效果与单独的标准护理进行比较。汇总分析观察到羟氯喹组1331例参与者的251例死亡和对照组1577例参与者的363例死亡。羟氯喹和支持性护理组的死亡事件发生率无差异 [1.25 (95% CI: 0.65,2.38); I2 =   80%]。在中等偏倚风险研究中观察到类似的趋势 [0.95 (95% CI: 0.44,2.06); I2 =   85%]。羟氯喹 + 阿奇霉素治疗患者的死亡率显著高于单独支持治疗 [2.34 (95% CI: 1.63,3.34); I2 =   0%]。对最近发表的研究的汇总分析表明,当羟氯喹作为标准护理的补充时,对于降低新型冠状病毒肺炎患者的死亡率没有额外的益处。图形摘要。
  • 【≥ 80  岁COVID-19患者的临床特征及预后因素。】 复制标题 收藏 收藏
    DOI:10.1111/ggi.13960 复制DOI
    作者列表:Covino M,De Matteis G,Santoro M,Sabia L,Simeoni B,Candelli M,Ojetti V,Franceschi F
    BACKGROUND & AIMS: AIM:The aim of the present study was to describe the clinical presentation of patients aged ≥80 years with coronavirus disease 2019 (COVID-19), and provide insights regarding the prognostic factors and the risk stratification in this population. METHODS:This was a single-center, retrospective, observational study, carried out in a referral center for COVID-19 in central Italy. We reviewed the clinical records of patients consecutively admitted for confirmed COVID-19 over a 1-month period (1-31 March 2020). We excluded asymptomatic discharged patients. We identified risk factors for death, by a uni- and multivariate Cox regression analysis. To improve model fitting and hazard estimation, continuous parameters where dichotomized by using Youden's index. RESULTS:Overall, 69 patients, aged 80-98 years, met the inclusion criteria and were included in the study cohort. The median age was 84 years (82-89 years is interquartile range); 37 patients (53.6%) were men. Globally, 14 patients (20.3%) presented a mild, 30 (43.5%) a severe and 25 (36.2%) a critical COVID-19 disease. A total of 23 (33.3%) patients had died at 30 days' follow up. Multivariate Cox regression analysis showed that severe dementia, pO2 ≤90 at admission and lactate dehydrogenase >464 U/L were independent risk factors for death. CONCLUSIONS:The present data suggest that risk of death could be not age dependent in patients aged ≥80 years, whereas severe dementia emerged is a relevant risk factor in this population. Severe COVID-19, as expressed by elevated lactate dehydrogenase and low oxygen saturation at emergency department admission, is associated with a rapid progression to death in these patients. Geriatr Gerontol Int 2020; ••: ••-••.
    背景与目标:

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