Reza Jafarzadeh Esfehani; Mohammad ali khalilifar; Hadi Esmaeili Gouvarchinghaleh; Gholam Hossein Alishiri; Alireza Shahriary
Abstract
Introduction: Among various proposed pathologic mechanisms during the coronavirus disease 2019 (COVID-19) pandemic, overproduction of autoantibodies is not widely studied. Antiphospholipid antibodies (aPLs), target proteins with an affinity toward charged phospholipids, are thought to have pro-thrombotic ...
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Introduction: Among various proposed pathologic mechanisms during the coronavirus disease 2019 (COVID-19) pandemic, overproduction of autoantibodies is not widely studied. Antiphospholipid antibodies (aPLs), target proteins with an affinity toward charged phospholipids, are thought to have pro-thrombotic potentials and are mainly elevated during thromboembolism. The present systematic review and meta-analysis aimed to evaluate the relationship between serum aPLs level and COVID-19 mortality, severity, and thrombotic events.Material and methods: We designed our search strategy to evaluate all open access published articles in Medline, Scopus and Google Scholar. Studies evaluating individuals older than 18 years of age who were diagnosed with COVID-19 and reported to have positive aPLs results; and provided data on mortality or thrombotic events were included. Results: Five hundred and twelve articles identified according to the study search protocol and twenty-two studies were finally included. A total of Among the entire study population in 22 studies, 1462 patients were evaluated for aPLs and the prevalence of positive was 48.1%. Among 372 patients with positive aPLs, 156 patients (41.9%) had severe disease and aPLs positivity was related to severe disease (p<0.05). Also, a hundred and forty-eight out of 561 patients (26.3%) with positive aPLs developed thrombotic events and aPLs positivity was related to the development of thrombotic events (p=0.03). Moreover, aPLs positivity was related to anytime mortality in COVID-19 patients (p=0.01).Conclusion: The present review demonstrated that aPLs are linked to COVID-19 severity and thrombotic events but not short-term mortality. Further studies with longer follow up periods are warranted.
Alireza Sedaghat; Ali Ahmadabadi; Seyed Hassan Tavousi; Benyamin Fazli; Mahmood Khorsand; Bita Mirzaie Feyzabadi
Abstract
Background: Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are rare, but potentially life-threatening reactions to medications. Both conditions have significant morbidity and mortality. This study aimed to document the epidemiological features, aetiologies, treatment and clinical ...
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Background: Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are rare, but potentially life-threatening reactions to medications. Both conditions have significant morbidity and mortality. This study aimed to document the epidemiological features, aetiologies, treatment and clinical outcomes of such patients.Method: In this retrospective cross-sectional study the records of all patients with TEN treated for5 years in central Hospital, Mashhad, Iran were reviewed. Results: Thirty-four patients were studied with a mean age of 26.5 years. Mean age in the mortality and survivors groups was 33.6 and 25.3 years, respectively. Drugs accounted for all 34 cases were including Anti-convulsants (52.9%) other the most common implicated drug followed by antibiotics (26.5%), allopurinol (5.9%) and multiple drugs (anticonvulsants plus antibiotics) (14.7%). Antibiotics had the shortest interval between ingestion time and onset of symptoms. The mean ICU length of stay was 12.7 days, with a range of 1 to 30 days. The mean of SCORTEN was 2.3; it was 3.3 and 2.1 in the mortality and survivors group, respectively (P=0.001).All 34 TEN cases were given intravenous immunoglobulins (IVIG). Six patients with TEN died (17.6%). The highest mortality was found in the allopurinol group with 50%, whereas anticonvulsants and antibiotics had a mortality rate of 16.6% and 15.3%, respectively.Conclusion: Anti-convulsants especially Lamotrigine were the most frequently implicated drug, followed by antibiotics and allopurinol. IVIG was shown beneficial effects in TEN syndrome.
Mostafa Dastani
Abstract
Cardiovascular is the major cause of death in chronic kidney disease and end-stage renal disease. The cardiovascular mortality rate of patients with renal impairment is evaluated to be higher than general population. Coronary artery disease seems to be an important type of cardiovascular complication ...
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Cardiovascular is the major cause of death in chronic kidney disease and end-stage renal disease. The cardiovascular mortality rate of patients with renal impairment is evaluated to be higher than general population. Coronary artery disease seems to be an important type of cardiovascular complication among patients with chronic kidney disease and end-stage renal disease before the renal replacement therapy. Due to the strong association between chronic kidney disease and the incidence of coronary artery disease, accurate screening, diagnosis, and management of cardiovascular complications would be essential in patients at different stages of renal dysfunction. Despite the need for the comprehensive knowledge about different aspects of coronary artery disease in patients with renal failure, there is not sufficient evidence regarding the pathophysiology, ideal diagnosis, and treatment strategies for coronary heart disease in population with chronic kidney disease. In this study, we briefly reviewed the existing literatures about the possible screening, diagnosis, and the treatment approaches of risk of coronary heart disease in patients with kidney dysfunction.
Farideh Akhlaghi; Mahnaz Akhondzadeh
Abstract
Pre-gestational diabetes mellitus affects less than 1% of all pregnancies and is a significant cause of fetal morbidity and mortality. It is hypothesized that impaired placental function, in the form of abnormal placental weight and/or abnormal placental histology, may be responsible for this event in ...
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Pre-gestational diabetes mellitus affects less than 1% of all pregnancies and is a significant cause of fetal morbidity and mortality. It is hypothesized that impaired placental function, in the form of abnormal placental weight and/or abnormal placental histology, may be responsible for this event in such pregnancies. Delayed villous maturation of placental villi, which is one of the findings associated with pre-gestational diabetes increases the rate of perinatal mortality. There is limited literature regarding the delayed maturation of placental villous. This review included trials (randomized and non-randomized), cohort and case-control studies registered in Medline/PubMed database, from January 2001 to September 2012 that evaluated the clinical significance of delayed villous maturation and its prevalence in pre-gestational diabetic cases compared to normal pregnancies.It emphasizes that further studies with focus on possible clinical or ultrasound markers of placental delayed villous maturation, especially in a high risk-group such as women with pre-gestational diabetes mellitus are highly recommended.