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Cardiovascular disease as part of Long COVID: A systematic review.
Get PDFBACKGROUND
Long COVID syndrome has had a major impact on million patients' lives worldwide. The cardiovascular system is an important aspect of this multifaceted disease that may manifest in many ways. We have hereby performed a narrative review in order to identify the extent of the cardiovascular manifestations of the Long COVID syndrome.
METHODS AND RESULTS
An in-depth systematic search of the literature has been conducted for this narrative review. The systematic search of PubMed and Cochrane databases yielded 3,993, of which 629 underwent full text screening. A total of 78 studies were included in the final qualitative synthesis and data evaluation. The pathophysiology of the cardiovascular sequelae of Long COVID syndrome and the cardiac manifestations and complications of Long COVID syndrome are critically evaluated. In addition, potential cardiovascular risk factors are assessed, and preventive methods and treatment options are examined in this review.
CONCLUSIONS
This systematic review poignantly summarises the evidence from the available literature regarding the cardiovascular manifestations of Long COVID syndrome and reviews potential mechanistic pathways, diagnostic approaches, preventive measures and treatment options
Development and external validation of a home-based risk predicTion modEl of natUral onseT of menopAuse -TEUTA.
Get PDFOBJECTIVE
To develop and externally validate a 10-year risk prediction model of natural onset of menopause using ready-to-use predictors.
DESIGN
Population-based prospective cohort study.
PARTICIPANTS
Community-dwelling, premenopausal women aged 28 years and older enrolled in the Swiss (CoLaus) and Dutch (PREVEND) study.
MAIN OUTCOME MEASURE
Incidence of self-reported natural menopause.
MODEL DEVELOPMENT
Based on existing literature, 11 predictors were tested in this study. The CoLaus cohort was used to develop the model by applying the backward-elimination approach and Bayesian Model Averaging. Internal validation was performed by bootstrapping. External validation was performed using data from the PREVEND cohort and recalibrating the baseline survival estimate. C-statistic, calibration slopes, and expected/observed probabilities were calculated as measures of model internal and/or external performances.
RESULTS
The final analysis included 750 and 1032 premenopausal women from the CoLaus and the PREVEND cohort, respectively. Among them, 445 (59%) from CoLaus and 387 (38%) from PREVEND experienced menopause over a median follow-up of 10.7 and 9 years, respectively. The final model included age, alcohol consumption, smoking status, education level, and systolic blood pressure. Upon external calibration in the PREVEND cohort, the model exhibited good discrimination, with a C-statistic of 0.888 and an expected/observed probability of 0.82.
CONCLUSIONS
We present the first internally and externally validated prediction model of natural menopause onset using readily available predictors. Validation of our model to other populations is needed
Potential immunological triggers for narcolepsy and idiopathic hypersomnia: Real-world insights on infections and influenza vaccinations.
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It is hypothesized that narcolepsy type 1 (NT1) develops in genetically susceptible people who encounter environmental triggers leading to immune-mediated hypocretin-1 deficiency. The pathophysiologies of narcolepsy type 2 (NT2) and idiopathic hypersomnia (IH) remain unknown. The main aim of this study was to collect all reported immunological events before onset of a central disorder of hypersomnolence.
METHODS
Medical records of 290 people with NT1, and 115 with NT2 or IH were retrospectively reviewed to extract infection and influenza vaccination history. Prevalence, distribution of immunological events, and time until hypersomnolence onset were compared between NT1 and the combined group of NT2 and IH.
RESULTS
Immunological events were frequently reported before hypersomnolence disorder onset across groups. Flu and H1N1 influenza vaccination were more common in NT1, and Epstein-Barr virus and other respiratory and non-respiratory infections in NT2 and IH. Distributions of events were comparable between NT2 and IH. Rapid symptom onset within one month of infection was frequent across groups, especially after flu infection in NT1. Hypersomnolence disorder progression after an immunological event was reported in ten individuals.
CONCLUSIONS
Our findings suggest a variety of immunological triggers potentially related to NT1, including H1N1 influenza infection or vaccination, infection with other flu types, and other respiratory and non-respiratory infections. Frequent reports of immunological events (other than those reported in NT1) immediately prior to the development of NT2 and IH support the specificity of triggers for NT1, and open important new research avenues into possible underlying immunological mechanisms in NT2 and IH
Toward a common methodological framework for the sampling, extraction, and isotopic analysis of water in the Critical Zone to study vegetation water use
Get PDFAdaptive multi-interventional trial platform to improve patient care for fibrotic interstitial lung diseases.
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Fibrotic interstitial lung diseases (fILDs) are a heterogeneous group of lung diseases associated with significant morbidity and mortality. Despite a large increase in the number of clinical trials in the last 10 years, current regulatory-approved management approaches are limited to two therapies that prevent the progression of fibrosis. The drug development pipeline is long and there is an urgent need to accelerate this process. This manuscript introduces the concept and design of an innovative research approach to drug development in fILD: a global Randomised Embedded Multifactorial Adaptive Platform in fILD (REMAP-ILD).
METHODS
Description of the REMAP-ILD concept and design: the specific terminology, design characteristics (multifactorial, adaptive features, statistical approach), target population, interventions, outcomes, mission and values, and organisational structure.
RESULTS
The target population will be adult patients with fILD, and the primary outcome will be a disease progression model incorporating forced vital capacity and mortality over 12 months. Responsive adaptive randomisation, prespecified thresholds for success and futility will be used to assess the effectiveness and safety of interventions. REMAP-ILD embraces the core values of diversity, equity, and inclusion for patients and researchers, and prioritises an open-science approach to data sharing and dissemination of results.
CONCLUSION
By using an innovative and efficient adaptive multi-interventional trial platform design, we aim to accelerate and improve care for patients with fILD. Through worldwide collaboration, novel analytical methodology and pragmatic trial delivery, REMAP-ILD aims to overcome major limitations associated with conventional randomised controlled trial approaches to rapidly improve the care of people living with fILD
Nucleosynthetic isotope variations in chondritic meteorites and their relationship to bulk chemistry
No full textThe relationship of mass-independent stable isotope anomalies with the chemistry of chondritic meteorites provides constraints on mixing and fractionation processes in the early solar nebula. The present study emphasizes the strong correlation of nucleosynthetic isotope variations among ordinary chondrites (OC), enstatite chondrites (EC), Earth, CI-chondrites, and Ca, Al-rich inclusions (CAI) in ε50Ti versus ε54Cr space. This correlation indicates variable contamination of chondritic reservoirs with material from a single source providing neutron-rich nuclei such as 50Ti, 54Cr, and 62Ni. The well-defined linear relationship of ε50Ti versus ε54Cr indicates that all reservoirs on the correlation line (“chondrite reference line”) started with a CI-chondritic (solar) Cr/Ti ratio, irrespective of the present Cr/Ti ratio of the samples falling on the chondrite reference line. The isotope compositions of carbonaceous chondrites (CC) do not fit the chondrite reference line. Their isotope composition is consistent with a mixture of chondritic meteorites originally falling on the chondrite reference line and volatile element depleted CAIs. However, CC cannot result from addition of CAIs to OC or EC. Neither can OC and EC be produced by loss of refractory components from CI-meteorites. Also, stable isotopes are inconsistent with OC being derived from EC, and vice versa, by a chemical fractionation process. The enrichment of the Earth in refractory lithophile elements is not the result of addition of a refractory component to a chondritic reservoir. It is rather the result of internal fractionation of a chondritic reservoir
The dispensability of 14-3-3 proteins for the regulation of human cardiac sodium channel Nav1.5.
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14-3-3 proteins are ubiquitous proteins that play a role in cardiac physiology (e.g., metabolism, development, and cell cycle). Furthermore, 14-3-3 proteins were proposed to regulate the electrical function of the heart by interacting with several cardiac ion channels, including the voltage-gated sodium channel Nav1.5. Given the many cardiac arrhythmias associated with Nav1.5 dysfunction, understanding its regulation by the protein partners is crucial.
AIMS
In this study, we aimed to investigate the role of 14-3-3 proteins in the regulation of the human cardiac sodium channel Nav1.5.
METHODS AND RESULTS
Amongst the seven 14-3-3 isoforms, only 14-3-3η (encoded by YWHAH gene) weakly co-immunoprecipitated with Nav1.5 when heterologously co-expressed in tsA201 cells. Total and cell surface expression of Nav1.5 was however not modified by 14-3-3η overexpression or inhibition with difopein, and 14-3-3η did not affect physical interaction between Nav1.5 α-α subunits. The current-voltage relationship and the amplitude of Nav1.5-mediated sodium peak current density were also not changed.
CONCLUSIONS
Our findings illustrate that the direct implication of 14-3-3 proteins in regulating Nav1.5 is not evident in a transformed human kidney cell line tsA201
Community-based symptom reporting among agro-pastoralists and their livestock in Chad in a One Health approach.
Get PDFOne Health Syndromic Surveillance has a high potential for detecting early epidemiological events in remote and hard-to-reach populations. Chadian pastoralists living close to their animals and being socio-economically unprivileged have an increased risk for zoonosis exposure. Engaging communities in disease surveillance could also strengthen preparedness capacities for outbreaks in rural Chad. This study describes a retrospective cross-sectional survey that collected data on clinical symptoms reported in people and livestock in Chadian agro-pastoral communities. In January-February 2018, interviews were conducted in rural households living in nomadic camps or settled villages in the Yao and Danamadji health districts. The questionnaire covered demographic data and symptoms reported in humans and animals for the hot, wet, and cold seasons over the last 12 months. Incidence rates of human and animal symptoms were comparatively analyzed at the household level. Ninety-two households with a homogeneous socio-demographic distribution were included. We observed cough and diarrhea as the most frequent symptoms reported simultaneously in humans and animals. In all species, the incidence rate of cough was significantly higher during the cold season, and diarrhea tended to occur more frequently during the wet season. However, the incidence rate of cough and diarrhea in animals did not predict the incidence rate of these symptoms in humans. Overall, the variations in reported symptoms were consistent with known seasonal, regional, and sociological influences on endemic diseases. Our retrospective study demonstrated the feasibility of collecting relevant health data in humans and animals in remote regions with low access to health services by actively involving community members. This encourages establishing real-time community-based syndromic surveillance in areas such as rural Chad
The Sac Evolution Imaging Follow-Up after EVAR: an international expert opinion-based Delphi consensus study.
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Management of follow-up protocols after endovascular aortic repair (EVAR), vary significantly between centres and is not standardized according to the sac regression. By designing an international expert-based Delphi consensus, the study aimed to create recommendations on follow-up after EVAR according to sac evolution.
METHODS
Eight facilitators created appropriate statements regarding the study topic that were voted, using a 4-point Likert scale, by a selected panel of international experts using a three-round modified Delphi consensus process. Based on the experts' responses, only those statements reaching a Grade A (full agreement ≥75%) or B (overall agreement ≥80% and full disagreement <5%) were included in the final document.
RESULTS
One-hundred and seventy-four participants were included in the final analysis, and each voted the initial 29 statements related to the definition of sac regression (Q1-Q9), EVAR follow-up (Q10-Q14), and the assessment and role of sac regression during follow-up (Q15-Q29). At the end of the process, 2 statements (6.9%) were rejected, 9 statements (31%) received a grade B consensus strength, and 18 (62.1%) reached a grade A consensus strength. Out of twenty-seven final statements, fifteen statements (55.6%) were classified as grade I, while twelve (44.4%) were classified as grade II. Experts agreed that sac regression should be considered an important indicator of EVAR success and always be assessed during follow-up after EVAR.
CONCLUSIONS
Based on the elevated strength and high consistency of this international expert-based Delphi consensus, most of the statements might guide current clinical management of follow-up after EVAR according to the sac regression. Future studies are needed to clarify debated issues
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