Neurologic manifestations in hospitalized patients with COVID-19

Neurology, Journal Year: 2020, Volume and Issue: 95(8)

Published: June 2, 2020

The coronavirus disease 2019 (COVID-19) has spread worldwide since December 2019. Neurologic symptoms have been reported as part of the clinical spectrum disease. We aimed to determine whether neurologic manifestations are common in hospitalized patients with COVID-19 and describe their main characteristics.We systematically reviewed all diagnosed admitted hospital a Spanish population during March 2020. Demographic characteristics, systemic manifestations, complementary tests were analyzed.Of 841 (mean age 66.4 years, 56.2% men), 57.4% developed some form symptom. Nonspecific such myalgias (17.2%), headache (14.1%), dizziness (6.1%) present mostly early stages infection. Anosmia (4.9%) dysgeusia (6.2%) tended occur (60% first manifestation) more frequent less severe cases. Disorders consciousness occurred commonly (19.6%), older advanced stages. Myopathy (3.1%), dysautonomia (2.5%), cerebrovascular diseases (1.7%), seizures (0.7%), movement disorders encephalitis (n = 1), Guillain-Barré syndrome optic neuritis 1) also reported, but frequent. complications cause death 4.1% deceased study participants.Neurologic COVID-19. In our series, than half presented Clinicians need maintain close surveillance for prompt recognition these complications. mechanisms consequences acute respiratory type 2 involvement require further studies.

Language: Английский

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Obesity and diabetes as high‐risk factors for severe coronavirus disease 2019 (Covid‐19)

Diabetes/Metabolism Research and Reviews, Journal Year: 2020, Volume and Issue: 37(2)

Published: June 27, 2020

The outbreak of the coronavirus disease 2019 (Covid-19) has become an evolving worldwide health crisis. With rising prevalence obesity and diabetes come increasing awareness their impacts on infectious diseases, including increased risk for various infections, post-infection complications mortality from critical infections. Although epidemiological clinical characteristics Covid-19 have been constantly reported, no article systematically illustrated role in Covid-19, or how affects diabetes, special treatment these at-risk populations. Here, we present a synthesis recent advances our understanding relationships between obesity, along with underlying mechanisms, provide guidance

Language: Английский

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Promoting the healing of infected diabetic wound by an anti-bacterial and nano-enzyme-containing hydrogel with inflammation-suppressing, ROS-scavenging, oxygen and nitric oxide-generating properties

Biomaterials, Journal Year: 2022, Volume and Issue: 286, P. 121597 - 121597

Published: May 22, 2022

Language: Английский

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COVID-19 and the role of chronic inflammation in patients with obesity

International Journal of Obesity, Journal Year: 2020, Volume and Issue: 44(8), P. 1790 - 1792

Published: May 14, 2020

Coronavirus disease 2019 (COVID-19) and the risk of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) poses a particular to people living with preexisting conditions that impair immune response or amplify pro-inflammatory response. Low-grade chronic systemic inflammation, common in obesity, is associated development atherosclerosis, type diabetes, hypertension, well known comorbidities adversely affect outcomes patients COVID-19. Risk stratification based on Edmonton Obesity Staging System (EOSS), which classifies obesity presence medical, mental, and/or functional complications rather than body mass index (BMI), has been shown be better predictor all-cause mortality it may EOSS stages describe hyperinflammation COVID-19 infection. Analyzing group metabolic ill (EOSS 3), we found an increased interleukin-6 linear regression analysis showed positive correlation C-reactive protein (CRP) (p = 0.014) waist-to-hip-ratio (WHR) 0.031). Physicians should aware these findings Early identification possible could fundamental guide decision making regarding hospitalization, early support, therapy immunosuppression improve mortality.

Language: Английский

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Obesity: A critical risk factor in the COVID ‐19 pandemic

Clinical Obesity, Journal Year: 2020, Volume and Issue: 10(6)

Published: Aug. 28, 2020

Summary Obesity is an emerging independent risk factor for susceptibility to and severity of coronavirus disease 2019 (COVID‐19) caused by the severe acute respiratory syndrome coronavirus‐2 (SARS‐CoV‐2). Previous viral pandemics have shown that obesity, particularly obesity (BMI > 40 kg/m 2 ), associated with increased hospitalization, critical care admission fatalities. In this narrative review, we examine evidence influence on COVID‐19, challenges clinical management from pulmonary, endocrine immune dysfunctions in individuals identify potential areas further research. We recommend people be deemed a vulnerable group COVID‐19; trials pharmacotherapeutics, immunotherapies vaccination should prioritize inclusion obesity.

Language: Английский

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Obesity and COVID-19: immune and metabolic derangement as a possible link to adverse clinical outcomes

AJP Endocrinology and Metabolism, Journal Year: 2020, Volume and Issue: 319(1), P. E105 - E109

Published: May 27, 2020

Recent reports have shown a strong association between obesity and the severity of COVID-19 infection, even in absence other comorbidities. After infecting host cells, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) may cause hyperinflammatory reaction through excessive release cytokines, condition known as "cytokine storm," while inducing lymphopenia disrupted immune response. Obesity is associated with chronic low-grade inflammation dysregulation, but exact mechanisms which it exacerbates infection are not fully clarified. The production increased amounts cytokines such TNFα, IL-1, IL-6, monocyte chemoattractant protein (MCP-1) lead to oxidative stress defective function innate adaptive immunity, whereas activation NOD-like receptor family pyrin domain containing 3 (NLRP3) inflammasome seems play crucial role pathogenesis infection. Endothelial dysfunction arterial stiffness could favor recently discovered endothelium by SARS-CoV-2, alterations cardiac structure prothrombotic microenvironment provide link for cardiovascular events these patients. successful use anti-inflammatory agents IL-1 IL-6 blockers similar settings, like that rheumatoid arthritis, has triggered discussion whether be administrated selected patients disease.

Language: Английский

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When Pandemics Collide: The Impact of COVID-19 on Childhood Obesity

Journal of Pediatric Nursing, Journal Year: 2020, Volume and Issue: 56, P. 90 - 98

Published: Nov. 11, 2020

•Children with obesity face increased biopsychosocial risks during COVID-19.•Stress exacerbates inflammation and immune response in COVID-19.•The COVID-19 pandemic has significantly interrupted children's daily routines.•The health effects of the obesogenic environment are exacerbated by COVID-19.•Access to timely, comprehensive healthcare is critical COVID-19. Obesity pandemics that negatively affect well-being children. The disease childhood risen levels United States (U.S.) youth fastest rise seen severe (Skinner et al., 2018Skinner A.C. Ravanbakht S.N. Skelton J.A. Perrin E.M. Armstrong S.C. Prevalence US children, 1999-2016.Pediatrics. 2018; 142e20181916https://doi.org/10.1542/peds.2018-1916Crossref PubMed Scopus (17) Google Scholar). a highly contagious humans causing significant rates illness, hospitalization, death. World Health Organization (World Organization, 2020World Novel Coronavirus(2019-nCoV) situation report – 51.https://www.who.int/docs/default-source/coronaviruse/situation-reports/20200311-sitrep-51-covid-19.pdf?sfvrsn=1ba62e57_10Date: 2020, JulyGoogle Scholar) declared on March 11, 2020. identified as an independent risk factor for severity (Lighter 2020Lighter J. Phillips M. Hochman S. Sterling Johnson D. Francois F. Stachel A. patients younger than 60 years Covid-19 hospital admission.Clinical Infectious Diseases. 2020; (Advance online publication)https://doi.org/10.1093/cid/ciaa415Crossref (857) Children may experience more trajectory, including need respiratory support (Zachariah 2020Zachariah P. C.L. Halabi K.C. Ahn Sen A.I. Fischer Columbia Pediatric Management Group Epidemiology, clinical features, Coronavirus Disease 2019 (COVID-19) New York City, York.JAMA Pediatrics. publication): e202430https://doi.org/10.1001/jamapediatrics.2020.2430Crossref (349) Responses evoked major lifestyle changes stay-at-home orders physical distancing. Schools closed children lost safety net access nutritious food, safe place be, mandatory activity well their social networks familiar routines. Potential consequences being restricted home, addressed this report, threaten obesity. This will address impact obesity, describe how stress both conditions, identify interventions reduce negative impact. Childhood complex disease, multiple influences varied outcomes. Urie Bronfenbrenner's Social Ecological Model (SEM) been useful framework describing multi-factorial interactions associated (Davison Birch, 2001Davison K.K. Birch L.L. overweight: A contextual model recommendations future research.Obesity Reviews. 2001; 2: 159-171https://doi.org/10.1046/j.1467789x.2001.00036.xCrossref Scholar; Feeg 2014Feeg V.D. Candelaria L.M. Krenitsky-Korn Vessey relationship weight gain teasing.Journal Nursing. 2014; 29: 511-520https://doi.org/10.1016/j.pedn.2014.08.011Abstract Full Text PDF (12) Golden Earp, 2012Golden S.D. Earp ecological approaches individuals contexts: Twenty education & behavior promotion interventions.Health Education Behavior. 2012; 39: 364-372https://doi.org/10.1177/1090198111418634Crossref (761) Lemus 2016Lemus B. Mercado Bryars T. Mouttapa Conkey Robertson Reflections regarding Southern California youth.California Journal Promotion. 2016; 14: 64-69Crossref Ohri-Vachaspati 2015Ohri-Vachaspati DeLia DeWeese R.S. Crespo N.C. Todd Yedidia M.J. relative contribution layers obesity.Public Nutrition. 2015; 18: 2055-2066https://doi.org/10.1017/S1368980014002365Crossref (92) early work SEM emphasized context. However, over time, evolved developmental experiences continuity change through four dynamic, interrelated components: proximal processes (interaction between organisms environment), person characteristics, context time (Bronfenbrenner Ceci, 1994Bronfenbrenner U. Ceci S.J. Nature-nurture reconceptualized perspective: bioecological model.Psychological Review. 1994; 101: 568-586https://doi.org/10.1037/0033-295x.101.4.568Crossref Bronfenbrenner Morris, 2006Bronfenbrenner Morris P.A. human development.in: Lerner R.M. Damon W. Handbook child psychology: Theoretical models development. John Wiley Sons Inc., 2006: 793-828Google Rosa Tudge, 2013Rosa Tudge theory development: Its evolution from ecology bioecology.Journal Family Theory 2013; 5: 243-258Crossref constructive exploring Fig. 1 depicts five nested or multi-layered systems subsystems. Chronosystem connotes lifespan development (ontogeny) which individual lives (history). Macrosystem entails policy societal impacts, along culture, traditions, values, beliefs. Exosystem reflects institutions person's existence, government, legal system, mass media, school industry workforce. Mesosystem captures bidirectional relationships linkages Microsystems vital parts immediate most environment, such family, neighborhood, school, peers. Examination perspective framed Bioecological reveals plethora antecedents, potential consequences. current overlapping economic crises have triggered cascade demands parents. With schools daycare centers using hybrid models, workers furloughed laid off, peer group activities cancelled, families coping myriad stressors uncertainty about future. creates effective assessment intervention assist understanding management environment. Obesity, chronic resulting breakdown body's energy regulatory system (ERS), impacted genetic, environmental, psychosocial factors. Centers Control Prevention (Centers Prevention, 2020Centers Defining obesity.https://www.cdc.gov/obesity/childhood/defining.htmlDate: 2020Google standardized growth charts define excess adiposity overweight (85th–94th percentiles), (95-98th (≥99th percentile). affects 337 million globally 213 classified 124 (NCD Risk Factor Collaboration (NCD-RisC), 2017NCD (NCD-RisC)Worldwide trends body-mass index, underweight, overweight, 1975 2016: pooled analysis 2416 population-based measurement studies 128·9 adolescents, adults.Lancet. 2017; 390: 2627-2642https://doi.org/10.1016/S0140-6736(17)32129-3Abstract (4848) vary age, ethnicity, location, determinate factors (Ogden 2018Ogden Fryar C.D. Hales C.M. Carroll M.D. Aoki Y. Freedman D.S. Differences prevalence demographics urbanization 2013-2016.JAMA. 319: 2410-2418https://doi.org/10.1001/jama.2018.5158Crossref (314) Yusuf 2020Yusuf Z.I. Dongarwar R.A. Bell Harris Salihu H.M. determinants among States.International MCH AIDS. 9: 22-33https://doi.org/10.21106/ijma.337Crossref U.S. adolescents 1053 cases per 100,000 (792,188 cases) 11% all (American Academy Pediatrics Children's Hospital Association, 2020American Children''s Association COVID-19: State data report.https://downloads.aap.org/AAP/PDF/AAP%20and%20CHA%20-%20Children%20and%20COVID-19%20State%20Data%20Report%207.30.20%20FINAL.pdfDate: October 16Google number not confirmed testing unknown. form COVID-19, multisystemic inflammatory syndrome (MIS-C), was first reported March, By July 53 hospitals had 186 MIS-C pediatric age groups (Feldstein 2020Feldstein L.R. Rose E.B. Horwitz S.M. Collins J.P. Newhams M.M. Son Randolph A.G. Multisystem adolescents.The England Medicine. (NEJMoa2021680. Advance publication)https://doi.org/10.1056/NEJMoa2021680Crossref (1716) As CDC reports 1097 20 deaths 2020dCenters (COVID-19).https://www.cdc.gov/mis-c/cases/index.htmlDate: 22Google Understanding regulation (ERS) simplistic "calories = calories out" recognition modulated genetics (Roh 2016Roh E. Song D.K. Kim M.S. Emerging role brain homeostatic glucose metabolism.Experimental Molecular 48e216https://doi.org/10.1038/emm.2016.4Crossref (224) Timper Brüning, 2017Timper K. Brüning J.C. Hypothalamic circuits regulating appetite homeostasis: Pathways obesity.Disease Models Mechanisms. 10: 679-689https://doi.org/10.1242/dmm.026609Crossref (455) Ingested (calories) triggers pathways designed assess, process, store, expend body perceives its acute long-term needs. When working well, needs accurately assessed, managed timely manner, stable (Berthoud 2017Berthoud H.R. Münzberg H. Morrison Blaming obesity: Integration hedonic mechanisms.Gastroenterology. 152: 1728-1738https://doi.org/10.1053/j.gastro.2016.12.050Abstract (233) Individuals injured ERS less capable efficient management. Adipose tissue active endocrine organ plays maintaining balance (Reilly Saltiel, 2017Reilly Saltiel A.R. Adapting adipose inflammation. Nature Reviews.Endocrinology. 13: 633-643https://doi.org/10.1038/nrendo.2017.90Crossref (782) nutrients enter adipocyte (specialized cell storage fat), cellular initiates results sustained increase cortisol production Chronic marked over-expression mediators decreased adiponectin (an anti-inflammatory adipokine) (Ellulu 2017Ellulu Patimah I. Khaza'ai Rahmat Abed inflammation: linking mechanism complications.Archives Medical Science. 851-863https://doi.org/10.5114/aoms.2016.58928Crossref (1030) Unchecked, leads dysfunction manifesting cardiovascular metabolic abnormalities, depression, cancer, other conditions. decreases individual's response. stress, complications (Yuki 2020Yuki Fujiogi Koutsogiannaki pathophysiology: review.Clinical Immunology. 215: 108427https://doi.org/10.1016/j.clim.2020.108427Crossref (1256) Inflammation combined hyperinflammation weakened (Frydrych 2018Frydrych Bian G. O'Lone D.E. Ward Delano type 2 diabetes mellitus drive dysfunction, infection development, sepsis mortality.Journal Leukocyte Biology. 104: 525-534https://doi.org/10.1002/JLB.5VMR0118-021RRCrossref (177) Korakas 2020Korakas Ikonomidis Kousathana Balampanis Kountouri Raptis Lambadiari V. Immune derangement possible link adverse outcomes.American Physiology, Endocrinology Metabolism. E105-E109https://doi.org/10.1152/ajpendo.00198.2020Crossref (132) increases developing overwhelming failure (Shekerdemian 2020Shekerdemian L.S. Mahmood N.R. Wolfe Riggs B.J. Ross C.E. McKiernan C.A. International PICU CollaborativeCharacteristics outcomes coronavirus admitted Canadian intensive care units.JAMA https://doi.org/10.1001/jamapediatrics.2020.1948Crossref (712) two pandemics. introduced potentially traumatic events into (Fegert 2020Fegert J.M. Vitiello Plener P.L. Clemens Challenges burden adolescent mental health: narrative review highlight research phase long return normality.Child Adolescent Psychiatry Mental Health. 20https://doi.org/10.1186/s13034-020-00329-3Crossref (1077) Human Rights Watch, 2020Human Watch COVID-19's devastating children.https://www.hrw.org/news/2020/04/09/covid-19s-devastating-impact-childrenDate: April 9, Stress activation our systems. "Toxic stress" ensues prolonged experiencing strong, frequent, protracted (Condon 2018Condon Sadler Mayes L.C. Toxic protective multi-ethnic children: protocol.Research Nursing 41: 97-106https://doi.org/10.1002/nur.21851Crossref (15) Reichel, 2019Reichel C. can last adulthood. Harvard Kennedy School, Shorenstein Center Media, Politics, Public Policy, 2019https://journalistsresource.org/studies/society/public-health/aces-toxic-stress-health-research/Google Shonkoff 2012Shonkoff Garner A.S. Siegel B.S. Dobbins M.I. Earls M.F. Wood D.L. lifelong adversity toxic stress.Pediatrics. 129: e232-e246https://doi.org/10.1542/peds.2011-2663Crossref (3208) Sustained lead issues, supportive adults help "buffer" stressful child's adaptation. high parental due job loss, isolation, unexpectedly home difficulty parents providing buffering presence Parental some studies, recently non-Hispanic Black (Baskind 2019Baskind Taveras Gerber M.W. Fiechtner L. Horan Sharifi Parent-perceived association obesity-related behaviors.Preventing Disease. 2019; 16E39https://doi.org/10.5888/pcd16.180368Crossref (39) Disturbances infancy appear play (Hemmingsson, 2018Hemmingsson Early factors: Socioeconomic adversity, family offspring distress, junk food self-medication.Current Reports. 7: 204-209https://doi.org/10.1007/s13679-018-0310-2Crossref (147) disproportionally vulnerable populations already poverty, racism structural inequality (Bailey 2017Bailey Z.D. Krieger N. Agénor Graves Linos Bassett M.T. Structural inequities USA: Evidence interventions.Lancet. 389: 1453-1463https://doi.org/10.1016/S0140-6736(17)30569-XAbstract (2755) Bowleg, 2020Bowleg We're together: On intersectionality, inequality.American 110: 917https://doi.org/10.2105/AJPH.2020.305766Crossref (281) Lack of, access, treatments and/or illness conditions exacerbate Rates domestic violence abuse Guardian, 2020The Guardian Lockdowns around world bring violence.https://www.theguardian.com/society/2020/mar/28/lockdowns-world-rise-domestic-violenceDate: pre-existing be particularly at risk. Studies demonstrate exposure (Bethell 2014Bethell Newacheck Hawes Halfon Adverse experiences: Assessing engagement mitigating resilience.Health Affairs. 33: 2106-2115https://doi.org/10.1377/hlthaff.2014.0914Crossref (425) Garasky 2009Garasky Stewart Gundersen Lohman Eisenmann obesity.Social Science Research. 2009; 38: 755-766https://doi.org/10.1016/j.ssresearch.2009.06.002Crossref (109) 2009Lohman Links insecurity individual, maternal, stressors.The 45: 230-237https://doi.org/10.1016/j.jadohealth.2009.01.003Abstract (101) Responding unpredictable threat like evokes responses (Brooks 2020Brooks S.K. Webster R.K. Smith L.E. Woodland Wessely Greenberg Rubin G.J. psychological quarantine it: Rapid evidence.Lancet (London, England). 395: 912-920https://doi.org/10.1016/S0140-6736(20)30460-8Abstract (9573) Vinkers 2020Vinkers C.H. van Amelsvoort Bisson J.I. Branchi Cryan J.F. Domschke der Wee resilience pandemic.European Neuropsychopharmacology. 35: 12-16https://doi.org/10.1016/j.euroneuro.2020.05.003Crossref (270) Table 1). Post-traumatic disorder (PTSD) one-third who were isolated quarantined after H1N1 SARS epidemics Central North America (Sprang Silman, 2013Sprang Silman Posttraumatic health-related disasters.Disaster Medicine Preparedness. 105-110https://doi.org/10.1017/dmp.2013.22Crossref (729) having similar 27% self-reporting worsening 14% reporting behavioral (Patrick 2020Patrick S.W. Henkhaus Zickafoose J.S. Lovell Halvorson Loch Davis Well-being pandemic: national survey.Pediatrics. https://doi.org/10.1542/peds.2020- 016824Crossref Scholar).Table 1Common sources pandemic.Sources stressResponses stressQuarantineDecreased concentrationSocial isolationIrritabilityLess interaction peersSleep disturbancesThreat insecurityAnxietyChanges routines schedulesInterpersonal conflictThreat financesDepressionLimits activityAngerAdaptation learningEmotional exhaustionParental stressWeight gainFear Open table new tab health, (Small Aplasca, 2016Small Aplasca Child interaction.Child Psychiatric Clinics America. 25: 269-282https://doi.org/10.1016/j.chc.2015.11.008Abstract (70) higher depression (Smith 2020Smith J.D. Fu Kobayashi M.A. comorbidities.Annual Review Clinical Psychology. 16: 351-378https://doi.org/10.1146/annurev-clinpsy-100219-060201Crossref (104) because stigma isolation. (Thaker 2020Thaker V.V. Osganian deFerranti Sonneville K.R. Cheng J.K. Feldman H.A. Richmond T.K. Psychosocial, correlates obesity.BMC 20: 291https://doi.org/10.1186/s12887-020-02145-2Crossref (8) eat greater degree normal peers (Miller 2019Miller A.L. Riley Domoff S.E. Gearhardt A.N. Sturza Kaciroti Lumeng Weight status moderates stress-eating absence hunger associations children.Appetite. 136: 184-192https://doi.org/10.1016/j.appet.2019.02.005Crossref (18) Promoting important approach successful strategy difficult when isolation issues (Vinkers spread across globe, many countries employed closure part distancing policies slow transmission ease It estimated 138 worldwide, affecting 80% (Van Lancker Parolin, 2020Van Parolin Z. closures, poverty: crisis making.The Lancet e243-e244https://doi.org/10.1016/S2468-2667(20)30084-0Abstract (834) anticipated related closures detrimental especially those living poverty underserved communities. Out Hispanics, African Americans, (Rundle 2020Rundle Park Herbstman J.B. Kinsey E.W. Wang Y.C. COVID-19-related closings children.Obesity. 28: 1008-1009https://doi.org/10.1002/oby.22813Crossref (540) School ability maintain healthy ways (Table 2).Table 2Impact children.Lack expertise facilitating learning accessing resourcesExacerbation insecurityChange availability foodsChange activityRegression academic progress decrease art, music, library, educationOnline challenges inadequate computers internetNegative beingLack immunizations school-based For provides food. Thirty receive lunch National Lunch Program 14.7 participate Breakfast (Hess, 2020Hess Widespread mean 30 kids might go without meals. CNBC, 14https://www.cnbc.com/2020/03/14/widespread-school-closures-mean-30-million-kids-might-go-without-meals.htmlGoogle Access these programs varies depending location district, community support. recent study found 32.6 36% March–July 2020 Regression linked out schooling Limited discomfort influence regression. Isolation disruption also well-being. Finally, provided schools. There currently 6.3 students 2584 48 50 states, District Columbia, Puerto Rico (Love 2019Love H.E. Schlitt Soleimanpour Panchal Behr expansion.Health 755-764https://doi.org/10.1377/hlthaff.2018.05472Crossref (98) These centers, (51% Federally Qualified Centers) serve 10,629 provide primary poor populations. In addition t

Language: Английский

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Obesity and infectious diseases: pathophysiology and epidemiology of a double pandemic condition

International Journal of Obesity, Journal Year: 2022, Volume and Issue: 46(3), P. 449 - 465

Published: Jan. 21, 2022

Language: Английский

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The Obesity Paradox and Mortality in Older Adults: A Systematic Review

Nutrients, Journal Year: 2023, Volume and Issue: 15(7), P. 1780 - 1780

Published: April 6, 2023

“Obesity paradox” describes the counterintuitive finding that aged overweight and obese people with a particular disease may have better outcomes than their normal weight or underweight counterparts. This systematic review was performed to summarize publications related obesity paradox in older adults, gain an in-depth understanding of this phenomenon. PubMed©, Embase©, Scopus© were used perform literature search for all up 20 March 2022. Studies included if they reported data from adults on relation between BMI mortality. The following article types excluded study: reviews, editorials, correspondence, case reports series. Publication year, study setting, medical condition, design, sample size, age, outcome(s) extracted. has been registered PROSPERO (no. CRD42021289015). Overall, 2226 studies identified, which 58 review. In all, did not find any evidence paradox. Of these studies, 16 involved patients no specific 1 chronic diseases, 2 type diabetes mellitus. Seven out nine looked at short-term mortality found 28 examined longer-term mortality, 15 conducted condition (n = 24), appeared 18 cases. Our work supports existence paradox, especially when comorbidities acute problems are present. These findings should help guide strategies nutritional counselling populations.

Language: Английский

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Glucose Oxidase Driven Hydrogen Sulfide-Releasing Nanocascade for Diabetic Infection Treatment

Nano Letters, Journal Year: 2023, Volume and Issue: 23(14), P. 6610 - 6618

Published: July 17, 2023

Diabetic ulcers have received much attention in recent years due to their high incidence and mortality, motivating the scientific community develop various strategies for such chronic disease treatments. However, therapeutic outcome of these approaches is highly compromised by invasive bacteria a severe inflammatory microenvironment. To overcome dilemmas, microenvironment-responsive self-delivery glucose oxidase@manganese sulfide (GOx@MnS) nanoparticles (NPs) are developed one-step biomineralization. When they encounter level ulcer site, GOx particles catalyze decrease local pH trigger steady release both manganese ions (Mn2+) hydrogen (H2S). Mn2+ reacts with peroxide generate hydroxyl radicals elimination bacterial infection; meanwhile, H2S able suppress response accelerate diabetic wound healing through macrophage polarization. The excellent biocompatibility, strong bactericidal activity, considerable immunomodulatory effect promise GOx@MnS NPs great potential treatment.

Language: Английский

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