Search

Background: The outcome of hospitalized COVID-19 patients is predictable according to demographic, clinical, laboratory, and imaging risk factors. We aimed to determine the best outcome predictors and their trends during 30 days of hospitalization. Methods: This retrospective study was conducted on moderate to severe hospitalized COVID-19 patients from 26 January 2020 to 13 January 2021. The length of stay in the hospital was considered as the time interval between admission and discharge, and the patient's final condition was defined as either dead or alive. Demographic, clinical, and laboratory data were collected from the hospital information system. The generalized additive model and the Cox regression model were used to model data. Results: Of the 1520 hospitalized COVID-19 patients, 232 (15.26%) died and 1288 survived or reached the end of 30 days of hospitalization. We selected demographic, clinical, and 131 independent laboratory variables. Blood urea nitrogen (BUN) had a nearly double average in the dead group (44.603 [± 25.408] mg/dL) than the survived group (21.304 [± 13.318] mg/dL), and the lymphocyte (Lymph) count showed the opposite trend. The estimated hazard ratio (HR) of these 2 factors was higher than 1 and was statistically significant. In daily stay trends, the hazard function of them also increased rapidly after 15 days. Conclusion: Blood urea nitrogen and complete blood count provide strong predictive clues about the prognosis of hospitalized COVID-19 patients, and rapid dynamic changes in the second week can predict a poor outcome in these patients. [ABSTRACT FROM AUTHOR]

Objective: The aim of the present study is assessment of insulin resistance (IR) in obese women by TyG-Index and compared with the HOMA-IR index. Materials and Methods: This cross-sectional study was performed on 61 obese women aged 18-45 years. Weights, height, waist circumference (WC) were measured and body mass index (BMI) was calculated and recorded. A sample of fasting serum was collected to determine the glucose, triglyceride, insulin, total cholesterol, HDL-C and LDL-C concentration. HOMA-IR and TyG-Index were calculated as markers of insulin resistance. Results: The mean age of the precipitants was 32.5 ±0.79 years old and the mean weight was 86.0±1.7 Kg. The number of people with IR who determined by HOMA and TyG index were 21(34%) and 36(61%), respectively. There was a significant relationship between HOMA-IR and TyG Index, r= 0.044 (P<0.001). Conclusion: TyG index represents a useful and accessible tool for assessment of IR instead HOMA_IR in Iranian population, but more researches with greater sample size and via gold standard lab test need to evaluate the specificity and sensitivity of this new method. [ABSTRACT FROM AUTHOR]

Background: Caloric stimulation of the vestibular system is associated with autonomic response. The lateralization in the nervous system activities also involves the autonomic nervous system., Aim: To compare the effect of the right and left ear caloric test on the cardiac sympathovagal tone in healthy persons., Methods: This self-control study was conducted on 12 healthy male volunteers. The minimal ice water caloric test was applied for vestibular stimulation. This was done by irrigating 1 milliliter of 4 ± 2 °C ice water into the external ear canal in 1 s. In each experiment, only one ear was stimulated. For each ear, the pessimum position was considered as sham control and the optimum position was set as caloric vestibular stimulation of horizontal semicircular channel. The order of right or left caloric vestibular stimulation and the sequence of optimum or pessimum head position in each set were random. The recovery time between each calorie test was 5 min. The short-term heart rate variability (HRV) was used for cardiac sympathovagal tone metrics. All variables were compared using the analysis of variance., Results: After caloric vestibular stimulation, the short-term time-domain and frequency-domain HRV indices as well as, the systolic and the diastolic arterial blood pressure, the respiratory rate and the respiratory amplitude, had no significant changes. These negative results were similar in the right and the left sides. Nystagmus duration of left caloric vestibular stimulations in the optimum and the pessimum positions had significant differences ( e.g ., 72.14 ± 39.06 vs 45.35 ± 35.65, P < 0.01). Nystagmus duration of right caloric vestibular stimulations in the optimum and the pessimum positions had also significant differences ( e.g ., 86.42 ± 67.20 vs 50.71 ± 29.73, P < 0.01). The time of the start of the nystagmus following caloric vestibular stimulation had no differences in both sides and both positions., Conclusion: Minimal ice water caloric stimulation of the right and left vestibular system did not affect the cardiac sympathovagal balance according to HRV indices., Competing Interests: Conflict-of-interest statement: The authors have no conflicts of interest to declare., (©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.)

Background: During the four steps of the Valsalva maneuver (VM), opposite changes can be observed in some physiologic parameters. Manifestations of the VM in the electrocardiogram (ECG) have been studied in detail, but there have been few reports comparing VM-related biochemical and hemodynamic changes with a focus on the strain phase of the VM., Objectives: We studied strain-related ECG changes during the VM., Patients and Methods: This self-control descriptive study was conducted in 20 healthy male college students aged 20.12 ± 2.23 years. They were well trained to perform the standard VM: maintenance of a 15-second expiratory pressure at 40 mmHg with open glottis. An ECG was continuously recorded in the supine position at (a) rest (before the VM) and at (b) the start and (c) end of strain maintenance in the second phase of the VM. The averages of four successive beats were computed for each set of (a), (b), and (c). Means ± standard errors of the mean were used for comparison., Results: Following the VM, the RR and PR intervals, corrected QT interval (QTc), P wave duration and amplitude, T wave amplitude, and the ratio of T/R amplitudes showed significant changes. The QRS duration and R wave amplitude did not show significant changes., Conclusions: The VM caused time and voltage changes in some ECG waves during the strain phase. Alterations in heart or lung volume, electrode-related alterations, and autonomic tone may cause these changes.