BACKGROUND: Monitoring nociception during general anaesthesia remains a substantial challenge. The Conox monitor uses two EEG indices, the qCon and the qNox. The qNox refers to the probability that a nociceptive stimulation triggers a movement of the patient and the response probability of reaction to nociceptive stimulation. We decided to test the feasibility of monitoring the qNOX index during adult cardiac surgery and to investigate whether this index correlates with hemodynamic and hormonal signs of nociceptive stimulation. METHOD: We enrolled 19 patients undergoing elective cardiac surgery. These were randomised to 2 groups receiving different doses of sufentanil via target controlled infusion: group A (n=9) 0.25 ng/mL and group B (n=10) 0.75 ng/mL. All patients were maintained at the same depth of anaesthesia. We recorded the Conox monitor indices (qNOX, qCON, electromyographic), hemodynamic variables and plasmatic levels of cortisol and noradrenaline. RESULTS: There was significantly higher blood pressure (P=0.013) and plasmatic cortisol (P=0.003) in group A and a significant increase in plasmatic noradrenaline with increasing intensity of surgical stimulation in both groups: A (P=0.001), B (P=0.008). We found no significant corresponding changes in the qNOX index. There was a positive correlation between qNOX and hemodynamic signs of stimulation (P=0.012) and between the qNOX and EMG indices (P=0.013) after endotracheal intubation, but not later after EMG index dropped. CONCLUSION: Our results do not support the assumption that signs of nociceptive stimulation during adult cardiac surgery will be reflected by the qNOX index. This may be related to compounding of qNOX processing and use of muscle relaxants. Further investigation on this field is needed.

• MeSH
• Anesthesia, General MeSH
• Adult MeSH
• Electroencephalography MeSH
• Hydrocortisone * MeSH
• Cardiac Surgical Procedures * MeSH
• Humans MeSH
• Nociception MeSH
• Norepinephrine MeSH
• Feasibility Studies MeSH
• Check Tag
• Adult MeSH
• Humans MeSH
• Publication type
• Journal Article MeSH

BACKGROUND: Coronavirus disease 2019 (COVID-19) is a life-threatening disease with a heterogeneous course. Even some young patients are at increased risk of severe course or death, as they can face severe complications. It would be very useful to have a cheap and easily available marker to predict COVID-19 course in the early stages of the disease. The COVID-19 prognostic score could be a very useful clinical indicator available at the time of primary contact with the patient. METHODS: The COVID-19 prognostic score and the clinical condition together with selected laboratory parameters were evaluated in patients with respiratory tract infection and a positive PCR test for the SARS-CoV-2 during the first contact with the patient. Prognostic significance was evaluated using receiver operating characteristic curves (ROC) and area under the curve (AUC). Selected parameters of the blood count and hemostasis, as well as selected biochemical indicators, were examined too. RESULTS: Thirty-seven of 164 patients developed serious symptoms. The COVID-19 score had one of the highest AUC values (0.855) of all markers. The highest combination of sensitivity (91.9%) and specificity (71.7%) for identifying patients with a subsequent moderate and severe course of the disease was achieved at the threshold 1.5. The predictive value of a negative test is beneficial too (0.968). CONCLUSIONS: The COVID-19 prognostic score is a promising indicator stratifying patients with COVID-19 into prognostic groups at the time of the first contact, thus allowing the timely provision of increased care in patients at high risk of severe development.

• MeSH
• COVID-19 * diagnosis   MeSH
• Respiratory Tract Infections * MeSH
• Humans MeSH
• Prognosis MeSH
• Retrospective Studies MeSH
• ROC Curve MeSH
• SARS-CoV-2 MeSH
• Check Tag
• Humans MeSH
• Publication type
• Journal Article MeSH

Objectives: Nursing home (NH) residents' capacity to communicate deteriorates with dementia. Consequently, NHs with high proportions of people living with dementia (PLWD) may receive fewer resident complaints, and/or investigating complaints may be challenging. We assessed NHs' proportion of PLWD in relation to total and substantiated complaints. Methods: Data were from the ASPEN Complaints/Incident Tracking System and the Certification and Survey Provider Enhanced Reports (2017). NHs (N = 15,499) were categorized based on high (top-10%), medium (middle-80%), and low (bottom-10%) dementia prevalence. Negative binomial Poisson regression assessed complaint patterns in relation to NHs' high/low (vs. medium) proportions of PLWD and other facility/resident characteristics. Results: Compared to NHs with medium-dementia prevalence, NHs with low proportions of PLWD had higher total (average marginal effect [AME] = 0.16, p < 0.001) and substantiated (AME = 0.30, p < 0.001) complaints, whereas NHs with high proportions of PLWD had fewer total (AME= -0.07; p < 0.05) and substantiated (AME= -0.11, p < 0.05) complaints. Also, NHs' profit status, chain-affiliation, size, staffing, and resident ethnicity were associated with total and substantiated complaints. Conclusion: The association between high proportions of PLWD and lower NH complaints suggests either that these NHs have higher overall quality or that complaints are underreported. Regardless, surveyors and families may need more involvement in monitoring higher dementia prevalence facilities.

• MeSH
• Dementia * epidemiology   MeSH
• Humans MeSH
• Nursing Homes * MeSH
• Check Tag
• Humans MeSH
• Publication type
• Journal Article MeSH

This study evaluated the effects of dietary methionine level and rearing water temperature on growth, antioxidant capacity, methionine metabolism, and hepatocyte autophagy in spotted seabass (Lateolabrax maculatus). A factorial design was used with six methionine levels [0.64, 0.85, 1.11, 1.33, 1.58, and 1.76%] and two temperatures [moderate temperature (MT): 27 °C, and high temperature (HT): 33 °C]. The results revealed the significant effects of both dietary methionine level and water temperature on weight gain (WG) and feed efficiency (FE), and their interaction effect was found on WG (P < 0.05). In both water temperatures tested, fish WG increased with increasing methionine level up to 1.11% and decreased thereafter. The groups of fish reared at MT exhibited dramatically higher WG and FE than those kept at HT while an opposite trend was observed for feed intake. Liver antioxidant indices including reduced glutathione and malondialdehyde (MDA) concentrations, and catalase and superoxide dismutase (SOD) activities remarkably increased in the HT group compared to the MT group. Moreover, the lowest MDA concentration and the highest SOD activity were recorded at methionine levels between 1.11% and 0.85%, respectively, regardless of water temperatures. Expression of methionine metabolism-related key enzyme genes (mat2b, cbs, ms, and bhmt) in the liver was increased at moderate methionine levels, and higher expression levels were detected at MT compared to HT with the exception of ms gene relative expression. Relative expression of hepatocyte autophagy-related genes (pink1, atg5, mul1, foxo3) and hsp70 was upregulated by increasing methionine level up to a certain level and decreased thereafter and increasing water temperature led to significantly enhanced expression of hsp70. In summary, HT induced heat stress and reduced fish growth, and an appropriate dietary methionine level improved the antioxidant capacity and stress resistance of fish. A second-order polynomial regression analysis based on the WG suggested that the optimal dietary methionine level for maximum growth of spotted seabass is 1.22% of the diet at 27 °C and 1.26% of the diet at 33 °C, then 1.37 g and 1.68 g dietary methionine intake is required for 100 g weight gain at 27 °C or 33 °C, respectively.

• MeSH
• Antioxidants MeSH
• Diet veterinary   MeSH
• Weight Gain MeSH
• Animal Feed MeSH
• Methionine * pharmacology   MeSH
• Bass * MeSH
• Dietary Supplements MeSH
• Racemethionine MeSH
• Superoxide Dismutase MeSH
• Temperature MeSH
• Animals MeSH
• Check Tag
• Animals MeSH
• Publication type
• Journal Article MeSH

Dedifferentiated and undifferentiated ovarian carcinomas (DDOC/UDOC) are rare neoplasms defined by the presence of an undifferentiated carcinoma. In this study, we detailed the clinical, pathological, immunohistochemical, and molecular features of a series of DDOC/UDOC. We collected a multi-institutional cohort of 23 DDOC/UDOC and performed immunohistochemistry for core switch/sucrose nonfermentable (SWI/SNF) complex proteins (ARID1A, ARID1B, SMARCA4, and SMARCB1), mismatch repair (MMR) proteins, and p53. Array-based genome-wide DNA methylation and copy number variation analyses were performed on a subset of cases with comparison made to a previously reported cohort of undifferentiated endometrial carcinoma (UDEC), small cell carcinoma of the ovary, hypercalcemic type (SCCOHT), and tubo-ovarian high-grade serous carcinoma (HGSC). The age of all 23 patients with DDOC/UDOC ranged between 22 and 71 years (with an average age of 50 years), and a majority of them presented with extraovarian disease (16/23). Clinical follow-up was available for 19 patients. Except for 2 patients, the remaining 17 patients died from disease, with rapid disease progression resulting in mortality within a year in stage II-IV settings (median disease-specific survival of 3 months). Eighteen of 22 cases with interpretable immunohistochemistry results showed loss of expression of core SWI/SNF protein(s) that are expected to result in SWI/SNF complex inactivation as 10 exhibited coloss of ARID1A and ARID1B, 7 loss of SMARCA4, and 1 loss of SMARCB1. Six of 23 cases were MMR-deficient. Two of 20 cases exhibited mutation-type p53 immunoreactivity. Methylation profiles showed coclustering of DDOC/UDOC with UDEC, which collectively were distinct from SCCOHT and HGSC. However, DDOC/UDOC showed an intermediate degree of copy number variation, which was slightly greater, compared with SCCOHT but much less compared with HGSC. Overall, DDOC/UDOC, like its endometrial counterpart, is highly aggressive and is characterized by frequent inactivation of core SWI/SNF complex proteins and MMR deficiency. Its molecular profile overlaps with UDEC while being distinct from SCCOHT and HGSC.

• MeSH
• Neoplastic Syndromes, Hereditary * MeSH
• DNA Helicases genetics   metabolism   MeSH
• Adult MeSH
• Carcinoma, Ovarian Epithelial MeSH
• Nuclear Proteins genetics   MeSH
• Carcinoma * pathology   MeSH
• Colorectal Neoplasms * MeSH
• Middle Aged MeSH
• Humans MeSH
• Carcinoma, Small Cell * MeSH
• Young Adult MeSH
• Biomarkers, Tumor genetics   metabolism   MeSH
• Tumor Suppressor Protein p53 genetics   MeSH
• Endometrial Neoplasms * pathology   MeSH
• Brain Neoplasms * MeSH
• Ovarian Neoplasms * genetics   pathology   MeSH
• Aged MeSH
• Transcription Factors genetics   metabolism   MeSH
• DNA Copy Number Variations MeSH
• Check Tag
• Adult MeSH
• Middle Aged MeSH
• Humans MeSH
• Young Adult MeSH
• Aged MeSH
• Female MeSH
• Publication type
• Journal Article MeSH

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• Meeting Abstract MeSH

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• Meeting Abstract MeSH

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• Meeting Abstract MeSH