COVID-19:
Introduction
immunosenescence, ARDS,
Hyperinflammation and mortality
Cytokine storm , Inflammatory storm,
Treatment of COVID-19,
Acalabrunitib, Tocilizumab, Anakinra and Itolizumab,
Roleof itolizumab in suppressing the cytokine storm.
Approval status of Itolizumab.
Treatment with the anti-CD6 MAb Itolizumab.
Current status of itolizumab in the treatment of COVID-19,
Common side effects of itolizumab.
Expert opinion
A broad perspective on COVID-19: a global pandemic and a focus on preventive ...LucyPi1
Abstract Coronavirus 2019 has become a highly infectious disease caused by severe acute respiratory syndrome coronavirus-2, a strain of novel coronavirus, which challenges millions of global healthcare facilities. Coronavirus are sub-microscopic, single stranded positive sense RNA viruses that leads to multi organ dysfunction syndrome, severe acute and chronic respiratory distress syndrome and pneumonia. The spike glycoprotein structure of the virus causes the viral protein to bind with the receptors on the lung and gut through angiotensin-converting enzyme 2. In some cases, the infected patients become hyper to the immune system because of the uncontrolled production of cytokines resulting in “cytokine storm”, a devastating consequence of coronavirus disease 2019. Due to the rapid mutant strain and infective nature of severe acute respiratory syndrome coronavirus-2, discovering a drug or developing a vaccine remains a global challenge. However, some anti-viral agents, certain protease inhibitor drugs, non-steroidal inflammatory drugs and convalescent plasma treatment were suggested. The containment and social distancing measures only aim at reducing the rate of new infections. In this view, we suggest certain traditional herbs and complementary and alternative medicine as a supporting public healthcare measure to boost the immune system and also may provide some lead to treat and prevent this infection.
Cytokine release syndrome and Cytokine storm in COVID- 19 by Dr. Sonam Agga...Dr. Sonam Aggarwal
Cytokine storm syndrome is one of the most important cause of mortality in severe COVID-19 cases. It can be treated if diagnosed in time and life of a patient can be saved.
COVID-19:
Introduction
immunosenescence, ARDS,
Hyperinflammation and mortality
Cytokine storm , Inflammatory storm,
Treatment of COVID-19,
Acalabrunitib, Tocilizumab, Anakinra and Itolizumab,
Roleof itolizumab in suppressing the cytokine storm.
Approval status of Itolizumab.
Treatment with the anti-CD6 MAb Itolizumab.
Current status of itolizumab in the treatment of COVID-19,
Common side effects of itolizumab.
Expert opinion
A broad perspective on COVID-19: a global pandemic and a focus on preventive ...LucyPi1
Abstract Coronavirus 2019 has become a highly infectious disease caused by severe acute respiratory syndrome coronavirus-2, a strain of novel coronavirus, which challenges millions of global healthcare facilities. Coronavirus are sub-microscopic, single stranded positive sense RNA viruses that leads to multi organ dysfunction syndrome, severe acute and chronic respiratory distress syndrome and pneumonia. The spike glycoprotein structure of the virus causes the viral protein to bind with the receptors on the lung and gut through angiotensin-converting enzyme 2. In some cases, the infected patients become hyper to the immune system because of the uncontrolled production of cytokines resulting in “cytokine storm”, a devastating consequence of coronavirus disease 2019. Due to the rapid mutant strain and infective nature of severe acute respiratory syndrome coronavirus-2, discovering a drug or developing a vaccine remains a global challenge. However, some anti-viral agents, certain protease inhibitor drugs, non-steroidal inflammatory drugs and convalescent plasma treatment were suggested. The containment and social distancing measures only aim at reducing the rate of new infections. In this view, we suggest certain traditional herbs and complementary and alternative medicine as a supporting public healthcare measure to boost the immune system and also may provide some lead to treat and prevent this infection.
Cytokine release syndrome and Cytokine storm in COVID- 19 by Dr. Sonam Agga...Dr. Sonam Aggarwal
Cytokine storm syndrome is one of the most important cause of mortality in severe COVID-19 cases. It can be treated if diagnosed in time and life of a patient can be saved.
Γρηγόριος Γεροτζιάφας, Health Innovation Conference 2021Starttech Ventures
Ομιλία – Παρουσίαση:“Artificial intelligence and personalised medicine for patients at high risk of severe COVID-19”
Γρηγόριος Γεροτζιάφας, Καθηγητής Αιματολογίας, Ιατρική σχολή της Σορβόνης, Υπεύθυνος, Τμήμα Θρόμβωσης, Νοσοκομείο Tenon, Παρίσι & Διευθυντής, Ερευνητική Ομάδα Καρκίνος και Θρόμβωση INSERM U938
The outbreak of Covid 19 was initially identified in Wuhan city of China in December 2019 and led to a global pandemic. Clinical evidence indicates that covid 19 infection can range from asymptomatic or mild symptoms in the majority of cases to serious complication such as ARDS, multi organ failure and death in severe cases. It has been also indicated that there is uncontrolled and excessive production of cytokine in critically ill patients of covid 19 which give rise to “cytokine storm”. Which are responsible for the exacerbation of symptoms and development of the disease There are many unresolved questions regarding the pathological features, pathophysiological mechanisms and treatment of the cytokine storm induced by covid 19. This review will be aimed at suggesting therapeutic strategies such as the use of immunomodulators to confront the cytokine storm and an overview of the current understanding of the covid 19 infection. Shatabdi Dey | Sreekiran. CV "Cytokine and COVID19: A Literature Review" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Volume-4 | Issue-6 , October 2020, URL: https://www.ijtsrd.com/papers/ijtsrd33685.pdf Paper Url: https://www.ijtsrd.com/biological-science/immunobiology/33685/cytokine-and-covid19-a-literature-review/shatabdi-dey
Cardiovascular Disease Associated with SARS-CoV-2 and HIV InfectionsInsideScientific
Dr. Xuebin Qin discusses the development and characterization of new models of SARS-CoV-2 and HIV, and how his lab uses these models to study cardiovascular injury associated with infection.
Despite ongoing research around the world to better understand the pathogenesis of SARS-CoV-2, the ways in which it exacerbates cardiovascular disease (CVD) are not fully understood. While it is well accepted that SARS-CoV-2 infects lung epithelial cells, whether it can also infect endothelial cells is less clear.
In this webinar, Dr. Xuebin Qin discusses his lab’s development and characterization of new rodent models of COVID-19, and how they use these models to study endothelial dysfunction and injury resulting from immune activation. Dr. Qin also discusses why HIV infection is associated with increased risk of CVD. He provides an overview of the cellular and molecular mechanisms underlying HIV-1-associated CVD, and the mouse and NHP models he has worked with to elucidate them.
Key Topics Include:
- Cellular mechanisms by which SARS-CoV-2 and HIV contribute to cardiovascular disease
- Development, characterization and analysis of Mouse and NHP models for the study of COVID-19- or HIV-associated CVD
- Potential targets for therapeutic vaccine testing and pathogenesis studies
Immune Responses To The Pandemic New Coronavirus (COVID-19)by Prof. Mohamed L...Prof. Mohamed Labib Salem
In response to an invitation from Benha University, in this presentation, Prof. Mohamed Labib Salem, Prof. of Immunology, Faculty of Science, Tanta University, Egypt, presents entitled "Immune Responses To The Pandemic New Coronavirus (COVID-19)".
في هذه المحاضرة يقدم يا.د. محمد لبيب سالم أستاذ علم المناعة بكلية العلوم جامعة طنطا مصر محاضرة عن فيروس كورونا والمناعة
A Predictive Factor For Short-Term Outcome In Patients With COVID-19: CT Scor...JohnJulie1
This study enrolled 253 patients (63 died in the hospital, 190 were discharged). Compared to survivors, non-survivors were older, mostly male, had a higher prevalence of preexisting comorbidity, higher incidences of hypoxemia, lymphopenia and bacterial coinfection (p<0.001 for each). Regarding CT evaluations, non-survivors had higher CT scores (14.3±3.4 vs. 8.1±2.9), higher incidences of bronchial dilation with mosaic (34.9% vs. 10.5%), emphysema (28.6% vs. 10.5%), and diffuse opacity distribution (76.1% vs. 36.8%; all p<0.001).
A Predictive Factor For Short-Term Outcome In Patients With COVID-19: CT Scor...suppubs1pubs1
This study enrolled 253 patients (63 died in the hospital, 190 were discharged). Compared to survivors, non-survivors were older, mostly male, had a higher prevalence of preexisting comorbidity, higher incidences of hypoxemia, lymphopenia and bacterial coinfection (p<0.001 for each). Regarding CT evaluations, non-survivors had higher CT scores (14.3±3.4 vs. 8.1±2.9), higher incidences of bronchial dilation with mosaic (34.9% vs. 10.5%), emphysema (28.6% vs. 10.5%), and diffuse opacity distribution (76.1% vs. 36.8%; all p<0.001).
Γρηγόριος Γεροτζιάφας, Health Innovation Conference 2021Starttech Ventures
Ομιλία – Παρουσίαση:“Artificial intelligence and personalised medicine for patients at high risk of severe COVID-19”
Γρηγόριος Γεροτζιάφας, Καθηγητής Αιματολογίας, Ιατρική σχολή της Σορβόνης, Υπεύθυνος, Τμήμα Θρόμβωσης, Νοσοκομείο Tenon, Παρίσι & Διευθυντής, Ερευνητική Ομάδα Καρκίνος και Θρόμβωση INSERM U938
The outbreak of Covid 19 was initially identified in Wuhan city of China in December 2019 and led to a global pandemic. Clinical evidence indicates that covid 19 infection can range from asymptomatic or mild symptoms in the majority of cases to serious complication such as ARDS, multi organ failure and death in severe cases. It has been also indicated that there is uncontrolled and excessive production of cytokine in critically ill patients of covid 19 which give rise to “cytokine storm”. Which are responsible for the exacerbation of symptoms and development of the disease There are many unresolved questions regarding the pathological features, pathophysiological mechanisms and treatment of the cytokine storm induced by covid 19. This review will be aimed at suggesting therapeutic strategies such as the use of immunomodulators to confront the cytokine storm and an overview of the current understanding of the covid 19 infection. Shatabdi Dey | Sreekiran. CV "Cytokine and COVID19: A Literature Review" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Volume-4 | Issue-6 , October 2020, URL: https://www.ijtsrd.com/papers/ijtsrd33685.pdf Paper Url: https://www.ijtsrd.com/biological-science/immunobiology/33685/cytokine-and-covid19-a-literature-review/shatabdi-dey
Cardiovascular Disease Associated with SARS-CoV-2 and HIV InfectionsInsideScientific
Dr. Xuebin Qin discusses the development and characterization of new models of SARS-CoV-2 and HIV, and how his lab uses these models to study cardiovascular injury associated with infection.
Despite ongoing research around the world to better understand the pathogenesis of SARS-CoV-2, the ways in which it exacerbates cardiovascular disease (CVD) are not fully understood. While it is well accepted that SARS-CoV-2 infects lung epithelial cells, whether it can also infect endothelial cells is less clear.
In this webinar, Dr. Xuebin Qin discusses his lab’s development and characterization of new rodent models of COVID-19, and how they use these models to study endothelial dysfunction and injury resulting from immune activation. Dr. Qin also discusses why HIV infection is associated with increased risk of CVD. He provides an overview of the cellular and molecular mechanisms underlying HIV-1-associated CVD, and the mouse and NHP models he has worked with to elucidate them.
Key Topics Include:
- Cellular mechanisms by which SARS-CoV-2 and HIV contribute to cardiovascular disease
- Development, characterization and analysis of Mouse and NHP models for the study of COVID-19- or HIV-associated CVD
- Potential targets for therapeutic vaccine testing and pathogenesis studies
Immune Responses To The Pandemic New Coronavirus (COVID-19)by Prof. Mohamed L...Prof. Mohamed Labib Salem
In response to an invitation from Benha University, in this presentation, Prof. Mohamed Labib Salem, Prof. of Immunology, Faculty of Science, Tanta University, Egypt, presents entitled "Immune Responses To The Pandemic New Coronavirus (COVID-19)".
في هذه المحاضرة يقدم يا.د. محمد لبيب سالم أستاذ علم المناعة بكلية العلوم جامعة طنطا مصر محاضرة عن فيروس كورونا والمناعة
A Predictive Factor For Short-Term Outcome In Patients With COVID-19: CT Scor...JohnJulie1
This study enrolled 253 patients (63 died in the hospital, 190 were discharged). Compared to survivors, non-survivors were older, mostly male, had a higher prevalence of preexisting comorbidity, higher incidences of hypoxemia, lymphopenia and bacterial coinfection (p<0.001 for each). Regarding CT evaluations, non-survivors had higher CT scores (14.3±3.4 vs. 8.1±2.9), higher incidences of bronchial dilation with mosaic (34.9% vs. 10.5%), emphysema (28.6% vs. 10.5%), and diffuse opacity distribution (76.1% vs. 36.8%; all p<0.001).
A Predictive Factor For Short-Term Outcome In Patients With COVID-19: CT Scor...suppubs1pubs1
This study enrolled 253 patients (63 died in the hospital, 190 were discharged). Compared to survivors, non-survivors were older, mostly male, had a higher prevalence of preexisting comorbidity, higher incidences of hypoxemia, lymphopenia and bacterial coinfection (p<0.001 for each). Regarding CT evaluations, non-survivors had higher CT scores (14.3±3.4 vs. 8.1±2.9), higher incidences of bronchial dilation with mosaic (34.9% vs. 10.5%), emphysema (28.6% vs. 10.5%), and diffuse opacity distribution (76.1% vs. 36.8%; all p<0.001).
A Predictive Factor For Short-Term Outcome In Patients With COVID-19: CT Scor...suppubs1pubs1
This study enrolled 253 patients (63 died in the hospital, 190 were discharged). Compared to survivors, non-survivors were older, mostly male, had a higher prevalence of preexisting comorbidity, higher incidences of hypoxemia, lymphopenia and bacterial coinfection (p<0.001 for each). Regarding CT evaluations, non-survivors had higher CT scores (14.3±3.4 vs. 8.1±2.9), higher incidences of bronchial dilation with mosaic (34.9% vs. 10.5%), emphysema (28.6% vs. 10.5%), and diffuse opacity distribution (76.1% vs. 36.8%; all p<0.001).
Dr. Rahul VC Tiwari - Fellowship In Orthognathic Surgery - Jubilee Mission Medical College Hospital and Research Center, Thrissur, Kerala - 29th publication iosr jdms 3rd name
To Assess the Severity and Mortality among Covid 19 Patients after Having Vac...YogeshIJTSRD
The severity and mortality of COVID 19 cases has been associated with the Three category such as vaccination status, severity of disease and outcome. Objective presently study was aimed to assess the severity and mortality among covid 19 patients. Methods Using simple lottery random method 100 samples were selected. From these 100 patients, 50 patients were randomly assigned to case group and 50 patients in control group after informed consents of relative obtained. Patients in the case group who being died after got COVID 19 whereas 50 patients in the control group participated who were survive after got infected from COVID 19 patients. Result It has three categories such as a Vaccination status For the vaccination status we have seen 59 patients were not vaccinated and 41 patients was vaccinated out of 100. b Incidence There were 41 patients were vaccinated whereas 59 patients were not vaccinated. c Severity In the case of mortality we selected 50 patients who were died from the Corona and I got to know that out of 50 patients there were 12 24 patients were vaccinated whereas 38 76 patients were non vaccinated. Although for the 50 control survival group total 29 58 patients were vaccinated and 21 42 patients was not vaccinated all graph start. Conclusion we have find out that those people who got vaccinated were less infected and mortality rate very low. Prof. (Dr) Binod Kumar Singh | Dr. Saroj Kumar | Ms. Anuradha Sharma "To Assess the Severity and Mortality among Covid-19 Patients after Having Vaccinated: A Retrospective Study" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Volume-5 | Issue-5 , August 2021, URL: https://www.ijtsrd.com/papers/ijtsrd45065.pdf Paper URL: https://www.ijtsrd.com/other-scientific-research-area/other/45065/to-assess-the-severity-and-mortality-among-covid19-patients-after-having-vaccinated-a-retrospective-study/prof-dr-binod-kumar-singh
Characteristics of COVID-19 and Tuberculosis Co-Infection: A Cross-Sectional ...semualkaira
Coronavirus disease 2019 (COVID-19) and Tuberculosis (TB) are two major infectious diseases posing significant
public health threats. This study aimed to investigate the clinical
features of COVID-19 and TB co-infected patients.
Can Lung Ultrasound in Patients with Fever of Unknown Origin Detect Early Sig...navasreni
The increasing interest in Lung Ultrasound (LUS) over the last years led to a great diffusion and better experience in using this technique, which became an essential tool for clinicians. During the current Coronavirus Disease 2019 (COVID-19) pandemic, LUS is being extensively applied to the evaluation and monitoring....
Can Lung Ultrasound in Patients with Fever of Unknown Origin Detect Early Sig...clinicsoncology
The increasing interest in Lung Ultrasound (LUS) over the last years led to a great diffusion and better experience in using this technique, which became an essential tool for clinicians. During the current Coronavirus Disease 2019 (COVID-19) pandemic
Can Lung Ultrasound in Patients with Fever of Unknown Origin Detect Early Sig...pateldrona
The increasing interest in Lung Ultrasound (LUS) over the last years led to a great diffusion and better experience in using this technique, which became an essential tool for clinicians. During the current Coronavirus Disease 2019 (COVID-19) pandemic, LUS is being extensively applied to the evaluation and monitoring....
Can Lung Ultrasound in Patients with Fever of Unknown Origin Detect Early Sig...georgemarini
The increasing interest in Lung Ultrasound (LUS) over the last years led to a great diffusion and better experience in using this technique, which became an essential tool for clinicians. During the current Coronavirus Disease 2019 (COVID-19) pandemic
Can Lung Ultrasound in Patients with Fever of Unknown Origin Detect Early Sig...SarkarRenon
The increasing interest in Lung Ultrasound (LUS) over the last years led to a great diffusion and better experience in using this technique, which became an essential tool for clinicians. During the current Coronavirus Disease 2019 (COVID-19) pandemic, LUS is being extensively applied to the evaluation and monitoring....
Can Lung Ultrasound in Patients with Fever of Unknown Origin Detect Early Sig...komalicarol
In this case report we describe the detection of very early ultrasonographic signs of lung involvement in a patient who presented no clinical signs of Severe Acute Respiratory Syndrome
Coronavirus 2 (SARS-CoV-2) pneumonia, but who developed respiratory symptoms and tested
positive for SARS-CoV-2 infection 22 days later
Can Lung Ultrasound in Patients with Fever of Unknown Origin Detect Early Sig...AnonIshanvi
The increasing interest in Lung Ultrasound (LUS) over the last years led to a great diffusion and better experience in using this technique, which became an essential tool for clinicians. During the current Coronavirus Disease 2019 (COVID-19) pandemic, LUS is being extensively applied to the evaluation and monitoring....
Monitoring Cellular Immune Response in Real Time with Next Generation Immunoa...InsideScientific
To learn more and watch the webinar, go to:
https://insidescientific.com/webinar/monitoring-cellular-immune-response-in-real-time-with-next-generation-immunoassays-on-the-ella-platform/
Experts discuss the use of Simple Plex immunoassays on Ella to monitor the cellular immune response to SARS-CoV-2 in real time.
Ella enables the rapid and high quality cytokine and pro inflammatory biomarker monitoring in support of disease severity and progression research in a multi-analyte, automated and standardized format.
Carmen Cámara Hijón, PhD – Usefulness of Cytokine Measurement to Support Decision-Making in Patients with COVID-19
The correct characterization of the immune response induced by SARS-Cov-2 includes the pattern of cytokines in peripheral blood. Dr. Carmen Camara discusses how assaying cytokine profiles allows us not only to establish a cause-effect relationship in unusual conditions (e.g. chiblain lesions and COVID-19) but even to make therapeutic decisions in some of them (e.g. pediatric multisystemic inflammatory syndrome).
She also describes a fast and cost-efficient method of measuring the cellular response induced by vaccines by measuring IFN-γ and IL-2 after whole-blood overnight stimulation with SARS-CoV-2 peptides, to identify the correlate of immunity in patients at risk, such as those with primary immunodeficiencies.
Martina Fabris, MD – Cytokines and COVID-19: The Value in Risk Stratification Within the First 72 Hours of Hospitalization
It is increasingly clear that the immune response to COVID-19, and not the pathogen itself, is responsible for the exaggerated release of inflammatory molecules during infection. Several cytokines play a key role in SARS-CoV-2 pathogenesis and can help to identify patients with worse prognosis or in a different phase of the pathological process. However, these cytokines can be difficult to assay, and we do not yet understand their relationship with classic inflammatory markers like CRP.
Dr. Martina Fabris discusses which cytokines, alongside standard markers of systemic inflammation, are most valuable in identifying patients at a high risk of an unfavorable outcome, and on the other hand, low-risk patients who can reasonably be discharged from the hospital. She also describes the challenge of using these new biomarkers effectively in daily clinical practice to support complicated diagnoses, to evaluate risk more effectively, and to ensure increasingly targeted therapies.
DISCLAIMER: The Ella™ automated immunoassay platform is currently offered for research use only; not for use in diagnostic procedures.
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
Knee anatomy and clinical tests 2024.pdfvimalpl1234
This includes all relevant anatomy and clinical tests compiled from standard textbooks, Campbell,netter etc..It is comprehensive and best suited for orthopaedicians and orthopaedic residents.
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
Acute scrotum is a general term referring to an emergency condition affecting the contents or the wall of the scrotum.
There are a number of conditions that present acutely, predominantly with pain and/or swelling
A careful and detailed history and examination, and in some cases, investigations allow differentiation between these diagnoses. A prompt diagnosis is essential as the patient may require urgent surgical intervention
Testicular torsion refers to twisting of the spermatic cord, causing ischaemia of the testicle.
Testicular torsion results from inadequate fixation of the testis to the tunica vaginalis producing ischemia from reduced arterial inflow and venous outflow obstruction.
The prevalence of testicular torsion in adult patients hospitalized with acute scrotal pain is approximately 25 to 50 percent
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
2. P R E S E N T A T I O N
• The virus is thought to spread mainly from person-to-person.
• There is currently no vaccine to prevent coronavirus disease
2019 (COVID-19).
• The best way to prevent illness is to avoid being exposed to
this virus.
Clean your hands often
Avoid close contact
Stay home if you’re sick
Cover coughs and sneezes
Corona
VIRUS
3. WHAT MAKES US
DIFFERENT
• Clean your hands often
• Avoid close contact
• Stay home if you’re sick
• Cover coughs and sneezes
• Wear a facemask if you are sick
• Clean and disinfect
Protech to yourself |Coronavirus
5. Maria Antonella Zingaropoli a,*, Valentina Perri a, Patrizia Pasculli a, Francesco Cogliati Dezza a, Parni
Nijhawan a, Giulia Savelloni a, Giuseppe La Torre a, Claudia D’Agostino a, Fabio Mengoni a, Miriam
Lichtner b, Maria Rosa Ciardi a, Claudio Maria Mastroianni
a a Department of Public Health and Infectious Diseases, Sapienza University of Rome, Italy
b Infectious Diseases Unit, SM Goretti Hospital, Polo Pontino, Sapienza University of Rome, Latina, Italy
5
6. Keywords
Flow Cytometry
SARS-CoV-2
Immunophenotyping analysis
CD56bright
CD56dim
ABSTRACT
Background: NK cells seem to be mainly involved in COVID-19
pneumonia. Little is known about NKT cells which represent a bridge
between innate and adaptive immunity.
Methods: We characterized peripheral blood T, NK and NKT cells in
45 patients with COVID-19 pneumonia (COVID-19 subjects) and 19
healthy donors (HDs). According to the severity of the disease, we
stratified COVID- 19 subjects into severe and non-severe groups.
Results: Compared to HDs, COVID-19 subjects showed higher
percentages of NK CD57+ and CD56dim NK cells and lower
percentages of NKT and CD56bright cells. In the severe group we
found a significantly lower percentage of NKT cells. In a multiple
logistic regression analysis, NKT cell was independently associated
with the severity of the disease. Conclusions: The low percentage of
NKT cells in peripheral blood of COVID-19 subjects and the
independent association with the severity of the disease suggests a
potential role of this subset.
ARTICLE INFO
COVID-19
C O R O N A V I R U S
7.
8. The pathogenesis of coronavirus disease-
2019 (COVID-19) pneumonia related to the
novel coronavirus, severe acute respiratory
syndrome coronavirus-2 (SARS-CoV-2), is
still unknown. Although virological,
epidemiological, clinical, routine laboratory,
imaging, and management outcome
features of patients with COVID-19
pneumonia have been rapidly defined [1–7],
the immune system response is not well
understood.
9. Beside dyspnea, hypoxemia and acute
respiratory distress, lymphopenia and
cytokine release syndrome are also
important clinical features in patients with
severe COVID-19 pneumonia [4] suggesting
that homeostasis of the immune system
plays an important role in the development
of COVID-19 pneumonia. The increase of
neutrophils/ lymphocytes ratio and the
reduction of lymphocytes were correlated
with the severity of the disease and death
[8–10]. Furthermore, exhaustion markers,
such as the inhibitory NK group 2 member A
(NKG2A) receptors on NK cells and CD8+ T
cells, are up-regulated in patients with
COVID-19 pneumonia and these cytotoxic
cells reduced perforin and granzyme
content, suggesting an impaired cytotoxic
immuneresponse in COVID-19 pneumonia
[11].
10. De Biasi et al., have recently reported an
increase of CD57 expression on CD8+ T
cells [13]. CD57 is considered a key marker
of in vitro replicative senescence and is
associated either to human aging or
prolonged chronic infection [14]. Cell
surface markers, mainly absence of CD28
or expression of CD57, have been used to
identify T lymphocytes as senescent in vitro.
In the immune system, immunosenescence
includes a shift towards less functional T
cells [15,16]. However, CD57 expression is
reported to be also a marker of mature NK
cells. Functionally, CD57 is associated with
NK cell adhesion and homing to inflamed
tissue [17].
11. Apart T and NK cells, NKT cells represent
a unique subset that shares some
characteristics with both NK and T cells and
are particularly interesting due to their
powerful role in the immune system. This
population seems to be involved in tissue
damage after acute myocardial infarction
and chronic pulmonary diseases [18,19].
To better understand the mechanisms
underlying functional immune impairment in
COVID-19 pneumonia, we investigated the
characteristics of peripheral blood T, NK and
NKT cells in patients with COVID-19
pneumonia correlating these obtained
findings with clinical parameters.
12. Fig. 1. Flow cytometric gating strategy. Using forward scatter (FSC) and side scatter
(SSC), the PMN and lymphocyte populations were gated. After gating lymphocytes
population, T cells were defined as CD3 + CD56- and then characterized into CD3 +
CD8- (CD3 + CD56-CD8-) and CD3 + CD8+ (CD3 + CD56-CD8+) cells and their
relative frequency of immunosenescence (CD28-CD57+) was evaluated. The NK
cell population was identified as CD3-CD56+ cells and the expression of CD57 was
evaluated. Further NK cells were categorized into different subsets according to the
expression of CD16 and CD56 molecules as CD56bright (CD3-CD56brightCD16+/-
), CD56dim (CD3- CD56dimCD16+/- ). Finally, the NKT cell population was defined
as CD3 + CD56 + . 12
13. HDs: healthy donors, IQR: interquartile range, CRP: C-reactive protein, WBC:
white blood cells, P/F: PaO2/FiO2, AST: aspartate aminotransferase, LDH:
lactate dehydrogenase.
Bold indicates p value significant.
a The 2-tailed χ2 test or Fisher’s exact test was used for comparing
proportions between severe and non-severe groups.
b The nonparametric comparative Mann-Whitney test was used to compare
medians between severe and non-severe groups.
c Normal range of laboratory findings in healthy donors.
Tablet 1: Demographics and clinical characteristics of study population.
13
14.
15. Study population
This study was approved by ethics committee of Policlinico
Umberto I, Sapienza University of Rome (protocol number
298/2020) and written informed consent was obtained for each
subject.
Flow cytometry antibody staining
vAt the enrollment, peripheral whole blood samples were
collected in heparin tube for each subject and tested within three
hours withdrawal.
Statistical analysis
All data were reported as median with IQR (25th-75th percentile).
Flow cytometry data were described as percentages.
Study methods
16. This study was approved by ethics
committee of Policlinico Umberto I, Sapienza
University of Rome (protocol number
298/2020) and written informed consent was
obtained for each subject.
A case-control design was used. Cases were
patients with COVID-19 pneumonia (COVID-
19 subjects) admitted to the Policlinico
Umberto I Hospital, Sapienza University of
Rome. COVID-19 pneumonia was initially
diagnosed based on the clinical symptoms
and later confirmed by detecting SARS-CoV-2
RNA in nasal and pharyngeal swab specimens
using a SARS-CoV-2 nucleic acid detection kit
according to the manufacturer’s protocol
(RealStar® SARS-CoV-2 Altona Diagnostic,
Germany). For each patient with COVID-19
pneumonia enrolled, the following data was
extracted from electronic medical records:
age, sex, medical history, symptoms,
Study population
17. As the control group, healthy donors (HDs)
with similar age and sex, absence of
symptoms, negative swab for SARS-CoV-2
RNA detection and negative serostatus for
SARS-CoV-2 were enrolled.
Based on the severity disease, COVID-19
subjects were stratified into two groups:
severe and non-severe. A non-severe case
was defined as a confirmed case with fever,
respiratory symptoms and radiographic
evidence of pneumonia, while a severe case
was defined with dyspnea or respiratory
failure. Specifically, severe illness was defined
according to the following criteria at the time of
the admission:
breathing rate ≥ 30 times/min, pulse oximeter
oxygen saturation (SpO2) ≤93% at rest and
ratio of partial pressure of arterial oxygen
(PaO2) to fraction of inspired oxygen (FiO2)
≤300 mmHg.
21. At the enrollment, peripheral whole blood
samples were collected in heparin tube for
each subject and tested within three hours
withdrawal.
Using multiparameter flow cytometry, the
subset distribution and immunophenotype of
polymorphonuclear (PMN) cells, T cells, CD3
+
CD8- cells, CD3 + CD8+ cells, NK cells,
CD56dim NK cells, CD56bright NK cells, NKT
cells were investigated in peripheral whole
blood samples from COVID-19 subjects and
HDs. Specifically, Pacific Blue-conjugated anti-
CD3 and APC/Cy7-conjugated anti-CD56
antibodies were used to defined T (CD3 +
CD56-), NK (CD3-CD56+) and NKT (CD3 +
CD56+) cells.
Flow cytometry antibody staining
22. Our streptavidin, Pacific Blue™ conjugate is a
bright, blue-fluorescent probe with excitation/emission
~410/455 nm. ... It is widely used to detect biotinylated
probes, because it reportedly exhibits less nonspecific
binding than does the glycosylated, biotin-binding protein,
avidin.
Pacific Blue-conjugated
23. for T cells, using the APC-conjugated anti-
CD8 antibody, two populations were defined:
CD3 + CD8- (CD3 + CD56-CD8-) and CD3 +
CD8+ (CD3 + CD56-CD8+) and their relative
percentage of immunosenescence as lack of
CD28- and expression of CD57+ was
evaluated.
For NK cells, the APC/Cy7-conjugated anti-
CD56 and PE/Cy7- conjugated anti-CD16
antibodies were used to identify CD56dim
(CD3-CD56dimCD16+/- ) and CD56bright
(CD3-CD56brightCD16+/- ). The expression of
the PE-conjugated anti-CD57 was evaluated
on total NK cells (CD3-CD56 + CD57+).
For NKT cells were defined as the co-
expression of the Pacific Blue conjugated anti-
CD3 and APC/Cy7-conjugated anti-CD56
antibodies.
Gating strategy is shown in Fig. 1.
24. Briefly, for each panel, 50 μl of whole blood
was stained with the relative mix of
monoclonal antibodies (all from BioLegend).
The mixture was incubated in darkness at 4 ◦C
for 20 min. Following direct
immunofluorescence staining of peripheral
blood cells with monoclonal antibodies, lyse
red blood cells was performed by incubating in
dark at
room temperature for 10 min (BD
Biosciences). The cells were washed twice in
phosphate-buffered saline (PBS) containing
1% of Fetal Calf Serum (FCS). Next, cells
were fixed in PBS containing 0.5% of
formaldehyde (Sigma-Aldrich) before analysis.
The stained blood was acquired using
MACSQuant (Miltenyi Biotec, Germany) and
analyzed using FlowJo™ v10.6.2 software.
25. Fig. 2. Immunophenotyping analysis performed in COVID-19 subjects and HDs.
Data are shown as median (lines) and interquartile ranges (whiskers). PMN: polymorphonuclear cell percentage,
PMN/T: PMN cell percentage/T cell percentage.
HDs: healthy donors. *p < 0.05, **0.01 < p < 0.001, **** p < 0.0001 (Mann-Whitney test). 25
26. a The nonparametric comparative Mann-Whitney test was used to compare medians between HDs and COVID-19
subjects
b The nonparametric comparative Mann-Whitney test was used to compare medians between severe and non-severe
groups. HDs: healthy donors, PMN/T: polymorphonuclear
cell percentage/T cell percentage, ns: not significant.
Tablet 2
Immunophenotyping analysis data on study population.
26
27. All data were reported as median with IQR
(25th-75th percentile).
Flow cytometry data were described as
percentages. Nonparametric comparative
Mann-Whitney test was used to compare
medians between the two groups. The 2-tailed
χ2 test or Fisher’s exact test was used for
comparing proportions of categorical
variables. Spearman correlation coefficient
was calculated for assessing the correlation
between quantitative variables. Moreover, a
linear regression model was built for all
peripheral blood cell subsets as dependent
variables, while the independent variable of
interest was being a COVID-19 subject. The
analyses were conducted using age and
gender as possible confounders. The
goodness of fit was assessed using the R2
value. The results are reported as Beta
coefficients (p value).
Statistical analysis
28. Finally, considering only cases, a multivariate
logistic regression analysis was used to
evaluate the effects of the severity of the
disease of different peripheral blood cell
subsets, using age, gender and presence of
comorbidities as potential confounders.
Results are expressed as OR with 95% CI.
All statistical analyses were performed using
GraphPad Prism v.8.4.1 software and p ≤ 0.05
was considered statistically significant. Linear
and logistic regression analyses were
performed with the statistical software SPSS,
release 25.0.
29.
30. Between March 2020 and April 2020, a total of 45
patients with laboratory confirmed COVID-19
pneumonia (COVID-19 subjects) hospitalized at
Policlinico Umberto I, Sapienza University of Rome,
Italy, were included in the study. In addition, 19
healthy donors (HDs) with similar age and sex were
unrolled as the control group. Demographic and
clinical characteristics of study population are
reported in Table 1.
Characteristics of study
population
31. Among COVID-19 subjects, 57.8% had at
least one comorbidity (chronic obstructive
pulmonary disease, hypertension,
cardiovascular disease, diabetes, malignant
tumor, dyslipidemia, obesity) and the most
common symptoms were fever (77.8%), dry
cough (44.4%), shortness of breath (20%) and
anosmia and ageusia (6.7%). According to CT
or X-ray findings, all COVID-19 subjects
showed bilateral pneumonia. At the admission,
in blood test, laboratory findings showed
increase of CRP, ferritin, lactate
dehydrogenase (LDH) and D-dimer levels
compared to normal range. Otherwise, a
reduction of PaO2/FiO2 (P/F) ratio was
observed. Aspartate aminotransferase (AST)
levels were in the normal range (Table 1).
32. Among all COVID-19 subjects, 31.1% was
clinically diagnosed as severe COVID-19
pneumonia (severe group) and 68.9% as non-
severe COVID-19 pneumonia (non-severe
group) (Table 1). In the severe group, COVID-
19 subjects were older and showed a higher
prevalence of comorbidities (85.7%)
compared to the non-severe group (45.1%). In
the severe group, laboratory findings showed
a significant higher level of CRP, P/F ratio,
AST, LDH, and D-dimer compared to the non-
severe group (Table 1).
33. First, the evaluation of PMN cell percentage/T
cell percentage (PMN/T) ratio showed a
significantly higher ratio in COVID-19 subjects
compared to HDs (Fig. 2B).
Total T cells were immunophenotyped and
subsequentially sub-divided according to the
CD8 expression in two subsets: CD3 + CD8-
and CD3 + CD8+ cells. For each of these
subsets immunesenescence percentages
(CD28-CD57+) were evaluated. Compared to
HDs, COVID- 19 subjects showed a
significantly lower percentages of total T cells
(Fig. 2C) and CD3 + CD8- cells (Fig. 2D).
Otherwise, COVID-19 subjects showed a
significantly higher percentage of CD3 + CD8-
CD28-CD57+ cells compared to HDs (Fig.
2F). Moreover, we observed higher
percentages of CD3 + CD8 + CD28-CD57+
cells in COVID-19 subjects compared to HDs,
although not statistically significant (Fig. 2G).
Immunophenotyping analysis
findings in COVID-19 group
compared to HDs
34. Total NK cells were defined as CD3-CD56+
and CD57 expression was evaluated. COVID-
19 subjects showed lower percetanges of total
NK cells compared to HDs, although not
statistically significant (Fig. 2H). However, a
higher percentage of NK CD57+ cells in
COVID-19 subjects compared to HDs was
observed (Fig. 2I). NK cells were divided into a
CD56bright and CD56dim population. COVID-
19 subjects showed a significantly lower
percentage of CD56bright NK cells (Fig. 1J)
and a significantly higher percentage of
CD56dim NK cells (Fig. 2K). Apart from NK
and T cells, peripheral blood comprises other
leucocyte subsets. For instance, co-
expression of CD3 and CD56 is used to
identify NKT cells. Compared to HDs, COVID-
19 subjects showed a significantly lower
percentage of NKT cells (Fig. 2L). All results
are reported in Table 2.
35. COVID-19 subjects were stratified according to the
severity of the disease into two groups: severe and
non-severe (Table 2).
The severe group showed a significantly higher
PMN/T ratio (Fig. 3B) and a significantly lower
percentage of total T cells (Fig. 3C), CD3 + CD8-
cells (Fig. 3D) and CD3 + CD8+ cells (Fig. 3E)
compared to the non-severe group. A higher
percentage of CD3 + CD8 + CD28-
CD57+ cells in severe group compared to non-severe
one was found, although not statistically significant
(Fig. 3G).
The evaluation of NK subsets showed a lower
percentage of CD56bright (Fig. 3J) and a higher
percentage of CD56dim in the severe group
compared to the non-severe one, although not
statistically significant (Fig. 3K).
Finally, the severe group showed a statistically lower
percentage of NKT cells compared to the non-severe
group (Fig. 3L).
Immunophenotyping analysis
findings and COVID-19 severity
36. Fig. 3. Immunophenotyping analysis performed in severe and non-severe groups.
Data are shown as median (lines) and interquartile ranges (whiskers). Dotted grey lines represent median values for healthy donors.
PMN/T: PMN cell percentage/T
cell percentage. *p < 0.05, **0.01 < p < 0.001, **** p < 0.0001 (Mann-Whitney test).
36
37. PMN/T: polymorphonuclear cell percentage/T cell percentage, ß: coefficient.
Tablet 3
Multiple linear regression analysis. Dependent variables: peripheral blood
cell subsets; Independent variable: being a COVID-19 subject.
Tablet 4
Simple and multiple logistic regression results for the severity of the disease.
for gender, comorbidities and ages. PMN/T: PMN cell percentage/T cell percentage, NKT: natural killer T, ß: coefficient.
37
38. Multiple linear regression analysis adjusted for
gender and ages was performed. The higher
PMN/T ratio and the percentage of CD56dim
NK cells as well as the lower percentages of T
cells, CD56bright NK cells and NKT cells
resulted independently associated to COVID-
19 pneumonia (Table 3). Simple and multiple
logistic regression analysis was performed in
COVID-19 subjects. The increase of PMN/T
ratio and the reduction in the percentages of T
cells, CD3 + CD8+ cells and NKT cells
resulted independently associated to the
severity of the disease in patients with COVID-
19 pneumonia (Table 4). A negative correlation
between P/F ratio and PMN/T ratio was
observed (Fig. 4A). Otherwise, a positive
correlation between P/F ratio and the
percentage of T cells (Fig. 4B) as well as
between P/F ratio and the percentage of NKT
Multiple linear and logistic
regression analysis and correlation
between immunophenotyping
subsets and clinical data
39.
40. T h a n k f o r y o u r a t t e n t i o n
Major reduction of NKT cells in patients with severe COVID-19 pneumonia
C l i n a i c a l i m m u n o l o g y