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An Introduction to Risk
Published in David J. Smith, Sam Samuel, Basic Statistical Techniques for Medical and Other Professionals, 2021
The purpose of this chapter is to provide a wider perspective by introducing the risk of fatality from scenarios other than those arising from medical issues. It provides a comparison between the background occupational and leisure related risks, to which we are exposed, and those relating to health. The following rates and probabilities are, by their nature, approximate estimates. References 3 and 4 (Appendix 9) also deal with this aspect.
Insect Venom Allergy
Published in Pudupakkam K Vedanthan, Harold S Nelson, Shripad N Agashe, PA Mahesh, Rohit Katial, Textbook of Allergy for the Clinician, 2021
William H Bermingham, Alex G Richter, Mamidipudi T Krishna
Hymenoptera venom are one of the main causes of fatal anaphylaxis in the USA and UK (Pumphrey 2000, DB 2007), the second most frequent cause of anaphylaxis outside of medical settings (Pumphrey 1996). A review of animal-related deaths in 2005 determined that Hymenoptera stings accounted for 533 deaths in the United States from 1991–2001 (Langley 2005). Other studies estimate wasps and bees cause 30–120 deaths annually in the United States and 2–9 in the United Kingdom (Pumphrey 1996). In 1989, 32 deaths were reported from fire ant stings in Texas, Florida, Louisiana and Georgia (Rhoades et al. 1989). Studies investigating fatality rates have demonstrated similar results in Australia (0.09 per million), Canada (0.1 per million) and the USA (0.09–0.17 per million) (Stoevesandt et al. 2019).
The Relevance of Endotoxin Detection in Sepsis
Published in Helmut Brade, Steven M. Opal, Stefanie N. Vogel, David C. Morrison, Endotoxin in Health and Disease, 2020
Meta-analysis is a statistical technique by which the key data of several individual studies can be summarized. Moreover, it provides an objective test of heterogeneity, which is a measure of how disparate the results of individual studies are from each other. Two meta-analyses were recently published that used this technique to evaluate and summarize the published experience with the Limulus lysate assay in patients with suspected gram-negative sepsis. The first meta-analysis applied the technique to examine the concordance between endotoxemia and gram-negative bacteremia (13). The second meta-analysis examined the relationship between these two factors on the one hand and the fatality risk on the other (55).
Role of vitamin D in pathogenesis and severity of COVID-19 infection
Published in Archives of Physiology and Biochemistry, 2023
Maryam Honardoost, Maryam Ghavideldarestani, Mohammad E. Khamseh
Patients with chronic diseases have significantly higher risk of death from respiratory tract infections. On the other hand, deficient vitamin D concentration isassociated with increased risk of various diseases, including cardiovascular disease, diabetes mellitus, and hypertension (Grant et al. 2020, YAP et al. 2020). Observational studies suggest that serum 25(OH)D concentrations are generally low in many populations, especially in elderlies (Martineau et al. 2017, Grant et al. 2020). It has been shown that having comorbid conditions significantly increases the case fatality rate, especially with aging. This could be explained by compromised adaptive immune response (Grant et al. 2020). Moreover, age-associated reduced concentration of 1,25(OH)2D3 affects the immune system (Beard et al. 2011, Teymoori‐Rad et al. 2019). Therefore, it would be reasonable to postulate that the seasonality of many viral infections is associated with low 25(OH)D concentrations especially population with associated co-morbid conditions.
Phase 2 randomized study on chloroquine, hydroxychloroquine or ivermectin in hospitalized patients with severe manifestations of SARS-CoV-2 infection
Published in Pathogens and Global Health, 2021
Luis Enrique Bermejo Galan, Nayara Melo dos Santos, Mauro Shosuka Asato, Jucineide Vieira Araújo, Adriana de Lima Moreira, Aléxia Mahara Marques Araújo, Artur Diogenes Pinheiro Paiva, Diego Guilherme Santos Portella, Frank Silas Saldanha Marques, Gabriel Melo Alexandre Silva, Joana de Sousa Resende, Marycassiely Rodrigues Tizolim, Poliana Lucenados Santos, Steffi Ferreira Buttenbender, Stephanye Batista de Andrade, Roberto Carlos Cruz Carbonell, Juliana Gomes Da Rocha, Ruy Guilherme Silveira de Souza, Allex Jardim da Fonseca
Regarding the analysis of predictive factors for mortality, our study showed worse progression in obese patients (BMI> 33 kg/m2). Marked deregulation of lymphoid responses and exacerbation of pro-inflammatory cytokines has been described in obese patients, especially IL-6 and TNF [27,28]. IL-6 amplifies and supports the activation of various cytokine pathways for many days after the initial immune injury [29]. Thus, our data corroborate that obesity is an independent risk factor, doubling mortality, possibly because it contributes to the cytokine storm. Age was also a major predictor associated with fatality. The risk associated with increasing age has been a consistent finding among published works [4], but different from these reports, the present findings point to an earlier crucial point. While in different countries like Korea, China and Italy, the highest acceleration in fatality rates happened in patients over 70 years [30,31], in our data the most significant increase in fatality rates happened in patients over 60 years. Further studies should be directed to the role of local conditions in the lowering of the age range. Male gender has been related to a worse outcome [32,33], and although our data showed a trend to higher mortality, the difference was not statistically significant.
Pathogenesis guided therapeutic management of COVID-19: an immunological perspective
Published in International Reviews of Immunology, 2021
Ashutosh Kumar, Pranav Prasoon, Prakash S. Sekhawat, Vikas Pareek, Muneeb A. Faiq, Chiman Kumari, Ravi K. Narayan, Maheswari Kulandhasamy, Kamla Kant
COVID-19 is caused by a new viral strain—severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). SARS-CoV-2 belongs to the genus of betacoronaviruses which also contained SARS-CoV-1 and Middle East Respiratory Syndrome coronavirus (MERS-CoV) which had led the respiratory syndrome epidemic of SARS-2002/2003 and MERS-2012, respectively. Cellular entry of the coronaviruses (CoVs) depends on the binding of the spike (S) protein of the virus to a specific cell surface receptor and subsequent ‘S’ protein priming by cellular proteases. Recent studies showed cellular entry of the SARS-CoV-2 in humans is mediated by a cell surface receptor angiotensin converting enzyme 2 (ACE2), and the proteases like Transmembrane Protease, Serine 2 (TMPRSS2), and Cathepsin-L (CTS-L) which are also the receptors for SARS-CoV-1, and a common cold virus Human CoV NL63 [2,3]. COVID-19 patients present with diverse range of symptoms. However, it is primarily a respiratory disease causing acute respiratory distress syndrome (ARDS) which is also the prime cause of the fatality [4]. The clinical presentations in COVID-19 patients are unique with nearly 80% being either asymptomatic or have mild symptoms, about 14 percent developing severe symptoms like pneumonia, about 5 percent turn critical developing septic shock, respiratory failure, or multi-organ failure, and about 2 percent die of the disease [1]. Fatality is more pronounced in those who are old and/or have co-morbidities [1].