Predictive Value of Glycemia and Free Fatty Acid Levels upon Admission of Children with Scorpionism in Egypt

2022 ◽  
Author(s):  
Khaled Abdalla Abd-Elbaseer ◽  
Eman Ahmed Abd-Elmawgood ◽  
H. M. Qubaisy ◽  
Yaser F. Abd-Elraheem ◽  
Abdel-Rahman Abdel-Hamed El-Saied ◽  
...  
Keyword(s):  
Heart Failure ◽  
Organ Dysfunction ◽  
Serum Levels ◽  
Serum Glucose ◽  
Blood Levels ◽  
Scorpion Sting ◽  
Laboratory Findings ◽  
Scorpion Envenomation ◽  
Risk Patients ◽  
Life Threatening

Scorpion envenomation is a life-threatening emergency and causes serious health problems in tropical and subtropical regions. The aim of this study was to correlate the serum levels of biochemical parameters at admission in children with scorpion envenomation with subsequent morbidity and mortality. It was a prospective, observational, and descriptive study conducted for scorpion-envenomed children who presented to emergency and intensive care units between April 2019 and September 2019. Demographic, clinical, and laboratory findings of patients were recorded and tabulated. Routine investigations were done for all patients in addition to blood levels of lactate, free fatty acids (FFA), and insulin. All patients were compared according to outcome as survivors and nonsurvivors and according to glucose level as normoglycemic and hyperglycemic groups. There were 62 scorpion sting cases; their mean age was 8.6 ± 3.2 years. Patients aged more than 6 years (74.2%), and males (66.1%) were more affected than others. As regards severity, 25.8% were suffering organ dysfunction, 40.3% suffered systemic manifestations without organ dysfunction, and (33.9%) with only local manifestations. Serum glucose and FFA were significantly higher in nonsurvivors compared with survivors. Shock, convulsion, coma, heart failure, and pulmonary edema were significantly more common in hyperglycemic than normoglycemic group. Hyperglycemia, and raised FFA were associated with severe scorpion envenomation. Raised FFA was well correlated with presence of heart failure, leucocytosis, and hyperglycemia. Adding serum glucose and FFA to monitoring parameters of scorpionism severity can help the prediction of high-risk patients.

Field deployable platform for prognostic hepatic cancer screening.

2017 ◽  
Vol 35 (4_suppl) ◽  
pp. 267-267
Author(s):  
Jill E. Shea ◽  
Jennifer H Granger ◽  
Mark D Porter ◽  
Courtney L. Scaife
Keyword(s):  
High Risk ◽  
Point Of Care ◽  
Low Cost ◽  
Serum Levels ◽  
Blood Levels ◽  
Vertical Flow ◽  
Serum Samples ◽  
Point Of Care System ◽  
Risk Patients ◽  
Care System

267 Background: Hepatocellular carcinoma (HCC) incidence rates are increasing in many parts of the world particularly in low- and middle-income countries (LMICs). Although treatable if identified in the early stages in many LMICs patients are identified later in disease. A low cost point of care system that could identify patients at a higher risk of having HCC could be used as a screening tool to identify patients at an earlier stage. We are currently developing a low cost point of care hand held platform that can simultaneously evaluate the blood levels of common HCC markers. We present our preliminary findings on the limit of detection (LOD) of our system. Methods: Our device combines the rapid but qualitative results of a vertical flow assay with the quantitative capabilities of surface enhanced Raman scattering spectroscopy. Our final product will be able to simultaneously measure the blood levels of the five most proven markers of HCC: alphafetoprotein (AFP), lens-culinaris agglutinin binding alphafetoprotein (AFP-L3), des-gamma-carboxy prothrombin (DCP), core antibodies to hepatitis B virus (HBV), and core antibodies to hepatitis C virus (HCV). In this pilot study we initially evaluated the LOD of our system by evaluating known concentrations of AFP in human serum samples. We then evaluated serum levels of AFP in HCC patient samples (n = 5) with our device and compared with values obtained using a standard ELISA. Results: The LOD of our system for the detection of AFP in spiked serum samples was 1 ng/mL. Our quantitative lateral flow assay measured AFP within 10% of the values of obtained by standard ELISA, with serum values ranging from 10-900 ng/mL. The quantitative vertical flow assay was able to provide results within 5 minutes at a cost of approximately $2/sample. Conclusions: Our inexpensive, portable and rapid test was able to measure serum levels of AFP at values comparable to standard clinical methods. Importantly, one blood marker would be insufficient to identify high risk patients, so further research will be required to expand the number of markers within the panel. The end goal will be to evaluate the ability of our point of care system to screen high risk population in LMICs, thereby identifying at risk patients earlier in disease progression.

Getting stung by black scorpion Androctonus crassicauda

2013 ◽  
Vol 33 (10) ◽  
pp. 1081-1084 ◽  
Author(s):  
A Aghabiklooei ◽  
N Zamani ◽  
H Hassanian-Moghaddam
Keyword(s):  
Myocardial Infarction ◽  
Low Dose ◽  
Correct Diagnosis ◽  
Scorpion Sting ◽  
Early Management ◽  
Scorpion Envenomation ◽  
Life Threatening ◽  
Electrocardiographic Changes ◽  
Unknown Object ◽  
Black Scorpion

Importance of the correct diagnosis in the correct early management of a scorpion stung patient by using antivenom is not emphasized, particularly when there are little evidences. A 65-year-old female was brought to our emergency department with the chief compliant of being stung by an unknown object 3 h earlier while traveling in an intercity bus. She became agitated and simultaneously experienced tachycardia, very severe generalized sweating, cold and wet extremities, bilateral diffuse crackle in the base of lungs, tachypnea, and lethargy. With the primitive diagnosis of myocardial infarction, scorpion sting was documented as the cause of this combined cholinergic and adrenergic syndrome after the scorpion was found in the patient’s bed clothes. She dramatically responded to the administration of low dose of scorpion antivenom. This case dramatically responded to the antivenom administration, especially the cholinergic and sympathetic signs, pulmonary edema, and electrocardiographic changes were fully and almost immediately recovered. Scorpion antivenom may reverse life-threatening manifestations of scorpion envenomation if used early and in appropriate patients.

541 Prognostic signifcance of bedside clinical, electrocardiographic and laboratory findings in patients with congestive heart failure

2003 ◽  
Vol 2 (1) ◽  
pp. 114
Author(s):  
M SHTAINSHNAIDER ◽  
D ALMOZNINOSARAFIAN ◽  
I ALON ◽  
O GORELIC ◽  
S CHACHASHVILY ◽  
...  
Keyword(s):  
Heart Failure ◽  
Congestive Heart Failure ◽  
Laboratory Findings

391 Uric acid blood levels are associated with clinical and echocardiographic parameters of chronic heart failure

2003 ◽  
Vol 2 (1) ◽  
pp. 79
Author(s):  
P PAVLIDIS ◽  
J PARISSIS ◽  
S ANTONOPOULOS ◽  
D POLLATOS ◽  
P KIRIAZOPOULOS ◽  
...  
Keyword(s):  
Heart Failure ◽  
Uric Acid ◽  
Chronic Heart Failure ◽  
Blood Levels ◽  
Echocardiographic Parameters

Life-threatening Takotsubo Cardiomyopathy

2011 ◽  
Vol 9 (2) ◽  
pp. 119 ◽  
Author(s):  
Karen Mrejen-Shakin ◽  
Ricardo Lopez ◽  
Mohandas M Shenoy ◽  
◽  
◽  
...  
Keyword(s):  
Heart Failure ◽  
Left Ventricle ◽  
Acute Heart Failure ◽  
Takotsubo Cardiomyopathy ◽  
Stress Test ◽  
Systolic Dysfunction ◽  
Apical Ballooning ◽  
Assisted Ventilation ◽  
Two Dimensional ◽  
Life Threatening

Objective:To report a case of seizure-induced takotsubo cardiomyopathy with rare etiology and rarer complications.Methods:A 50-year-old woman had multiple epileptic seizures and later developed acute heart failure complicated by ventricular fibrillation and shock. A two-dimensional echocardiogram revealed apical ballooning of the left ventricle resembling a takotsubo (a Japanese fisherman's pot used to trap octopi). The apex was also hypokinetic.Results:The hemodynamic abnormalities normalized with defibrillation, assisted ventilation, inotropic support, and pressor agents. More importantly, the apical ballooning deformity and systolic dysfunction reversed. The echocardiogram normalized three months later. A nuclear treadmill stress test was negative for ischemia.Conclusions:Apical ballooning of the left ventricle and hypokinesis are typical echocardiographic features in takotsubo cardiomyopathy, a stress-induced heart disease. It may follow severe emotional, physical, and neurologic stressors, in our rare case, grand mal seizures (0.2 % of all takotsubo disease patients). Also rare are life-threatening complications. Based on these observations, in a case with severe stress followed by acute heart failure, takotsubo cardiomyopathy should be a major diagnostic consideration. The dramatic initial triggering event, in our case an epileptic seizure, should not mask the possibility of coexisting takotsubo cardiomyopathy. Awareness of this disease, anticipation of complications, and two-dimensional echocardiography will help channel the management in the right direction.

Biochemical Markers in Patients with Readmission for Congestive Heart Failure

2018 ◽  
Vol 69 (7) ◽  
pp. 1687-1691
Author(s):  
Razan Al Namat ◽  
Mihai Constantin ◽  
Ionela Larisa Miftode ◽  
Andrei Manta ◽  
Antoniu Petris ◽  
...  
Keyword(s):  
Heart Failure ◽  
Congestive Heart Failure ◽  
Rural Areas ◽  
Discharge Planning ◽  
Difficult Problem ◽  
Uncontrolled Hypertension ◽  
Medical Attention ◽  
Family Doctors ◽  
Increased Risk ◽  
Risk Patients

Repetitive or recurrent hospitalizations are a general major health issue in patients with chronic disease. Congestive heart failure, is associated with a high incidence and presence of early rehospitalization, but variables in order to identify patients at increased risk and also an analysis of potentially remediable factors contributing to readmission have not been previously reported and it remains still a difficult problem. We retrospectively assessed 100 patients aged between 48-85 years old, of which 75% were men, who had been hospitalized with documentation of congestive heart failure in St. Spiridon County Emergency Hospital. They were hospitalized between 2010-2017. Even if recurrent heart failure was the most common cause for readmission or rehospitalization, other cardiac disorders and noncardiac illnesses were also accounted for readmission. Predictive factors of an increased probability of readmission included prior patient�s medical heart failure history, heart failure decompensation precipitated or accelerated by an ischaemic episode, atrial fibrillation or uncontrolled hypertension. Factors contributing to preventable readmissions included noncompliance with medications or diet, inadequate discharge planning or follow-up, failure of both social support system and the seek of a promp medical attention when symptoms reappeared. We also identified an inappropriate colaboration with family doctors especially for the patients from rural areas. Patients were more likely to cite side effects of prescribed medications rather than nonadherence as a precipitating factor for readmission. Thus, we can appreciate that early rehospitalization in patients with congestive heart failure may be avoidable in up to 50% of cases. Identification of high risk patients is possible and also necessary shortly after admission in order to identify nonpharmacological interventions designed to decrease readmission frequency.

Does HbA1cc Play a Role in the Development of Cardiovascular Diseases?

2018 ◽  
Vol 24 (24) ◽  
pp. 2876-2882 ◽  
Author(s):  
Kailash Prasad
Keyword(s):  
Risk Factors ◽  
Cardiovascular Diseases ◽  
Cardiovascular System ◽  
Half Life ◽  
Serum Levels ◽  
Serum Glucose ◽  
Cvd Risk ◽  
Factors Affecting ◽  
Diagnosis And Management ◽  
Coronary Artery Atherosclerosis

Cardiovascular diseases (CVD) may be mediated through increases in the cardiovascular risk factors. Hemoglobin A1c (HbA1c) also called glycated hemoglobin is presently used for the diagnosis and management of diabetes. It has adverse effects on cardiovascular system. This review deals with its synthesis and effects on the cardiovascular system. The serum levels of HbA1c have been reported to be affected by various factors including, the lifespan of erythrocytes, factors affecting erythropoiesis, agents interfering glycation of Hb, destruction of erythrocytes, drugs that shift the formation of Hb, statins, and drugs interfering the HbA1c assay. Levels of HbA1c are positively correlated with serum glucose and advanced glycation end products ( AGE), but no correlation between AGE and serum glucose. AGE cannot replace HbA1c for the diagnosis and management of diabetes because there is no correlation of AGE with serum glucose, and because the half-life of protein with which glucose combines is only 14-20 days as compared to erythrocytes which have a half-life of 90-120 days. HbA1c is positively associated with CVD such as the carotid and coronary artery atherosclerosis, ischemic heart disease, ischemic stroke and hypertension.HbA1c induces dyslipidemia, hyperhomocysteinemia, and hypertension, and increases C-reactive protein, oxidative stress and blood viscosity that would contribute to the development of cardiovascular diseases. In conclusion, HbA1c serves as a useful marker for the diagnosis and management of diabetes. AGE cannot replace HbA1c in the diagnosis and management of diabetes. There is an association of HbA1c with CVD which be mediated through modulation of CVD risk factors.

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