A Retrospective Study

Publisher Copyright: © 2022, The Author(s).Diabetes is a risk factor for greater severity of coronavirus disease 2019 (COVID-19). The stress hyperglycemia ratio (SHR) is an independent predictor of critical illness, and it is reported to have a stronger association than absolute hyperglycemia. The aim of this study was to assess the relationship of absolute hyperglycemia and SHR with the severity of COVID-19, since there are no studies investigating SHR in patients with COVID-19. We conducted a retrospective observational study on hospitalized patients with COVID-19 in the first months of the pandemic, regarding absolute hyperglycemia, SHR, and severity outcomes. Of the 374 patients, 28.1% had a previous diagnosis of type 2 diabetes. Absolute hyperglycemia (64.8% versus 22.7%; p < 0.01) and SHR [1.1 (IQR 0.9–1.3) versus 1.0 (IQR 0.9–1.2); p < 0.001] showed a statistically significant association with previous diabetes. Absolute hyperglycemia showed a significant association with clinical severity of COVID-19 (79.0% versus 62.7%; p < 0.001), need for oxygen therapy (74.8% versus 54.4%; p < 0.001), invasive mechanical ventilation (28.6% versus 11.6%; p < 0.001), and intensive care unit (30.3% versus 14.9%; p = 0.002), but not with mortality; by contrast, there was no statistically significant association between SHR and all these parameters. Our results are in agreement with the literature regarding the impact of absolute hyperglycemia on COVID-19 severity outcomes, while SHR was not a significant marker. We therefore suggest that SHR should not be evaluated in all patients admitted in the hospital for COVID-19, and we encourage the standard measures at admission of blood glucose and HbA1c levels.publishersversionepub_ahead_of_prin

Absolute Hyperglycemia versus Stress Hyperglycemia Ratio for the Prognosis of Hospitalized Patients with COVID-19 in the First Months of the Pandemic: A Retrospective Study

Diabetes is a risk factor for greater severity of coronavirus disease 2019 (COVID-19). The stress hyperglycemia ratio (SHR) is an independent predictor of critical illness, and it is reported to have a stronger association than absolute hyperglycemia. The aim of this study was to assess the relationship of absolute hyperglycemia and SHR with the severity of COVID-19, since there are no studies investigating SHR in patients with COVID-19. We conducted a retrospective observational study on hospitalized patients with COVID-19 in the first months of the pandemic, regarding absolute hyperglycemia, SHR, and severity outcomes. Of the 374 patients, 28.1% had a previous diagnosis of type 2 diabetes. Absolute hyperglycemia (64.8% versus 22.7%; p < 0.01) and SHR [1.1 (IQR 0.9-1.3) versus 1.0 (IQR 0.9-1.2); p < 0.001] showed a statistically significant association with previous diabetes. Absolute hyperglycemia showed a significant association with clinical severity of COVID-19 (79.0% versus 62.7%; p < 0.001), need for oxygen therapy (74.8% versus 54.4%; p < 0.001), invasive mechanical ventilation (28.6% versus 11.6%; p < 0.001), and intensive care unit (30.3% versus 14.9%; p = 0.002), but not with mortality; by contrast, there was no statistically significant association between SHR and all these parameters. Our results are in agreement with the literature regarding the impact of absolute hyperglycemia on COVID-19 severity outcomes, while SHR was not a significant marker. We therefore suggest that SHR should not be evaluated in all patients admitted in the hospital for COVID-19, and we encourage the standard measures at admission of blood glucose and HbA1c levels.info:eu-repo/semantics/publishedVersio

Absolute hyperglycemia versus stress hyperglycemia ratio for the prognosis of hospitalized patients with COVID-19 in the first months of the pandemic: a retrospective study

Diabetes is a risk factor for the greater severity of coronavirus disease 2019 (COVID-19). The stress hyperglycemia ratio (SHR) is an independent predictor of critical illness, and it is reported to have a stronger association than absolute hyperglycemia. The aim of this study was to assess the relationship between absolute hyperglycemia and SHR with the severity of COVID-19 since there are no studies investigating SHR in patients with COVID-19. We conducted a retrospective observational study on hospitalized patients with COVID-19 in the first months of the pandemic, regarding absolute hyperglycemia, SHR, and severity outcomes. Of the 374 patients, 28.1% had a previous diagnosis of type 2 diabetes. Absolute hyperglycemia (64.8% versus 22.7%; p < 0.01) and SHR [1.1 (IQR 0.9-1.3) versus 1.0 (IQR 0.9-1.2); p < 0.001] showed a statistically significant association with previous diabetes. Absolute hyperglycemia showed a significant association with the clinical severity of COVID-19 (79.0% versus 62.7%; p < 0.001), need for oxygen therapy (74.8% versus 54.4%; p < 0.001), invasive mechanical ventilation (28.6% versus 11.6%; p < 0.001), and intensive care unit (30.3% versus 14.9%; p = 0.002), but not with mortality; by contrast, there was no statistically significant association between SHR and all these parameters. Our results are in agreement with the literature regarding the impact of absolute hyperglycemia on COVID-19 severity outcomes, while SHR was not a significant marker. We, therefore, suggest that SHR should not be evaluated in all patients admitted to the hospital for COVID-19, and we encourage the standard measures at the admission of blood glucose and HbA1c levels.info:eu-repo/semantics/publishedVersio

Municipal service delivery: the role of transaction costs in the choice between alternative governance mechanisms

Service provision by local governments can be delivered using in-house bureaucracies, private firms, and partnerships with other governments or the not-for-profit sector. This production decision has been a major focus of discussion among scholars, practitioners and political agents for the last quarter of a century. The transaction costs framework is an important tool to analyse decisions regarding the production of local services. In this paper, the authors employ this framework to analyse service delivery in Portugal and find that service characteristics and the local political environment play a key role in local officials’ choice among the three governance mechanisms to deliver public service

Legal and Social Issues of Stateless Children in Malaysia

Malaysia does not have official records on the number of stateless people in the country. This lack of proactivity makes it challenging to identify the number of stateless people from the country’s population of ‘non-citizens’. For many stateless children, they are the products of this endless cycle of statelessness that transmits from one generation to the next especially when attempts to obtain a Malaysian citizenship from the National Registration Department fall futile. Though statelessness remains their only identity, it has also robbed them of State protection over the most fundamental human rights. This paper seeks to address the legal and social issues faced by stateless children in Malaysia. It begins by exploring the legal definition of a stateless child and the international minimum standard of protection that they are entitled to. The second part of the paper will then analyse the current Malaysian legal framework on statelessness, and how it fails to provide adequate protection for stateless children. This is followed by proposing potential solutions to the issue, such as amending the relevant laws and introducing awareness campaigns. Finally, the paper will conclude by outlining the importance of addressing statelessness in Malaysia and how this will benefit the stateless population

Transporte de sedimentos em suspensão em um estuário altamente estratificado sob condições de descarga fluvial transiente

The present paper assesses the hydrodynamics and suspended sediment transport in the Araranguá river estuary in response to a flood peak. A field survey was carried out in May, 2006, when water level, current velocity and direction, salinity and suspended sediment concentration (SSC) were recorded. Current data were obtained through a moored acoustic Doppler current profiler, from which the SSC were estimated based on the acoustic backscattering. The field survey was carried out just after a flood 3 -1 peak, during the waning phase of the hydrogram, when the discharge decreased from 120 to 30 m s in a 50-hour period. The longitudinal salinity distribution was strongly affected as well as the currents and SSC. The currents responded to the flood peak by changing from a barotropic regime downstream to a two layer baroclinic, with downstream currents at surface layer and upstream currents at the bottom layer. The suspended sediment transport was directly related to the currents, changing from an exportation phase during the flood peak to an importation phase through the bottom layer.O presente trabalho investiga o regime hidrodinâmico e o transporte de sedimentos em suspensão no estuário do rio Araranguá sob condições de descarga fluvial transiente após um pico de vazão. Uma campanha de campo foi realizada em maio de 2006 durante a qual foram registrados dados de nível da água, velocidade e direção de correntes, salinidade e concentração de sedimentos em suspensão (CSS). Dados de correntes foram obtidos com o fundeio de um perfilador de correntes por efeito Doppler, a partir do qual foi também estimada a CSS através do retro-espalhamento acústico. A campanha foi realizada durante a fase de recessão do hidrograma de cheia, com a descarga fluvial diminuindo de 120 para 30 m3s-1 em um período de 50 horas. Durante este período ocorreu uma significativa mudança da distribuição longitudinal da salinidade, bem como das correntes e da CSS. As correntes responderam ao pico de descarga passando de um regime barotrópico com sentido a jusante para um regime baroclínico em duas camadas, com correntes com sentido a jusante na camada superficial, e sentido a montante na camada de fundo. O transporte de sedimentos em suspensão foi diretamente relacionado com as correntes, passando de um regime de exportação durante o pico de descarga para um regime de importação na camada de fundo

Fibrose idiopática do mediastino: A propósito de um caso clínico

Resumo: Descreve-se o caso clínico de um doente do sexo masculino com uma massa mediastínica de crescimento lento. Após terem-se efectuado vários exames complementares, foi através de cirurgia que se confirmou o diagnóstico de fibrose idiopática do mediastino. A remoção parcial da massa permitiu uma estabilização transitória das suas dimensões. Cerca de quatro anos depois, verificou-se um crescimento marcado com repercurssões importantes, através da inevitável compressão de estruturas vitais, que conduziram a hipertensão pulmonar grave. A fibrose idiopática do mediastino é uma entidade extremamente rara, estando descritas associações a outras patologias, mais frequentemente às auto-imunes, mas apresenta sempre um curso fatal quando não é possível a cirurgia.Rev Port Pneumol 2005; XI (2): 155-163 Abstract: We herein report a case of a male patient, who presented a mediastinal mass that had a slow growth over the years. After surgery, that made the diagnosis of idiopathic mediastinal fibrosis, the growth stabilized. Four years latter it was observed a substantial increase which lead to the inevitable compression of vital structures which, in turn, led to pulmonary hypertension. Idiopathic mediastinal fibrosis is an extremely rare pathology. There are same cases in which it is associated with other pathologies but has always a fatal prognosis when surgery is not an option.Rev Port Pneumol 2005; XI (2): 155-163 Palavras-chave: Fibrose do mediastino, síndroma da veia cava superior, hipertensão pulmonar, mediastinite fibrosante, Key words: Mediastinal fibrosis, superior vena cava syndrome, pulmonary hypertension, fibrosis mediastinite