Year in review in Intensive Care Medicine 2011: III. ARDS and ECMO, weaning, mechanical ventilation, noninvasive ventilation, pediatrics and miscellanea

SCOPUS: re.jinfo:eu-repo/semantics/publishe

COVID-19 symptoms at hospital admission vary with age and sex: results from the ISARIC prospective multinational observational study

Background: The ISARIC prospective multinational observational study is the largest cohort of hospitalized patients with COVID-19. We present relationships of age, sex, and nationality to presenting symptoms. Methods: International, prospective observational study of 60 109 hospitalized symptomatic patients with laboratory-confirmed COVID-19 recruited from 43 countries between 30 January and 3 August 2020. Logistic regression was performed to evaluate relationships of age and sex to published COVID-19 case definitions and the most commonly reported symptoms. Results: ‘Typical’ symptoms of fever (69%), cough (68%) and shortness of breath (66%) were the most commonly reported. 92% of patients experienced at least one of these. Prevalence of typical symptoms was greatest in 30- to 60-year-olds (respectively 80, 79, 69%; at least one 95%). They were reported less frequently in children (≤ 18 years: 69, 48, 23; 85%), older adults (≥ 70 years: 61, 62, 65; 90%), and women (66, 66, 64; 90%; vs. men 71, 70, 67; 93%, each P < 0.001). The most common atypical presentations under 60 years of age were nausea and vomiting and abdominal pain, and over 60 years was confusion. Regression models showed significant differences in symptoms with sex, age and country. Interpretation: This international collaboration has allowed us to report reliable symptom data from the largest cohort of patients admitted to hospital with COVID-19. Adults over 60 and children admitted to hospital with COVID-19 are less likely to present with typical symptoms. Nausea and vomiting are common atypical presentations under 30 years. Confusion is a frequent atypical presentation of COVID-19 in adults over 60 years. Women are less likely to experience typical symptoms than men

Elevations of Extracellular Vesicles and Inflammatory Biomarkers in Closed Circuit SCUBA Divers

Blood-borne extracellular vesicles and inflammatory mediators were evaluated in divers using a closed circuit rebreathing apparatus and custom-mixed gases to diminish some diving risks. “Deep” divers (n = 8) dove once to mean (±SD) 102.5 ± 1.2 m of sea water (msw) for 167.3 ± 11.5 min. “Shallow” divers (n = 6) dove 3 times on day 1, and then repetitively over 7 days to 16.4 ± 3.7 msw, for 49.9 ± 11.9 min. There were statistically significant elevations of microparticles (MPs) in deep divers (day 1) and shallow divers at day 7 that expressed proteins specific to microglia, neutrophils, platelets, and endothelial cells, as well as thrombospondin (TSP)-1 and filamentous (F-) actin. Intra-MP IL-1β increased by 7.5-fold (p < 0.001) after day 1 and 41-fold (p = 0.003) at day 7. Intra-MP nitric oxide synthase-2 (NOS2) increased 17-fold (p < 0.001) after day 1 and 19-fold (p = 0.002) at day 7. Plasma gelsolin (pGSN) levels decreased by 73% (p < 0.001) in deep divers (day 1) and 37% in shallow divers by day 7. Plasma samples containing exosomes and other lipophilic particles increased from 186% to 490% among the divers but contained no IL-1β or NOS2. We conclude that diving triggers inflammatory events, even when controlling for hyperoxia, and many are not proportional to the depth of diving

Assisted Ion Transfer at Organic Film-Modified Electrodes

International audienceAn experimental and theoretical study of a complex electrochemical mechanism at three-phase and thin organic film-modified electrodes, where the coupled electron–ion transfer reaction is complicated by complexation reaction of the transferring ion, is reported. The transfer of monovalent and divalent cations across water|nitrobenzene interface, coupled with the complexation reactions with the ionophore valinomycin, is studied. Both types of electrodes are assembled of an edge plane pyrolytic graphite electrode modified with a nitrobenzene solution of lutetium bis(tetra-tert-butylphthalocyaninato) as a redox mediator and valinomycin as an ionophore. The reversible redox transformations of the redox mediator to either a monovalent hydrophobic anion or cation serve to drive the ion transfer across the liquid|liquid interface. In contact of the modified electrode with an aqueous electrolyte containing alkali or earth alkaline metal cations, significant partition of the aqueous electrolyte is taking place, due to the interfacial complexation of the cation with valinomycin. Thus, the thermodynamics and kinetics of the interfacial complexation–partition reaction at the liquid|liquid interface affect markedly the overall electron–ion transfer reaction at the modified electrodes under voltammetric conditions. Experiments are qualitatively compared with theoretical data collected by simulation of two different electrochemical mechanisms coupled with chemical reactions under conditions of square-wave voltammetry. It has been concluded that the overall electrochemical mechanism at three-phase electrodes can be described as a specific CrE reaction scheme, where Cr represents the reversible interfacial complexation–partition reaction of the transferring ion with valinomycin at the liquid|liquid interface