Blue light effect and ethnicity - in shadow of skin pigmentation and eye colour

Department of Human Physiology and Biophysics, Nicolae Testemitanu State University of Medicine and Pharmacy, Chisinau, Republic of Moldova, The 8th International Medical Congress for Students and Young Doctors, September 24-26, 2020Introduction. Blue light [wavelength between 400-495nm], from digital sources and artificial lighting in the evening, hence inhibit normal secretion patterns of melatonin causing circadian rhythm and sleep disturbances. There is an inversely proportional relationship between blue light exposure and melatonin secretion. In the same time, blue light can be absorbed by the pigmental layer of the retina that contains melanin. Thereby, the quantity of blue light that will rich the retina can be influenced by the amount of melanin from the eyes. Aim of the study. The purpose is to appreciate the circadian rhythm and sleep disturbances and depth of blue light effect on melatonin secretion on different ethnical groups, integrating skin and eye pigmentation effects on the same matter; Materials and methods. An analysis of the latest scientific sources has been carried out using the PubMed search engines, 'HINARI' and Google Academic with the help of keywords: blue light, ethnicity, skin pigmentation and eye colour, sleep quality, sleep consistency, sleep duration. Results. The role of ethnicity in most aspects of human health is well documented. An example is the inefficiency of certain drugs used in asthma treatment in certain racial groups. Other studies determined a decrease in prevalence and incidence of Parkinson Disease in Americans of African descent compared to Caucasians. Also, shorter sleep was reported in black than in Asian, in Asian than in Hispanic/Latin and in Hispanic/Latin than in White. More sleep quality disturbance was reported in Black than in Asian and in Asian than in Latin. One of the explanations of the influence of ethnicity on sleep is the amount of melanin in the eyes. Some studies have shown that physiological responses to light depend on eye colour and that intraocular light scattering is higher in blue-eyed Caucasians. The percentage of suppression of melatonin secretion two hours after the start of light exposure was significantly more abundant in light-eyed Caucasians than in dark-eyed Asians. In the same time, in a comparative study which analysed the influence of light treatment in Seasonal Affective Disorder (SAD), was found that following six weeks of light therapy, African-American participants with SAD had a lower remission rate than Caucasian participants. Researchers suggested that higher melanin content of the pupil and retinal pigment epithelium in African-Americans may reduce the retinal illuminance in African-American SAD patients during light treatment hence reducing the effect of light therapy. These results suggest that the sensitivity of melatonin to light suppression is influenced by eye pigmentation and can be related to ethnicity, respectively

Side effects to antithrombotic therapy in patients with COVID-19 infection

Universitatea de Stat de Medicină şi Farmacie „Nicolae Testemiţanu”, Chişinău, Republica MoldovaIntroduction. Severe Acute Coronary Syndrome (SARS) corona virus-2 as SARS-CoV-2, led to an outbreak of respiratory infections started from Wuhan, China. COVID-19 has been associated with inflammation and prothrombotic state. Due to the state of hypercoagulability in covid-19, use of antithrombotic therapy for preventing thrombotic complications occurred. Purpose of the study. The relative risk versus benefit of antithrombotic therapy have not been addressed with clear distinction as of till now. This study focuses on possible negative side of therapy in covid patients using existing literature and clinical study findings. Materials and Methods. This study was performed by analysis and breakdown of existing literature concerning the topics SARS-CoV-2, hypercoagulability and antithrombotic therapy using online search engines like Google Scholar, PubMed, Hinari etc. The pathological association studies and drugs for treatment of SARS-CoV-2 patients were also referred for the study. Results. Major negative effect of antithrombotic therapy was bleeding. Anticoagulants was associated with increased risk of bleeding and complications mostly in the-rapeutic dose. In critically ill patients, therapeutic dose did not improve outcome but increased risk of bleeding whereas in moderately ill patients result was contradictory. In the latter therapeutic-dose heparin or LMWHs increased survival in different randomized clinical trials but no difference in primary result in this category from other studies. Nirmatrelvir-ritonavir (Paxlovid) usage interacted with some medications. There was an increased risk of blood clots when Paxlovid had higher risk of blood clots with clopidogrel and bleeding with ticagrelor. It interacted with DOACs, simvastatin, lovastatin, and anti-arrhythmics. Dexamethasone and covid infection had effects on drug metabolism. Conclusions. Most important entities associated with negative effect of anti-thrombotic therapy in covid patients needed to be addressed were bleeding and drug interactions. Rather than a simple cause, multiple factors like drug regimen, dosage, concomitant medications, and individual patient factors play a role in development of side effects in covid patients

Arterial hypertension and COVID-19 infection new insights

Universitatea de Stat de Medicină şi Farmacie „Nicolae Testemiţanu”, Chişinău, Republica MoldovaIntroduction. The SARS-Covid 2 infection was first reported in Wuhan, Hubei Province, China on 31 December 2019. Symptomatic SARS-CoV-2 infection was most frequent in the elderly and led to a more severe illness. At the same time, a large fraction of this patient population also suffered from arterial hypertension (AHT). Hence, AHT became a hot topic in the SARS-CoV-2 pandemic studies. Purpose of the study. This study aims to shine light on the current insights in this relationship spectrum. Materials and Methods. A literature analysis of the latest scientific sources has been carried out using the PubMed search engines, „HINARI” and Google Academic with the help of respective keywords. Additionally, a pathophysiological breakdown and newer advancements in this domain have been referred for the benefit of the study Results. AHT was the most prevalent cardiovascular comorbidity in patients with SARS-CoV-2 infection and a major risk factor for increased severity, mortality, and hospitalization. Influential factors included cardiovascular morbidity, co-morbidities, presenting symptoms, age of the patient etc. The role of AHT is mediated through its effect on the regulation of RAAS, inflammation, immunity and the gastrointestinal tract which partly explains the worse outcomes in covid patients. In contrast to the effect of AHT on SARS-CoV-2 patients, new- onset hypertension was also reported in a few post covid patients. RAAS inhibitors did not fuel clinical adversities and was associated with a lower risk of hospitalization, intubation and death. Newer therapies emerging from the common background include hACE2 and sACE2. Conclusions. AHT is an independent risk factor and the most frequently encountered co-morbidity in SARS-CoV-2 patients. New-onset AHT in post-covid patients points to a bidirectional relationship. Current data failed to discredit RAAS inhibitors. Newer therapies from common pathological background may help eliminate a vicious cycle from SARS-CoV-2 infection in AHT patients

Covid-19 infection and arterial hypertension: the relationship between the two entities

Background: The aim of the study was to breakdown the relationship and its nature between the two pathological entities arterial hypertension (AHT) and SARS-CoV-2 infection. The analysis of existing literature on both topics has been conducted. Sources including journals, books, existing publications and online platforms like Google Academic, PubMed, HINARI were used as search engines. Additionally, guidelines and circulars from European Society of Cardiology, American Heart Association and other respective bodies were also referred to. Data from large meta-analyses and clinical studies were included to bring out the relationship study. Pathophysiological breakdown of the two entities, contradicting proposals regarding treatment, new treatment modalities and de novo onset of AHT in post-Covid infection were included to delineate the relationship between the two pathological entities. Conclusions: Findings emphasize that the role of arterial hypertension in SARS-CoV-2 infection is mediated through its effect on the regulation of Renin Angiotensin Aldosteron System (RAAS), inflammation and immune responses. De-novo arterial hypertension was also reported in post SARS-CoV-2 infection patients. Though some initial studies hypothesized that RAAS inhibitors may add to clinical adversities, most studies afterward disproved the same and in fact revealed a protective role of the same. Angiotensin Converting Enzyme 2 (ACE2) is proposed as a treatment option in SARS-CoV-2 infection