Association of inpatient use of angiotensin converting enzyme inhibitors and angiotensin II receptor blockers with mortality among patients with hypertension hospitalized with COVID-19

Rationale: Use of angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin II receptor blockers (ARBs) is a major concern for clinicians treating coronavirus disease 2019 (COVID-19) in patients with hypertension. Objective: To determine the association between in-hospital use of ACEI/ARB and all-cause mortality in COVID-19 patients with hypertension. Methods and Results: This retrospective, multi-center study included 1128 adult patients with hypertension diagnosed with COVID-19, including 188 taking ACEI/ARB (ACEI/ARB group; median age 64 [IQR 55-68] years; 53.2% men) and 940 without using ACEI/ARB (non-ACEI/ARB group; median age 64 [IQR 57-69]; 53.5% men), who were admitted to nine hospitals in Hubei Province, China from December 31, 2019 to February 20, 2020. Unadjusted mortality rate was lower in the ACEI/ARB group versus the non-ACEI/ARB group (3.7% vs. 9.8%; P = 0.01). In mixed-effect Cox model treating site as a random effect, after adjusting for age, gender, comorbidities, and in-hospital medications, the detected risk for all-cause mortality was lower in the ACEI/ARB group versus the non-ACEI/ARB group (adjusted HR, 0.42; 95% CI, 0.19-0.92; P =0.03). In a propensity score-matched analysis followed by adjusting imbalanced variables in mixed-effect Cox model, the results consistently demonstrated lower risk of COVID-19 mortality in patients who received ACEI/ARB versus those who did not receive ACEI/ARB (adjusted HR, 0.37; 95% CI, 0.15-0.89; P = 0.03). Further subgroup propensity score-matched analysis indicated that, compared to use of other antihypertensive drugs, ACEI/ARB was also associated with decreased mortality (adjusted HR, 0.30; 95%CI, 0.12-0.70; P = 0.01) in COVID-19 patients with hypertension. Conclusions: Among hospitalized COVID-19 patients with hypertension, inpatient use of ACEI/ARB was associated with lower risk of all-cause mortality compared with ACEI/ARB non-users. While study interpretation needs to consider the potential for residual confounders, it is unlikely that in-hospital use of ACEI/ARB was associated with an increased mortality risk

Bowel symptoms and self-care strategies of survivors in the process of restoration after low anterior resection of rectal cancer

Abstract Background The purpose of this research is to identify the bowel symptoms and self-care strategies for rectal cancer survivors during the recovery process following low anterior resection surgery. Methods A total of 100 participants were investigated under the structured interview guide based on the dimensions of “symptom management theory”. Results 92% of participants reported changes in bowel habits, the most common being the frequent bowel movements and narrower stools, which we named it finger-shaped consistency stools. The 6 most frequently reported bowel symptoms were excessive flatus (93%), clustering (86%), urgency (77%), straining (62%), bowel frequency (57%) and anal pendant expansion (53%). Periodic bowel movements occurred in 19% participants. For a group of 79 participants at 6 to 24 months post-operation, 86.1% reported a significant improvement of bowel symptoms. Among 68 participants of this subgroup with significant improvements, 70.5% participants reported the length of time it took was at least 6 months. Self-care strategies adopted by participants included diet, bowel medications, practice management and exercise. Conclusions It is necessary to educate patients on the symptoms experienced following low anterior resection surgery. Through the process of trial and error, participants have acquired self-care strategies. Healthcare professionals should learn knowledge of such strategies and help them build effective interventions

Coxixodes (Coxixodes) Schulze 1941

Subgenus <i>Coxixodes</i> Schulze, 1941 <p> <b>Type species:</b> <i>Ixodes ornithorhynchi</i> Lucas, 1846.</p> <p> <b>Type depository</b>: The notes of Guglielmone <i>et al</i>. (2014) about the location of the types (syntypes) are correct: MNHN (Museum National d’Histoire Naturelle, Paris, France).</p> <p> <b>Species included</b>: <i>Ixodes ornithorhynchi</i> Lucas, 1846.</p> <p> <b>Subgeneric combination:</b> <i>Ixodes</i> (<i>Coxixodes</i>) <i>ornithorhynchi</i> Lucas, 1846.</p> <p> <b>Diagnosis</b>: With characteristics of its sole constituent species, <i>Ixodes ornithorhynchi</i>. Roberts (1960) has generous diagnoses of the female, nymph and larvae; these will not be repeated here.</p> <p> <b>Distribution:</b> eastern Australia.</p> <p> <b>Remarks:</b> <i>Ixodes ornithorhynchi</i> is the only tick that is known to parasitise <i>Ornithorhynchus anatinus</i> (Shaw, 1799), the platypus, which occurs only in freshwater creeks and rivers in eastern Australia; this information together with the detailed diagnosis Roberts (1960) makes <i>I</i>. (<i>Coxixodes</i>) <i>ornithorhynchi</i> readily distinguishable from all other ticks.</p> <p> Guglielmone <i>et al</i>. (2020) has a list of the descriptions and redescriptions of the sole species in this subgenus, <i>I</i>. <i>ornithorhynchi</i>. <i>Coxixodes</i> was described as a genus by Schulze (1941) with <i>Ixodes ornithorhynchi</i> as the type species. The decision by Schulze to describe a new genus was based mainly on the structure of Haller’s organ and characteristics of the coxae (refer to Guglielmone <i>et al</i>. 2017). The genus <i>Coxixodes</i> was then treated as valid by Zumpt (1951) but has been ignored by most of the other authors on this topic (Roberts 1960, 1970; Filippova 1977; Camicas <i>et al</i>. 1998, Guglielmone <i>et al</i>. 2017 among others): none of these authors synonymised <i>Coxixodes</i> Schulze, 1941 with another taxon although Roberts (1960, 1970) placed the sole species in <i>Coxixodes</i>, <i>I</i>. <i>ornithorhynchi</i>, in the genus <i>Ixodes</i>. Camicas <i>et al</i>. (1998), on the other hand, treated <i>Coxixodes</i> as a subgenus. We note that Roberts (1970) has a truncated version of the diagnosis of Roberts (1960) so readers may wish to use the diagnosis of Roberts (1960) in favour of Roberts (1970). Pagenstecher (1861), as explained in Neumann (1899), described the nymph (refer to Guglielmone <i>et al</i>. 2020). Roberts (1969) described the larvae. The male has not been described.</p>Published as part of <i>Barker, Stephen C., Kelava, Samuael, Heath, Allen C. G., Seeman, Owen D., Apanaskevich, Dmitry A., Mans, Ben J., Shao, Renfu, Gofton, Alexander W., Teo, Ernest J. M., Byrne, Andrew F., Ito, Takuya, Tan, Craig J., Barker, Dayana & Nakao, Ryo, 2023, A new subgenus, Australixodes n. subgen. (Acari: Ixodidae), for the kiwi tick, Ixodes anatis Chilton, 1904, and validation of the subgenus Coxixodes Schulze, 1941 with a phylogeny of 16 of the 22 subgenera of Ixodes Latreille, 1795 from entire mitochondrial genome sequences, pp. 529-540 in Zootaxa 5325 (4)</i> on page 536, DOI: 10.11646/zootaxa.5325.4.4, <a href="http://zenodo.org/record/8243707">http://zenodo.org/record/8243707</a&gt

Ixodes (Australixodes) Barker & Kelava & Heath & Seeman & Apanaskevich & Mans & Shao & Gofton & Teo & Byrne & Ito & Tan & Barker & Nakao 2023, n. subgen.

Subgenus <i>Australixodes</i> n. subgen. Barker, S.C. & Barker, D. <p>urn:lsid:zoobank.org:act: ADD7AD7C-1317-4FE4-87C7-D70D08847456</p> <p> <b>Type species:</b> <i>Ixodes anatis</i> Chilton, 1904, here designated.</p> <p> <b>Subgeneric combination:</b> <i>Ixodes</i> (<i>Australixodes</i>) <i>anatis</i> Chilton, 1904.</p> <p> <b>Type depository</b>: The record of Kwak & Heath (2018) about the syntype are correct: Canterbury Museum, New Zealand (CMNZ, Reference number: 2015.162.1) (A.C.G. Heath).</p> <p> <b>Species included</b>: monotypic, <i>Ixodes anatis</i> Chilton, 1904.</p> <p> <b>Diagnosis</b>: With characteristics of its sole constituent species <i>Ixodes</i> (<i>Australixodes</i>) <i>anatis</i>. Kwak & Heath (2018) provided detailed diagnoses and illustrations of the larvae, nymphs, males and females; these will not be repeated here. <i>Ixodes</i> (<i>Australixodes</i>) <i>anatis</i> is the only tick that is known from the kiwi (New Zealand); this information, together with the combination of morphological features noted by Kwak & Heath (2018), make <i>I</i>. (<i>Australixodes</i>) <i>anatis</i> readily distinguishable from all other ticks. <i>Ixodes anatis</i> has been recorded from three taxa of kiwi in New Zealand: <i>Apteryx mantelli</i> Bartlett, 1852 (North Island kiwi), <i>A</i>. <i>australis australis</i> Shaw, 1813 (South Island brown kiwi) and <i>A</i>. <i>a</i>. <i>lawryi</i> Rothschild, 1891 (Stewart Island brown kiwi) (Heath 2010).</p> <p> <b>Etymology:</b> The name of this new subgenus refers to the geographic distribution of <i>I</i>. (<i>Australixodes</i>) <i>anatis</i> in New Zealand in Australasia (masculine).</p> <p> <b>Distribution:</b> New Zealand.</p> <p> <b>Remarks:</b> Guglielmone <i>et al</i>. (2020) gives a list of the descriptions and redescriptions of the sole species in this subgenus, <i>I</i>. (<i>Australixodes</i>) <i>anatis</i>. Other papers pertinent to the geographic distribution and biology of <i>I</i>. (<i>Australixodes</i>) <i>anatis</i>: Heath (2010 a, 2010b) and Heath <i>et al</i>. (2011), Swift <i>et al</i>. (2015), Bansal <i>et al</i>. (2021).</p> <p> <b>Discussion:</b> A subgenus is needed for <i>I</i>. <i>anatis</i> for two reasons. First, <i>I</i>. <i>anatis</i> does not fit, morphologically, into the subgenus <i>Sternalixodes</i> (Heath 1977; Kwak <i>et al</i>. 2017; Kwak & Heath 2018). The differences are discussed in detail by Kwak & Heath (2018) but here we reiterate that none of the life stages of <i>I</i>. <i>anatis</i> has a sternal plate, the eponymous character state that has been used to define the subgenus. Second, genetically, <i>I</i>. <i>anatis</i> does not fit into the subgenus <i>Sternalixodes</i> either (Fig. 2). Rather, our mt genome phylogeny revealed that the sister group of <i>I</i>. <i>anatis</i> is <i>Ceratixodes</i> + <i>Sternalixodes</i> (Fig. 2). Camicas <i>et al</i>. (1998) placed <i>I</i>. <i>anatis</i> in the <i>I</i>. <i>unicavatus</i> species group of the subgenus <i>Scaphixodes</i> but did not explain their reasons. The other three species in the <i>I</i>. <i>unicavatus</i> species group of Camicas <i>et al</i>. (1998) were <i>I</i>. <i>unicavatus</i> Neumann, 1908 from the Palaearctic, <i>I</i>. <i>signatus</i> (Birula, 1895) from Palaearctic and Nearctic, and <i>I</i>. <i>downsi</i> (Kohls, 1957) from the Neotropical region.</p>Published as part of <i>Barker, Stephen C., Kelava, Samuael, Heath, Allen C. G., Seeman, Owen D., Apanaskevich, Dmitry A., Mans, Ben J., Shao, Renfu, Gofton, Alexander W., Teo, Ernest J. M., Byrne, Andrew F., Ito, Takuya, Tan, Craig J., Barker, Dayana & Nakao, Ryo, 2023, A new subgenus, Australixodes n. subgen. (Acari: Ixodidae), for the kiwi tick, Ixodes anatis Chilton, 1904, and validation of the subgenus Coxixodes Schulze, 1941 with a phylogeny of 16 of the 22 subgenera of Ixodes Latreille, 1795 from entire mitochondrial genome sequences, pp. 529-540 in Zootaxa 5325 (4)</i> on pages 533-536, DOI: 10.11646/zootaxa.5325.4.4, <a href="http://zenodo.org/record/8243707">http://zenodo.org/record/8243707</a&gt