XI. STRATEGIES FOR IMPROVING DIABETES CARE D iabetes is a chronic illness that requires continuing medical care and patient self-management education to prevent acute complications and to reduce the risk of long-term complications. Diabetes care is complex and requires that many issues, beyond glycemic control, be addressed. A large body of evidence exists that supports a range of interventions to improve diabetes outcomes. These standards of care are intended to provide clinicians, patients, researchers, payors, and other interested individuals with the components of diabetes care, treatment goals, and tools to evaluate the quality of care. While individual preferences, comorbidities, and other patient factors may require modification of goals, targets that are desirable for most patients with diabetes are provided. These standards are not intended to preclude more extensive evaluation and management of the patient by other specialists as needed. For more detailed information, refer to Bode (Ed.): Medical Management of Type 1 Diabetes (1), Burant (Ed): Medical Management of Type 2 Diabetes (2), and Klingensmith (Ed): Intensive Diabetes Management (3). The recommendations included are diagnostic and therapeutic actions that are known or believed to favorably affect health outcomes of patients with diabetes. A grading system (Table 1), developed by the American Diabetes Association (ADA) and modeled after existing methods, was utilized to clarify and codify the evidence that forms the basis for the recommendations. The level of evidence that supports each recommendation is listed after each recommendation using the letters A, B, C, or E.

Standards of Medical Care in Diabetes

Prospective Cohort Study

https://publications.hse.ru/mirror/pubs/share/folder/myodg9xfxt/direct/143360779.pdf

Global, regional, and national age-sex specific all-cause and cause-specific mortality for 240 causes of death, 1990-2013: A systematic analysis for the Global Burden of Disease Study 2013

Summary Background Since December, 2019, Wuhan, China, has experienced an outbreak of coronavirus disease 2019 (COVID-19), caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Epidemiological and clinical characteristics of patients with COVID-19 have been reported but risk factors for mortality and a detailed clinical course of illness, including viral shedding, have not been well described. Methods In this retrospective, multicentre cohort study, we included all adult inpatients (≥18 years old) with laboratory-confirmed COVID-19 from Jinyintan Hospital and Wuhan Pulmonary Hospital (Wuhan, China) who had been discharged or had died by Jan 31, 2020. Demographic, clinical, treatment, and laboratory data, including serial samples for viral RNA detection, were extracted from electronic medical records and compared between survivors and non-survivors. We used univariable and multivariable logistic regression methods to explore the risk factors associated with in-hospital death. Findings 191 patients (135 from Jinyintan Hospital and 56 from Wuhan Pulmonary Hospital) were included in this study, of whom 137 were discharged and 54 died in hospital. 91 (48%) patients had a comorbidity, with hypertension being the most common (58 [30%] patients), followed by diabetes (36 [19%] patients) and coronary heart disease (15 [8%] patients). Multivariable regression showed increasing odds of in-hospital death associated with older age (odds ratio 1·10, 95% CI 1·03–1·17, per year increase; p=0·0043), higher Sequential Organ Failure Assessment (SOFA) score (5·65, 2·61–12·23; p Interpretation The potential risk factors of older age, high SOFA score, and d-dimer greater than 1 μg/mL could help clinicians to identify patients with poor prognosis at an early stage. Prolonged viral shedding provides the rationale for a strategy of isolation of infected patients and optimal antiviral interventions in the future. Funding Chinese Academy of Medical Sciences Innovation Fund for Medical Sciences; National Science Grant for Distinguished Young Scholars; National Key Research and Development Program of China; The Beijing Science and Technology Project; and Major Projects of National Science and Technology on New Drug Creation and Development.

Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study

Persistence of coronaviruses on inanimate surfaces and their inactivation with biocidal agents.

Disease control in food production animals is normally achieved through the use of antimicrobials, drugs and vaccines. However, the injudicious and wide use of antibiotics and other drugs/chemicals in animal husbandry practices and livestock raising systems have resulted in environmental, food safety and human health concerns, principally due to the emergence of drug-resistant microbes and residual toxicity in foods of animal origin. During recent years, therapeutic interventions with biologics and newer treatment modalities like phages, apoptins, cytokines, avian egg yolk antibodies, stem cell therapy, herbal remedies and others are gaining more and more focus into medical and veterinary sciences. Of these, cytokines therapy is of immense importance and possesses great potential and values for treating human as well as animal diseases. Cytokines, the natural mediators of immunity, include interleukins (IL), interferons (IFN), tumor necrosis factor (TNF), chemokines, adipokines and mesenchymal growth factors. Cytokines have characteristic multiple biological properties (pleiotropism), and affect various stages of embryonic development, disease pathogenesis, and immune responses including of both non-specific and specific ones. Their mode of action on the cells may be autocrine, paracrine or in endocrine manner; mediated by means of various cytokine receptors. Cytokines, their receptors and signal transduction pathways, are promising candidates for treatment purposes and therapeutic interferences due to their multiple functions, regulatory and effector cellular functions, in many diseases. In this regard TNF-TNF receptor interaction and neutralization of any such interaction requires special mention. Cytokines, being good immunomodulators, play crucial role in a vast array of infectious diseases, wherein the use of recombinant cytokines is worth mentioning. The therapeutic applicability of cytokines and modulation of their actions is being explored for a many infectious diseases, autoimmune diseases, immunocompromised patients (acquired immunodeficiency syndrome, AIDS), and in neoplasia. Cytokines possess potential capability in controlling various diseases of animals too and present possible alternatives to traditional / conventional therapeutics. Limitations of cytokine therapy like short half life and adverse affects are also being tackled with innovative novel strategies so as to widen the potent application of these wonderful molecules. The present review discusses the role of cytokines in various therapeutic interventions, anti-tumor effects, and their applications as adjuvants for new generation vaccines both in the field of human as well as animal science / medicine.

Cytokine therapy for combating animal and human diseases – A review

Artificial Insemination in Poultry and Possible Transmission of Infectious Pathogens: A Review

The world has been thrown into pandemonium due to the recent Coronavirus Disease-19 (COVID-19) pandemic Early available clinical data have indicated that geriatric persons cum those with co-morbidity such as cardiovascular, metabolic and immunological disorders suffered severe form of COVID-19 All countries and territories of the world are currently exploring available strategies to control the pandemic with the hope to significantly minimize its morbidity and mortality rate This present study critically reviewed available and latest research progress of the genetics and ecology of SARS-CoV-2, as well as the influence of climatic factors on the spread of COVID-19, and thus, discussed how these concepts could be harnessed for COVID-19 control and further scientific advancements in resolving the pandemic

Exploring the genetics, ecology of SARS-CoV-2 and climatic factors as possible control strategies against COVID-19

Strategies for combating and eradicating important infectious diseases of animals with particular reference to India: present and future perspectives.

COVID-19 caused by the virus SARS-CoV-2 has gripped essentially all countries in the world, and has infected millions and killed hundreds of thousands of people. Several innovative approaches are in development to restrain the spread of SARS-CoV-2. In particular, BCG, a vaccine against tuberculosis (TB), is being considered as an alternative therapeutic modality. BCG vaccine is known to induce both humoral and adaptive immunities, thereby activating both nonspecific and cross-reactive immune responses in the host, which combined could effectively resist other pathogens including SARS-CoV-2. Notably, some studies have revealed that SARS-CoV-2 infectivity, case positivity, and mortality rate have been higher in countries that have not adopted BCG vaccination than in countries that have done so. This review presents an overview of the concepts underlying BCG vaccination and its nonspecific immuological effects and protection, resulting in 'trained immunity' and potential utility for resisting COVID-19.

https://www.tandfonline.com/doi/pdf/10.1080/21645515.2020.1818522

Ruchi Tiwari

Papers

Cytokine therapy for combating animal and human diseases – A review

Artificial Insemination in Poultry and Possible Transmission of Infectious Pathogens: A Review

Exploring the genetics, ecology of SARS-CoV-2 and climatic factors as possible control strategies against COVID-19

Strategies for combating and eradicating important infectious diseases of animals with particular reference to India: present and future perspectives.

BCG vaccine: a hope to control COVID-19 pandemic amid crisis.