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

https://www.chpso.org/sites/main/files/file-attachments/chest-2008-geerts-381s-453s.pdf

Prevention of Venous Thromboembolism* American College of Chest Physicians Evidence- Based Clinical Practice Guidelines (8th Edition)

https://www.srcv.ro/en/ghiduri/Preventia%20trombembolismului%20la%20pacientii%20nonortopedici%20-%20Ghidurile%20ACCP%202012.pdf

Prevention of VTE in Nonorthopedic Surgical Patients : Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines

The Society for Vascular Surgery practice guidelines on the care of patients with an abdominal aortic aneurysm

The epidemiology of chronic venous insufficiency and varicose veins.

During ischemia, the cell structures are progressively damaged, but restoration of the blood flow, paradoxically, intensifies the lesions caused by the ischemia. The mechanisms of ischemia injury and reperfusion (I/R) have not been completely defined and many studies have been realized in an attempt to find an ideal therapy for mesenteric I/R. The occlusion and reperfusion of the splanchnic arteries provokes local and systemic alterations principally derived from the release of cytotoxic substances and the interaction between neutrophils and endothelial cells. Substances involved in the process are discussed in the present review, like oxygen-derived free radicals, nitric oxide, transcription factors, complement system, serotonin and pancreatic proteases. The mechanisms of apoptosis, alterations in other organs, therapeutic and evaluation methods are also discussed.

https://www.scielo.br/pdf/acb/v20n4/24991.pdf

Pathophysiology of mesenteric ischemia/reperfusion: a review.

The prevalence of varicose veins (VV) and of chronic venous insufficiency (CVI) was studied among 1755 adults over 15 years of age (443 men and 1312 women). These people attended the University Health Center in Botucatu, a country town in the State of Sao Paulo, Brazil, for routine examination or for any disease complaints. The prevalence of all grades of VV not including telangiectasis and reticular varices grade I was 47.6% (37.9% in men and 50.9% in non-pregnant women). The prevalence of VV recorded as moderate or severe was 21.2%. The more severe form of CVI with active or healed ulcer was present in 3.6% of the subjects (2.3% of men and 4% of women). For only 5.5% of the patients was VV or CVI the reason for medical consultation. The prevalence of VV increased with age and number of pregnancies and was greater among white than non-white people. Working posture or posture adopted for defaecation did not influence the prevalence of VV. Our data show the prevalence of VV and CVI to be higher or as high as the prevalence found in developed western countries. We therefore propose that studies of these conditions should be included in epidemiological surveys of other developing areas or countries, so that if data similar to ours are verified prophylaxis and early treatment could be included in health planning for these areas with the aim of reducing future morbidity and the related social onus.

Varicose Veins and Chronic Venous Insufficiency in Brazil: Prevalence among 1755 Inhabitants of a Country Town

http://www.venousdisease.com/Publications/ra%20caprini%20comparison.pdf?origin=publicationDetail

Incorrect use of thromboprophylaxis for venous thromboembolism in medical and surgical patients: results of a multicentric, observational and cross-sectional study in Brazil.

O oxido nitrico e um mediador gasoso responsavel por uma variedade de fenomenos fisiologicos. A l-arginina e a precursora da sintese do oxido nitrico, na presenca de oxido nitrico-sintase. Este artigo reve as funcoes das oxido nitrico-sintases e como o oxido nitrico atua na permeabilidade vascular e na sindrome de isquemia e reperfusao, assim como possiveis metodos para sua mensuracao.

/pdf/oxido-nitrico-revisao-5b34geqroy.pdf

Winston Bonetti Yoshida

Papers

Pathophysiology of mesenteric ischemia/reperfusion: a review.

Varicose Veins and Chronic Venous Insufficiency in Brazil: Prevalence among 1755 Inhabitants of a Country Town

Incorrect use of thromboprophylaxis for venous thromboembolism in medical and surgical patients: results of a multicentric, observational and cross-sectional study in Brazil.

Óxido nítrico: revisão

Doenças vasculares periféricas