Neurological comorbidity and severity of COVID-19

Journal of Neurology - Neurological symptoms of COVID-19 patients have been recently described. However, no comprehensive data have been reported on pre-existing neurological comorbidities and...     

Efficacy of safinamide as add-on therapy after subthalamic nucleus deep brain stimulation in Parkinson disease

Neurological Sciences - Subthalamic nucleus deep brain stimulation (STN-DBS) is an effective surgical treatment for advanced Parkinson’s disease (PD). However, some patients still experience...     

Heparin and SARS-CoV-2: Multiple Pathophysiological Links

Low molecular weight heparin, enoxaparin, has been one of most used drugs to fight the SARS-CoV-2 pandemic. Pharmacological properties of heparin recognize its specific ability, as with other oligosaccharides and glycosaminoglycan, to bind several types of viruses during their pass through the extracellular matrix of the respiratory tract, as well as its anticoagulant activity to prevent venous thromboembolism. Antithrombotic actions of enoxaparin have been testified both for inpatients with COVID-19 in regular ward and for inpatients in Intensive Care Units (ICUs). Prophylactic doses seem to be able to prevent venous thromboembolism (VTE) in inpatients in the regular ward, while intermediate or therapeutic doses have been frequently adopted for inpatients with COVID-19 in ICU. On the other hand, although we reported several useful actions of heparin for inpatients with COVID-19, an increased rate of bleeding has been recorded, and it may be related to several conditions such as underlying diseases with increased risks of bleeding, increased doses or prolonged administration of heparin, personal trend to bleed, and so on.     

Anxiety,depression, and worries in advanced Parkinson disease during COVID-19 pandemic

Neurological Sciences - The psychological impact of the COVID-19 outbreak and lockdown on frail populations with advanced Parkinson disease (APD) and their caregivers may present with peculiar...     

Bacteriuria in patients with an orthotopic ileal neobladder: urinary tract infection or asymptomatic bacteriuria?

OBJECTIVE

To investigate the prevalence of asymptomatic bacteriuria (ABU) and urinary tract infection (UTI), and the local and systemic inflammatory response, in patients with ileal neobladder.

PATIENTS AND METHODS

The study included 40 patients who had a radical cystectomy and ileal neobladder. Two urine samples, one for chemical and physical analysis, and cytofluorimetry, and one for urine culture, were collected every 3 months for 9 months after surgery.

RESULTS

Of 119 urine cultures, 69 (57%) were positive for bacteria. Only nine of the 40 patients had no bacteriuria on urine culture. Escherichia coli strains were cultured from eight of 10 patients with persistently positive urine. The incidence of bacteriuria was different according to gender. There was a high concentration of leukocytes (0–6 µL) in 118 of 119 samples. The mean concentration of leukocytes in sterile urine culture was 1181/µL, while in patients with ABU the mean was 491 (P < 0.05).

CONCLUSION

A positive urine culture is a very common finding in patients with an orthotopic bladder. The most interesting results was the absence of elevated inflammatory indices and/or symptoms, even in those patients with high levels of bacteriuria. Probably this is due to the completely different inflammatory response of ileal mucosa against bacteria than has bladder mucosa. Indeed, the leukocyte concentration detected in urinary sediment was inversely association with bacterial growth in urine cultures. These findings suggest a redefinition of ABU and UTI in patients with an orthotopic neobladder.     

Effects of the angiotensin II receptor blocker losartan on the monocyte expression of biglycan in hypertensive patients

1. Recently, we demonstrated that biglycan (BGN) is increased in circulating monocyte cells from hypertensive patients and that angiotensin (Ang) II is able to increase BGN expression. The present study was designed to investigate the effects of treatment with the angiotensin AT₁ receptor antagonist losartan on monocyte BGN mRNA and protein expression in essential hypertension. 2. One hundred and twenty‐six newly diagnosed hypertensive patients without additional risk factors for atherosclerosis and cardiovascular disease were treated with 100 mg losartan once daily for 6 months. Biglycan mRNA and protein expression was determined in monocytes isolated from peripheral blood before (T₀) and after (T₁) therapy. Plasma levels of interleukin (IL)‐6, tumour necrosis factor (TNF)‐α and high sensitivity C‐reactive protein (hs‐CRP) were also determined. In addition, BGN mRNA and protein expression was determined after the ex vivo addition of 1 μmol/L AngII to monocytes isolated from 20 randomly selected hypertensive patients. 3. Biglycan mRNA and protein expression, blood pressure and plasma levels of fibrinogen, IL‐6, TNF‐α and CRP were significantly lower at T₁ than at T₀. Variations in BGN expression were associated with inflammatory markers, but not directly with blood pressure. In AngII‐stimulated monocytes, BGN mRNA and protein expression was significantly lower at T₁ that at T₀. Moreover, mean BGN mRNA expression in AngII‐stimulated monocytes isolated from losartan‐treated patients was similar to baseline expression in unstimulated monocytes from untreated patients. 4. The results of the present study show that losartan can reduce BGN expression in monocytes from hypertensive patients, without any linear association with blood pressure, suggesting that the effects of AngII on BGN expression in monocytes may be modulated, in part, by an AT₁ receptor blocker.