Purpose The COVID-19 pandemic was noted for the high degree of contagion and the large number of cases, as well as for the various clinical forms, from asymptomatic towards rapid evolution to death. The hospitals limited care capacity imposed the need to identify some markers of unfavorable evolution. The purpose of our study is to identify the parameters correlated with COVID-19 unfavorable evolution and to draw the profile of the patient at risk of unfavorable evolution. This set of parameters will help the doctor in deciding whether to hospitalize a patient and in choosing the treatment. Patients and Methods We performed a prospective, observational, actively controlled study on 849 patients with COVID-19, hospitalized in the Second Clinic of “Sf. Cuv. Parascheva” Infectious Diseases Clinical Hospital Galati, Romania, between 1.03.2020–30.11.2020. Results The parameters statistically significant modified at the admission of the patients with COVID-19 unfavorable evolution were age, oxygen saturation, D-dimers, creatine kinase (CK), troponin, erythrocytes sedimentation rate (ESR), leukocytes, lymphocytes, neutrophils, platelets, hemoglobin (Hb), aspartate transaminase (AST), total and direct bilirubin (TBIL, DBIL), urea, creatinine, serum glucose. Strong correlations were observed between the unfavorable evolution and the admission values of D-dimers, AST, TBIL and between D-dimers and AST, which suggests that D-dimers levels can be considered predictive for the alteration of liver function and for the negative prognosis of the patient. Conclusion Coagulation disorders and acute respiratory failure are the prevailing causes of death from COVID-19. Together with other parameters that constitute the risk profile for severe COVID-19 evolution, the D-dimers dosing at admission proved to be extremely useful in the management of COVID-19.
The coronavirus disease 2019 (COVID-19) pandemic imposed arestructuring of global health systems by rethinking spaces used for the care of these patients and the additions of intensive care, infectious diseases and pneumology departments. This paper provides evidence on the presence of severe acute respiratory syndrome coronavirus 2 in hepatocytes and its direct cytopathic activity, as well as the degree of liver damage due to drug toxicity, inflammation and hypoxia in COVID-19. A review of clinical trials has quantified liver damage through both pathology and biochemistry studies. Additionally, we briefly present the results of a study conducted in our clinic on 849 patients admitted for COVID-19 treatment, of which 31 patients had pre-existing chronic liver disease and 388 patients had values above the normal limit for alanine aminotransferase, aspartate aminotransferase, and total bilirubin. It was observed that patients with abnormal liver tests were significantly statistically older, had more comorbidities and had a higher percentage of unfavourable evolution (death or transfer to intensive care). The conclusion of this paper is that the main causes of liver damage are direct viral aggression, coagulation dysfunction and endothelial damage, and patients with impaired liver function develop more severe forms of COVID-19 which requires special care by a multidisciplinary team that includes a hepatologist.
Drilling of polymeric materials can be challenging when holes are produced in large scale due to the necessity of controlling the holes quality. This paper presents the effect of machining parameters on the hole quality, in terms of surface roughness and circularity error, in drilling of high density polyethylene, polyamide and polyacetale. The analysis of variance was performed in order to assess the significance of cutting parameter on the hole quality parameters. The experimental results indicate that different cutting conditions are to be employed in order to achieve the optimum surface roughness and circularity.
Sandwich panels with composite/steel skin sheets and foam core are very often used as lightweight structures in automotive, maritime and aerospace applications due to their performances like high bending stiffness and strength and also lightweight. As an alternative to classical structural reinforced panels, the sandwich structures are justifying their use in various industrial fields, making these structures less complex, by eliminating the need for secondary stiffening. In the paper are presented three models of sandwich, steel-foam-steel, composite-foam-composite or steel-foam-composite structures, of different thicknesses, with functional use in various fields depending on necessities. The mechanical characteristics of the materials used in their manufacture have been determined. The panels have been subjected to various load cases in order to determine an optimal combination of weight and strength. At the same time, the numerical models used in the finite element analysis of the sandwich structures with specific elements for layered composites or sandwich (SHELL 4L and SOLID L) are presented.
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