RESUMEN
Objective: To fit and predict the trend of COVID-19 epidemics in the United States (USA) and the United Kingdom (UK), and analyze the effect of vaccination. Methods: Based on the SEIR dynamic model, considering the presymptomatic infections, isolation measures, vaccine vaccination coverage, etc., we developed a SEIR with vaccine inoculation, Presymptomatic infectious, unconfirmed infectious, hospital isolation and domiciliary isolation dynamics model. The publicly released incidence data of COVID-19 from November 6, 2020 to January 31, 2021 in USA and from November 23, 2020 to January 31, 2021 in UK were used to fit the model and the publicly released incidence data of COVID-19 from February 1, 2021 to April 1 were used to evaluate the predicting power of the model by software R 4.0.3 and predict changes in the daily new cases in the context of different vaccination coverage. Results: According to the cumulative confirmed cases, the fitting bias and the predicting bias of the SVEPIUHDR model for USA and UK were less than 5%, respectively. From the model prediction results, the cumulative cases after COVID-19 vaccination in USA in early April reached 31 864 970. If there had not had such vaccination, the cumulative cases of COVID-19 would have reached to 35 317 082, with a gap of more than 3.4 million cases. In UK, the cumulative cases of COVID-19 after the vaccination was estimated to be 4 195 538 in early April, compared with 4 268 786 cases if no COVID-19 vaccination had been provided, there would have heen a gap of more than 70 000 cases. Conclusion: SVEPIUHDR model shows a good prediction effect on the epidemic of COVID-19 in both USA and UK.
Asunto(s)
COVID-19 , Epidemias , Vacunas , Vacunas contra la COVID-19 , Humanos , SARS-CoV-2 , Estados Unidos/epidemiologíaRESUMEN
BACKGROUND: Improvements in immunosuppression, operative procedure, and posttransplant management have made clinical small bowel transplantation (SBT) feasible. Ischemia and reperfusion injury, total parenteral nutrition (TPN), and devoidment of enteral feeding lead to graft atrophy, gut barrier dysfunction, and bacterial translocation. Glutamine (Gln) is the principal fuel for the enterocyte. The influence of Gln dipeptide-supplemented TPN, especially long-term TPN, on intestinal graft permeability and bacterial translocation is not clear following SBT in the large animal model. Therefore, we studied the effect of glutamine dipeptide, glycyl-glutamine (Gly-Gln), on bacterial translocation following SBT in the pig, which has a physiology similar to humans. MATERIALS AND METHODS: The outbred pigs underwent segmental small bowel autotransplantation and were divided into two groups. In the STPN group (n = 5), the animal received standard TPN devoid of Gly-Gln for 28 days. In the GTPN group (n = 5), the animal received isonitrogenous (0.3 g/kg.day) and isocaloric (33 kcal/kg.day) TPN solution with 2% Gly-Gln for 28 days. RESULTS: At the end of the experiment, Gly-Gln-enriched TPN could maintain the plasma Gln level, graft mucosal Gln and protein concentrations, and skeletal muscle Gln and protein concentrations. Gly-Gln-enriched TPN significantly decreased the bacterial number of mesenteric lymph nodes in the liver and spleen and intestinal permeability to 99mTc-DTPA. There were no significant differences in body weight gain. CONCLUSIONS: The Gly-Gln-enriched long-term TPN may maintain the plasma Gln level, mucosal and muscle Gln, and protein concentrations and attenuate the intestinal permeability to 99mTc-DTPA and bacterial translocation following small bowel transplantation in the pig.
Asunto(s)
Dipéptidos/administración & dosificación , Intestino Delgado/microbiología , Intestino Delgado/trasplante , Nutrición Parenteral Total/métodos , Animales , Recuento de Colonia Microbiana , Femenino , Glutamina/sangre , Glutamina/metabolismo , Humanos , Mucosa Intestinal/metabolismo , Mucosa Intestinal/microbiología , Ganglios Linfáticos/microbiología , Masculino , Músculo Esquelético/metabolismo , Permeabilidad , Proteínas/metabolismo , Porcinos , Pentetato de Tecnecio Tc 99m , Trasplante AutólogoRESUMEN
Plasma aminogram changes were prospectively studied in 95 patients with external enteric fistula and intraabdominal infection who were under total parenteral nutrition (TPN) therapy with anfuming 14s. Plasma amino acids and albumin were determined before the administration of TPN, weekly and at the end of the therapy or 2 to 5 days before death of patients. In patients with sepsis and starvation, the aminogram showed remarkably low total free amino acids before TPN therapy. In survivors, free amino acids increased gradually to normal in 2 weeks after use of TPN and in the dead increased rapidly to a significantly high peak at the terminal stage. In both survivors and deceased, phenylalanine level remained high during the study. In response to infection, proline was also elevated but to a lesser degree; the ratio of branched chain amino acid (BCAA) to aromatic amino acid (AAA) was lower than normal and the decrease of arginine was parallel to the severity of infection. We conclude that the ideal amino acid preparation for the starved, septic patients should be high in BCAA and arginine but low in phenylalanine; the administration of inappropriate exogenous amino acids in metabolically decompensated septic patients may bring about more harm than benefit; and in septic patients the persistently elevated level of plasma phenylalanine and proline along with decrease of arginine is a useful prognostic sign.