The International Journal of Artificial Organs

The aim of our study was to compare the prevalence, etiology, and outcomes of sepsis and associated AKI in pre- and post-COVID-19 pandemic.

We conducted a retrospective observational analysis in 144 patients with sepsis and AKI, in two periods of time, 2 years before and after COVID-19 pandemic, with 2 years’ washout period.

The comparative analysis between the two periods demonstrated more severe forms of sepsis with septic shock dominating in the post pandemic period (5 (10%) vs 23 (25%), p = 0.037). According AKI staging we found AKI stage 3 more frequently present after pandemic and more patients needed dialysis in the post COVID-19 pandemic (35 (70%) vs 79 (84%), p = 0.04; 31 (62%) vs 78 (54%), p = 0.02; 16 (32%) vs 51% (54%), p = 0.018), respectively. Patients in post COVID-19 era survived less longer (22.66 ± 11.32 vs 17.132 ± 12.66, p = 0.021) with almost doubled risk for mortality HR: 1.977; 95% CI (1.127 ± 3.469), p = 0.018. Regarding causative agents’ there was similar distribution in both periods, but the multiple antibiotic resistance index (MAR) was significantly higher in the post COVID-19 period for Staphylococcus coagulase negative (0.48 vs 0.62, p = 0.001).

Sepsis and associated AKI occurrence, morbidity and mortality are significantly higher in the post COVID-19 pandemic and the increased MAR of the germs can be one of the main reason for it.

Conventional imaging fails to quantify the true physical density and mass of organs. This study aims to develop a spectral CT-based physical modeling approach to quantify organ remodeling in type 2 diabetes mellitus (T2DM).

A total of 97 subjects (46 T2DM patients and 51 non-diabetic controls) were evaluated. Organ regions (liver, pancreas, spleen) were automatically segmented using a V-Net neural network. A physical density model was constructed based on spectral parameters. We compared organ CT value, effective atomic number, mass, volume, and physical density between groups and analyzed their correlation with HbA1c levels.

The physical density model showed high accuracy, with measured subcutaneous fat density aligning with standard physical references. In T2DM patients, pancreatic mass and physical density decreased significantly. Conversely, liver and spleen mass increased without significant changes in physical density. Pancreatic physical density showed a significant negative correlation with HbA1c, with rho = −0.411 and p < 0.001.

The spectral physical density model provides a precise, non-invasive metric for assessing organ quality. The strong correlation between pancreatic density and glycemic supports its potential utility in evaluating functional reserve for artificial organ.

Artificial pancreas systems represent an important technological advancement in the management of type 1 diabetes mellitus (T1DM). These systems provide automated insulin delivery and have the potential to improve glycemic control and cardiometabolic outcomes. In this study, we aimed to evaluate the effects of artificial pancreas systems on glycemic control, lipid parameters, and proteinuria in patients with T1DM in a real-world clinical setting.

This retrospective study included 32 patients with T1DM who transitioned to artificial pancreas therapy. Glycemic parameters including HbA1c, fasting blood glucose (FBG), and postprandial blood glucose (PBG) were compared before pump initiation and at 3 months, 6 months, and 1 year after treatment. Lipid parameters and spot urine proteinuria levels were evaluated before pump therapy and at 1-year follow-up. Repeated measures ANOVA and paired t-tests were used for continuous variables, while Cochran’s Q and McNemar tests were used for categorical variables.

A significant reduction in HbA1c levels was observed over time, decreasing from 8.74 ± 1.21% before pump initiation to 7.92 ± 0.98% at 3 months, 7.61 ± 0.87% at 6 months, and 7.48 ± 0.83% at 1 year (p < 0.001). Fasting and postprandial glucose levels also significantly declined during follow-up (p < 0.001). LDL cholesterol and total cholesterol levels decreased significantly at 1 year (p = 0.029 and p = 0.006, respectively), while HDL cholesterol increased significantly (p = 0.022). The reduction in triglyceride levels was not statistically significant (p = 0.069). Proteinuria levels decreased from 84.6 ± 42.3 mg/g before pump therapy to 61.8 ± 35.7 mg/g at 1 year (p = 0.011). The proportion of patients achieving HbA1c target increased from 18.8% before pump therapy to 62.5% at 1 year (p < 0.001).

Artificial pancreas therapy significantly improves glycemic control and increases the proportion of patients achieving HbA1c targets in individuals with T1DM. In addition, favorable effects on lipid profile and proteinuria suggest potential cardiometabolic benefits of artificial pancreas systems.