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1.
Vestn Otorinolaringol ; 85(4): 35-39, 2020.
Artigo em Russo | MEDLINE | ID: mdl-32885634

RESUMO

According to WHO almost half of the population undergoing infectious diseases of the upper respiratory tract one third of which is inflammatory diseases of the pharynx. This article presents the therapy issue of patients with sore throat due to acute pharyngitis and/or acute tonsillitis of non-streptococcal etiology based on our own experience and literature data. Observational study was carried out at the Otorhinolaryngology department of MSUMD n.a. A.I. Evdokimov in order to evaluate efficacy and tolerability of complex local drug Doritricin. The study involved 52 patients, objective and subjective manifestations of the disease were evaluated. Obtained data indicate the effectiveness and safety of Doritricin, as well as the possibility of reducing the number of drugs used during treatment.


Assuntos
Laringe , Abscesso Peritonsilar , Faringite , Infecções Estreptocócicas , Humanos , Nariz , Faringe
2.
J Stroke Cerebrovasc Dis ; 29(9): 104981, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32807416

RESUMO

Coronavirus disease 19 (COVID-19) is an emerging infectious disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). In this scenario, managing acute medical conditions, such as stroke, requires a timely treatment together with proper strategies that minimize the risk of infection spreading to health care workers and other patients. We report the case of a 79-year-old woman, who was admitted for a wake-up stroke due to occlusion of the left middle cerebral artery. She was treated outside the COVID-19-dedicated track of the hospital because she had no concomitant signs or symptoms suggestive of SARS-CoV-2 infection nor recent contact with other infected individuals. Post-mortem nasal and pharyngeal swab was positive for SARS-CoV-2 infection. We propose that hyperacute stroke patients should be tested for SARS-CoV-2 infection at admission and then managed as having COVID-19 until cleared by a negative result. We are aware that such measure results in some delay of the acute treatment of stroke, which could be minimal using well-exercised containment protocols.


Assuntos
Betacoronavirus/isolamento & purificação , Técnicas de Laboratório Clínico , Infecções por Coronavirus/diagnóstico , Infarto da Artéria Cerebral Média/terapia , Nariz/virologia , Faringe/virologia , Pneumonia Viral/diagnóstico , Idoso , Infecções por Coronavirus/transmissão , Infecções por Coronavirus/virologia , Diagnóstico Tardio , Evolução Fatal , Feminino , Humanos , Infarto da Artéria Cerebral Média/diagnóstico , Infarto da Artéria Cerebral Média/fisiopatologia , Transmissão de Doença Infecciosa do Paciente para o Profissional/prevenção & controle , Exposição Ocupacional/efeitos adversos , Pandemias , Pneumonia Viral/transmissão , Pneumonia Viral/virologia , Valor Preditivo dos Testes , Fatores de Risco , Índice de Gravidade de Doença
3.
Medicine (Baltimore) ; 99(31): e21526, 2020 Jul 31.
Artigo em Inglês | MEDLINE | ID: mdl-32756197

RESUMO

RATIONALE: Dysphagia is a common presenting symptom in elderly people. Nevertheless, dysphagia resulting from diffuse idiopathic skeletal hyperostosis (DISH) of patients' cervical spine may be due to several factors. Despite computed tomography scan showing the size and shape of osteophytes, endoscopy may be necessary to exclude other intrinsic causes of dysphagia. Due to the anatomic variation of the pharynx secondary to DISH, patients undergoing endoscopy are at risk of perforation. Once perforation occurs, inappropriate treatments may finally lead to an irretrievable outcome. PATIENT CONCERNS: A 58-year-old male patient with a 20-day history of dysphagia initially visited an ear-nose-throat (ENT) doctor. He had no neck pain and no other history of cervical disease. DIAGNOSIS: This patient with dysphagia due to DISH of the cervical spine underwent laryngoscopy to exclude other causes. Pharyngeal perforation resulted as a complication of the procedure. INTERVENTIONS: The patient underwent laryngoscopy and biopsy by an ENT doctor to exclude intrinsic causes. After the procedure, a perforation was formed on the posterior wall of the pharynx. Conservative management, that is, 1 week of nothing per oral, and 1 month of antibiotics, was adopted. On the 30th day after the examination, the patient was voluntarily discharged from the hospital and recommended to take antibiotics orally. OUTCOMES: On the 56th day, the patient experienced fever and neck pain. Magnetic resonance imaging showed that the cervical vertebral bodies and spinal cord were infected. On the midday of the 60th day, the patient had a failed resuscitation and died. LESSONS: DISH involving the cervical spine is a complicated cause of dysphagia. Due to the anatomic variation of the pharynx secondary to DISH, patients undergoing endoscopy are at risk of perforation. If other intrinsic causes of dysphagia have to be excluded with the aid of endoscopy, plain films and computed tomography images should be read carefully first. To minimize the risk of perforation, it is necessary to perform endoscopy extremely carefully, especially biopsy. Once perforation occurs, operative treatment may be more appropriate and effective.


Assuntos
Transtornos de Deglutição/diagnóstico por imagem , Transtornos de Deglutição/etiologia , Hiperostose Esquelética Difusa Idiopática/complicações , Laringoscopia/efeitos adversos , Faringe/lesões , Humanos , Masculino , Pessoa de Meia-Idade
4.
Anal Chem ; 92(14): 9454-9458, 2020 07 21.
Artigo em Inglês | MEDLINE | ID: mdl-32615038

RESUMO

The outbreak of SARS-CoV-2 is posing serious global public health problems. Facing the emergence of this pandemic, we established a portable microfluidic immunoassay system for easy-to-use, sensitive, rapid (<15 min), multiple, and on-site detection of IgG/IgM/Antigen of SARS-CoV-2 simultaneously. This integrated method was successfully applied for detecting SARS-CoV-2 IgM and IgG antibodies in clinical human serum as well as SARS-CoV-2 antigen in pharyngeal swabs from 26 patients with COVID-19 infection and 28 uninfected people. The assay demonstrated high sensitivity and specificity, which is promising for the diagnosis and monitoring as well as control of SARS-CoV-2 worldwide.


Assuntos
Anticorpos Antivirais/análise , Betacoronavirus/imunologia , Infecções por Coronavirus/diagnóstico , Imunoensaio/métodos , Imunoglobulina G/análise , Imunoglobulina M/análise , Técnicas Analíticas Microfluídicas/métodos , Pneumonia Viral/diagnóstico , Técnicas de Laboratório Clínico/métodos , Ensaio de Imunoadsorção Enzimática , Humanos , Pandemias , Faringe/química , Faringe/imunologia , Sensibilidade e Especificidade
5.
J Laryngol Otol ; 134(7): 626-631, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32723416

RESUMO

OBJECTIVE: To verify the main advantages and drawbacks of mechanical suturing for pharyngeal closure after total laryngectomy versus a manual suturing technique. METHODS: A retrospective review was carried out of 126 total laryngectomies performed between 2008 and 2018. Manual closure was performed in 80 cases (63.5 per cent) and mechanical suturing was performed in 46 cases (36.5 per cent). RESULTS: Mechanical suturing was used significantly more frequently in patients with: glottic tumours (p = 0.008), less local tumour extension (p = 0.017) and less pre-operative morbidity (p = 0.014). There were no significant differences in the incidence of pharyngocutaneous fistula between the manual suture group (16.3 per cent) and the mechanical suture group (13.0 per cent) (p = 0.628). None of the patients treated with mechanical suturing had positive surgical margins. Cancer-specific survival for the mechanical suture group was higher than that for the manual suture group (p = 0.009). CONCLUSION: Mechanical suturing of the pharynx after total laryngectomy is an oncologically safe technique if used in suitable cases.


Assuntos
Laringectomia/métodos , Faringe/cirurgia , Técnicas de Sutura , Idoso , Feminino , Humanos , Neoplasias Laríngeas/cirurgia , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos
6.
Arq Gastroenterol ; 57(2): 150-153, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32609156

RESUMO

BACKGROUND: Gastroesophageal reflux disease is associated with slower transit of the bolus through the pharynx and upper esophageal sphincter. Functional heartburn has similar symptoms to gastroesophageal reflux disease, however, the symptoms are not caused by reflux. OBJECTIVE: The aim of this investigation was to evaluate oral and pharyngeal transit in patients with functional heartburn, with the hypothesis that, similar to patients with gastroesophageal reflux disease, they have changes in pharyngeal and upper esophageal sphincter transit time. METHODS: Oral and pharyngeal transit was evaluated by videofluoroscopy in eight women with functional heartburn, five with mild dysphagia for solid foods, and 12 female controls. Controls and patients swallowed in duplicate 5 mL and 10 mL of liquid and paste boluses. RESULTS: No difference in the oral or pharyngeal transit time was found between patients and controls. No aspiration of bolus into the airways was detected in any individual. Pharyngeal residues were detected in the same proportion of swallows, in patients (12.5%) and controls (15.0%), after swallows of 10 mL paste bolus. CONCLUSION: Oral, pharyngeal and upper esophageal sphincter transit time are similar in patients with functional heartburn to healthy controls.


Assuntos
Azia , Faringe , Deglutição , Transtornos de Deglutição , Feminino , Refluxo Gastroesofágico , Humanos , Manometria
7.
PLoS One ; 15(7): e0223080, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32639962

RESUMO

Recent reviews on sexual dichromatism in frogs included Mannophryne trinitatis as the only example they could find of dynamic dichromatism (males turn black when calling) within the family Aromobatidae and found no example of ontogenetic dichromatism in this group. We demonstrate ontogenetic dichromatism in M. trinitatis by rearing post-metamorphic froglets to near maturity: the throats of all individuals started as grey coloured; at around seven weeks, the throat became pale yellow in some, and more strongly yellow as development proceeded; the throats of adults are grey in males and variably bright yellow in females, backed by a dark collar. We demonstrated the degree of throat colour variability by analysing a large sample of females. The red: green (R:G) ratio ranged from ~1.1 to 1.4, reflecting variation from yellow to yellow/orange, and there was also variation in the tone and width of the dark collar, and in the extent to which the yellow colouration occurred posterior to the collar. Female M. trinitatis are known to be territorial in behaviour. We show a positive relationship between throat colour (R:G ratio) and escape performance, as a proxy for quality. Our field observations on Tobago's M. olmonae showed variability in female throat colour and confirmed that males in this species also turn black when calling. Our literature review of the 20 Mannophryne species so far named showed that all females have yellow throats with dark collars, and that male colour change to black when calling has been reported in eight species; in the remaining 12 species, descriptions of males calling are usually lacking so far. We predict that both dynamic and ontogenetic sexual dichromatism are universal in this genus and provide discussion of the ecological role of dichromatism in this genus of predominantly diurnal, non-toxic frogs, with strong paternal care of offspring.


Assuntos
Anuros/fisiologia , Caracteres Sexuais , Animais , Anuros/crescimento & desenvolvimento , Comportamento Animal , Cor , Feminino , Masculino , Faringe/fisiologia
9.
Vestn Otorinolaringol ; 85(3): 36-42, 2020.
Artigo em Russo | MEDLINE | ID: mdl-32628381

RESUMO

OBJECTIVE: The article demonstrates the experience of using laser fluorescence spectrometry (LFS) in the diagnosis of inflammatory diseases of pharynx, describes a method for recording spectra of pharyngeal tissues using the EnSpectr L405 hardware-software complex operating on the basis of laser radiation with a wavelength of 405 nm, and identifies characteristic features of spectral curves. PATIENTS AND METHODS: The authors presented the characteristics of the spectra from the surface of the pharynx tissue of healthy volunteers, patients with chronic tonsillitis and granular pharyngitis. RESULTS: The most informative parameters of the spectral curves were calculated, analyzing which it is possible to identify the morphometric, metabolic, functional features of the tissue of the tonsils and posterior pharyngeal wall in normal and pathological conditions. CONCLUSION: The article illustrates the importance of developing highly sensitive and highly specific methods for the rapid diagnosis of inflammatory diseases of the pharynx. The presented technology can be used in clinical practice in future.


Assuntos
Faringite , Tonsilite , Humanos , Tonsila Palatina , Faringe , Espectrometria de Fluorescência
10.
Medicine (Baltimore) ; 99(29): e21118, 2020 Jul 17.
Artigo em Inglês | MEDLINE | ID: mdl-32702862

RESUMO

INTRODUCTION: Lipomas are rarely found in primary mesenchymal tumors of the hypopharynx and larynx. When they do appear, they often macroscopically resemble a retention cyst or laryngeal nodule. The laryngeal spindle cell lipoma, a variant, is extremely rare. PATIENT CONCERNS: A 65-year-old woman presented with a 3-month history of pharyngeal paraesthesia. Laryngoscopy revealed the presence of a well-encapsulated, smooth-surfaced, yellowish, pedicled mass on the left epiglottis. Magnetic resonance imaging confirmed the epiglottic mass. DIAGNOSIS: Following excision of the mass, the diagnosis of an spindle cell lipoma was established and confirmed by immunohistochemistry. INTERVENTIONS: Surgical excision of the lesion using a controlled-temperature plasma technique (coblation). OUTCOMES: At the last (4-year) follow-up evaluation, the patient was asymptomatic and without recurrence. CONCLUSION: SLC involvement of the epiglottis is rare. Coblation is an effective means to remove it.


Assuntos
Sarcoma/diagnóstico , Idoso , Feminino , Humanos , Laringoscopia/métodos , Laringe/patologia , Imagem por Ressonância Magnética/métodos , Faringe/anormalidades , Faringe/fisiopatologia , Sarcoma/patologia , Sarcoma/cirurgia
11.
BMC Infect Dis ; 20(1): 429, 2020 Jun 19.
Artigo em Inglês | MEDLINE | ID: covidwho-608211

RESUMO

BACKGROUND: Since December 2019, over 80,000 patients with coronavirus disease 2019 (COVID-19) have been confirmed in China. With the increasing number of recovered patients, more attention should be paid to the follow-up of these patients. METHODS: In the study, 576 patients with COVID-19 discharged from hospital in Chongqing, China from January 24, 2020, to March 10, 2020 were evaluated by viral nucleic acid tests for severe acute respiratory syndrome coronavirus 2(SARS-CoV-2) to determine if they could be released from quarantine. Among the 576 patients, 61 patients (10.6%) had positive RT-PCR test results of SARS-CoV-2. We aimed to analyze the demographics, clinical characteristics and treatment of 61 patients. RESULTS: These positive patients were characterized by older age, chronic medical illness and mild conditions. 38 (62.3%) patients who were asymptomatic without abnormalities on chest radiographs were found in the positive with COVID-19. Also, they showed positive results of stool or sputum specimens with negative results of nasal and pharyngeal swab specimens. The median duration of positive result of SARS-CoV-2 was varied from 3 days to 35 days in the patients discharged from hospital with no family member infection. CONCLUSIONS: Multi-site screening of SARS-CoV-2 including nasal and pharyngeal swabs, stool and sputum specimens could be considered to improve the diagnosis, treatment and infection control in patients with COVID-19. Our findings provide the important information and clinical evidence for the improved management of patients recovered from COVID-19.


Assuntos
Infecções por Coronavirus/diagnóstico , Alta do Paciente , Pneumonia Viral/diagnóstico , Adulto , Idoso , Betacoronavirus , China , Técnicas de Laboratório Clínico , Fezes/virologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Nariz/virologia , Pandemias , Faringe/virologia , RNA Viral/isolamento & purificação , Escarro/virologia
12.
Eur Rev Med Pharmacol Sci ; 24(10): 5772-5777, 2020 May.
Artigo em Inglês | MEDLINE | ID: covidwho-542647

RESUMO

OBJECTIVE: It has recently been reported that some COVID-19 patients have long-term positive fecal nucleic acid after discharging from the hospital with negative nucleic acid in the respiratory tract, but it is unclear whether COVID-19 patients with positive long-term fecal nucleic acid tests have the risk of self-infection. PATIENTS AND METHODS: From January 25, 2020 to March 9, 2020, 5 COVID-19 patients with negative respiratory tract nucleic acid and positive fecal nucleic acid were observed and studied to explore whether these patients can re-infect themselves. Five patients with COVID-19 accompanied by diarrhea as the main gastrointestinal symptoms were carefully observed through clinical symptoms, imaging and other auxiliary examinations. The RT-PCR technology was used to continuously detect fecal and respiratory viral nucleic acids. The IgM antibody was detected on the 7th day of admission and IgM/IgG at the time of discharge. RESULTS: All 5 patients had symptoms of fever and diarrhea upon admission. The fecal nucleic acid was positive, as well as the throat swab was positive. All COVID-19 patients had positive IgM antibodies on the 7th day of admission and positive IgM and IgG at the time of discharge, and there were no abnormalities in the gastrointestinal examination on discharge. All 5 fecal nucleic acid tests were positive at the time of discharge. After continuous dynamic follow-up for 3-15 days, no clinical symptoms recurred, and the last nucleic acid test was negative. CONCLUSIONS: There is no risk of self-infection for COVID-19 patients with long-term 2019-nCoV nucleic acid positive in feces.


Assuntos
Betacoronavirus/genética , Infecções por Coronavirus/diagnóstico , Fezes/virologia , Pneumonia Viral/diagnóstico , RNA Viral/análise , Adulto , Betacoronavirus/imunologia , Betacoronavirus/isolamento & purificação , Infecções por Coronavirus/virologia , Feminino , Humanos , Imunoglobulina G/sangue , Imunoglobulina M/sangue , Masculino , Pessoa de Meia-Idade , Pandemias , Alta do Paciente , Faringe/virologia , Pneumonia Viral/virologia , RNA Viral/genética , RNA Viral/metabolismo , Recidiva , Tomografia Computadorizada por Raios X
13.
BMC Infect Dis ; 20(1): 429, 2020 Jun 19.
Artigo em Inglês | MEDLINE | ID: mdl-32560694

RESUMO

BACKGROUND: Since December 2019, over 80,000 patients with coronavirus disease 2019 (COVID-19) have been confirmed in China. With the increasing number of recovered patients, more attention should be paid to the follow-up of these patients. METHODS: In the study, 576 patients with COVID-19 discharged from hospital in Chongqing, China from January 24, 2020, to March 10, 2020 were evaluated by viral nucleic acid tests for severe acute respiratory syndrome coronavirus 2(SARS-CoV-2) to determine if they could be released from quarantine. Among the 576 patients, 61 patients (10.6%) had positive RT-PCR test results of SARS-CoV-2. We aimed to analyze the demographics, clinical characteristics and treatment of 61 patients. RESULTS: These positive patients were characterized by older age, chronic medical illness and mild conditions. 38 (62.3%) patients who were asymptomatic without abnormalities on chest radiographs were found in the positive with COVID-19. Also, they showed positive results of stool or sputum specimens with negative results of nasal and pharyngeal swab specimens. The median duration of positive result of SARS-CoV-2 was varied from 3 days to 35 days in the patients discharged from hospital with no family member infection. CONCLUSIONS: Multi-site screening of SARS-CoV-2 including nasal and pharyngeal swabs, stool and sputum specimens could be considered to improve the diagnosis, treatment and infection control in patients with COVID-19. Our findings provide the important information and clinical evidence for the improved management of patients recovered from COVID-19.


Assuntos
Infecções por Coronavirus/diagnóstico , Alta do Paciente , Pneumonia Viral/diagnóstico , Adulto , Idoso , Betacoronavirus , China , Técnicas de Laboratório Clínico , Fezes/virologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Nariz/virologia , Pandemias , Faringe/virologia , RNA Viral/isolamento & purificação , Escarro/virologia
14.
J Clin Microbiol ; 58(8)2020 07 23.
Artigo em Inglês | MEDLINE | ID: mdl-32518072

RESUMO

Real-time reverse transcription-PCR (RT-PCR) is currently the most sensitive method to detect severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) that causes coronavirus disease 2019 (COVID-19). However, the correlation between detectable viral RNA and culturable virus in clinical specimens remains unclear. Here, we performed virus culture for 60 specimens that were confirmed to be positive for SARS-CoV-2 RNA by real-time RT-PCR. The virus could be successfully isolated from 12 throat and nine nasopharyngeal swabs and two sputum specimens. The lowest copy number required for virus isolation was determined to be 5.4, 6.0, and 5.7 log10 genome copies/ml sample for detecting the nsp12, E, and N genes, respectively. We further examined the correlation of genome copy number and virus isolation in different regions of the viral genome, demonstrating that culturable specimens are characterized by high copy numbers with a linear correlation observed between copy numbers of amplicons targeting structural and nonstructural regions. Overall, these results indicate that in addition to the copy number, the integrity of the viral genome should be considered when evaluating the infectivity of clinical SARS-CoV-2 specimens.


Assuntos
Betacoronavirus/crescimento & desenvolvimento , Betacoronavirus/isolamento & purificação , Técnicas de Laboratório Clínico/métodos , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/virologia , Pneumonia Viral/diagnóstico , Pneumonia Viral/virologia , Cultura de Vírus/métodos , Betacoronavirus/genética , Correlação de Dados , Humanos , Nasofaringe/virologia , Pandemias , Faringe/virologia , Reação em Cadeia da Polimerase em Tempo Real/métodos , Reação em Cadeia da Polimerase Via Transcriptase Reversa/métodos
16.
Exp Mol Med ; 52(6): 963-977, 2020 06.
Artigo em Inglês | MEDLINE | ID: mdl-32546849

RESUMO

SARS-CoV-2 is very contagious and has rapidly spread globally. Due to various symptomatic and asymptomatic cases and the possibility of asymptomatic transmission, there is a pressing need for a fast and sensitive detection protocol to diagnose asymptomatic people. Various SARS-CoV-2 diagnostic kits are already available from many companies and national health agencies. However, publicly available information on these diagnostic kits is lacking. In response to the growing need and the lack of information, we developed and made available a low-cost, easy-access, real-time PCR-based protocol for the early detection of the virus in a previous study. During the development of the detection protocol, we found that unoptimized primer sets could inadvertently show false-positive results, raising the possibility that commercially available diagnostic kits might also contain primer sets that produce false-positive results. Here, we provide three-step guidelines for the design and optimization of specific primer sets. The three steps include (1) the selection of primer sets for target genes (RdRP, N, E, and S) in the genome of interest (SARS-CoV-2), (2) the in silico validation of primer and amplicon sequences, and (3) the optimization of PCR conditions (i.e., primer concentrations and annealing temperatures) for specific hybridization between the primers and target genes, and the elimination of spurious primer dimers. Furthermore, we have expanded the previously developed real-time PCR-based protocol to more conventional PCR-based protocols and applied a multiplex PCR-based protocol that allows the simultaneous testing of primer sets for RdRP, N, E, and S all in one reaction. Our newly optimized protocol should be helpful for the large-scale, high-fidelity screening of asymptomatic people, even without any high-specification equipment, for the further prevention of transmission, and to achieve early intervention and treatment for the rapidly propagating virus.


Assuntos
Betacoronavirus/genética , Técnicas de Laboratório Clínico/métodos , Infecções por Coronavirus/virologia , Primers do DNA , Pneumonia Viral/virologia , Reação em Cadeia da Polimerase/métodos , Infecções por Coronavirus/diagnóstico , Células HEK293 , Humanos , Reação em Cadeia da Polimerase Multiplex/métodos , Pandemias , Faringe/virologia , Pneumonia Viral/diagnóstico , RNA Replicase/genética , Reação em Cadeia da Polimerase em Tempo Real/métodos , Vírus da SARS/genética , Glicoproteína da Espícula de Coronavírus/genética , Proteínas não Estruturais Virais/genética , Proteínas Virais/genética
19.
Indian J Med Res ; 151(5): 438-443, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32474558

RESUMO

Background & objectives: A cluster of SARS-CoV-2 infection occurred among Italian tourists visiting India. We report here the epidemiological, clinical, radiological and laboratory findings of the first cluster of SARS-CoV-2 infection among the tourists. Methods: Information was collected on demographic details, travel and exposure history, comorbidities, timelines of events, date of symptom onset and duration of hospitalization from the 16 Italian tourists and an Indian with laboratory-confirmed SARS-CoV-2 infection. The clinical, laboratory, radiologic and treatment data was abstracted from their medical records and all tourists were followed up till their recovery or discharge or death. Throat and deep nasal swab specimens were collected on days 3, 8, 15, 18, 23 and 25 to evaluate viral clearance. Results: A group of 23 Italian tourists reached New Delhi, India, on February 21, 2020 and along with three Indians visited several tourist places in Rajasthan. By March 3, 2020, 17 of the 26 (attack rate: 65.4%) had become positive for SARS-CoV-2 infection. Of these 17 patients, nine were symptomatic, while eight did not show any symptoms. Of the nine who developed symptoms, six were mild, one was severe and two were critically ill. The median duration between the day of confirmation for COVID-19 and RT-PCR negativity was 18 days (range: 12-23 days). Two patients died with a case fatality of 11.8 per cent. Interpretation & conclusions: This study reconfirms higher rates of transmission among close contacts and therefore, public health measures such as physical distancing, personal hygiene and infection control measures are necessary to prevent transmission.


Assuntos
Infecções Assintomáticas/epidemiologia , Betacoronavirus , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/terapia , Pneumonia Viral/epidemiologia , Pneumonia Viral/terapia , Idoso , Betacoronavirus/genética , Análise por Conglomerados , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/transmissão , Estado Terminal , Evolução Fatal , Feminino , Humanos , Índia/epidemiologia , Itália/etnologia , Masculino , Cavidade Nasal/virologia , Pandemias , Gravidade do Paciente , Faringe/virologia , Pneumonia Viral/diagnóstico , Pneumonia Viral/transmissão , RNA Viral/análise , Reação em Cadeia da Polimerase Via Transcriptase Reversa , Viagem
20.
PLoS One ; 15(6): e0233983, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32484841

RESUMO

BACKGROUND: Anatomical feline models can aid in understanding the relationships between clinical findings and anatomical features and the course of foreign bodies passing through the oesophagus. This study has two goals 1) to assess feline oesophageal foreign bodies in feline patients using physical, radiologic and endoscopic examination and, how their location influences treatment plans and complications. 2) How the anatomical sharp angle of the oesophagus contribute to foreign body lodgement. Thirty-five cats were enrolled in this study; 30 of them were clinically ill, and five cats were used for anatomical study. RESULTS: Cats with clinical signs underwent complete clinical and radiologic examination. Endoscopy was performed in only five cases. The site with the highest occurrence of foreign body lodgement was the oesophageal entrance, caudal to the pharynx (63.3%), followed by the thoracic inlet (26.7%) and the mid-cervical region of the oesophagus (10%). Two types of foreign bodies were identified: sewing needles (25/30) and bone (5/30). Radiography was able to identify the location and nature of the foreign body in all 30 affected cats. Therapeutic regimens were applied according to the nature and location of the foreign body and any associated complications. Removal of the foreign body was achieved using Rochester pean artery forceps in 17/30 cases, using full surgical intervention in 8/30 cases, and during endoscopy in 5/30 cases. CONCLUSION: The results suggest that the location of the foreign body is strongly related to combination of consumed foreign body type and anatomic features of the cat oesophagus. The feline oesophagus has a variety of sharp angles that facilitate the entrapment of rigid linear and angular foreign bodies. Radiographic imaging remains the most frequently used diagnostic modality for determining the lodgement site and nature of radiopaque foreign bodies. Over all complication rate was low (6/30).


Assuntos
Esôfago/anatomia & histologia , Corpos Estranhos/diagnóstico por imagem , Faringe/anatomia & histologia , Animais , Gatos , Esofagoscopia , Esôfago/diagnóstico por imagem , Faringe/diagnóstico por imagem
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