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1.
Indian J Med Res ; 151(5): 411-418, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32611912

RESUMO

Coronavirus disease 2019 (COVID-19) is caused by a highly contagious RNA virus termed as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Ophthalmologists are at high-risk due to their proximity and short working distance at the time of slit-lamp examination. Eye care professionals can be caught unaware because conjunctivitis may be one of the first signs of COVID-19 at presentation, even precluding the emergence of additional symptoms such as dry cough and anosmia. Breath and eye shields as well as N95 masks, should be worn while examining patients with fever, breathlessness, or any history of international travel or travel from any hotspot besides maintaining hand hygiene. All elective surgeries need to be deferred. Adults or children with sudden-onset painful or painless visual loss, or sudden-onset squint, or sudden-onset floaters or severe lid oedema need a referral for urgent care. Patients should be told to discontinue contact lens wear if they have any symptoms of COVID-19. Cornea retrieval should be avoided in confirmed cases and suspects, and long-term preservation medium for storage of corneas should be encouraged. Retinal screening is unnecessary for coronavirus patients taking chloroquine or hydroxychloroquine as the probability of toxic damage to the retina is less due to short-duration of drug therapy. Tele-ophthalmology and artificial intelligence should be preferred for increasing doctor-patient interaction.


Assuntos
Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/transmissão , Transmissão de Doença Infecciosa do Paciente para o Profissional/prevenção & controle , Exposição Ocupacional/prevenção & controle , Saúde do Trabalhador/normas , Oftalmologia , Pandemias , Pneumonia Viral/epidemiologia , Pneumonia Viral/transmissão , Conjuntivite/virologia , Transplante de Córnea , Infecções por Coronavirus/complicações , Infecções por Coronavirus/diagnóstico , Humanos , Oftalmologia/métodos , Equipamento de Proteção Individual , Pneumonia Viral/complicações , Pneumonia Viral/diagnóstico , Guias de Prática Clínica como Assunto , Fatores de Risco , Lágrimas/virologia , Telemedicina , Obtenção de Tecidos e Órgãos/normas
2.
Br J Hosp Med (Lond) ; 81(6): 1-10, 2020 Jun 02.
Artigo em Inglês | MEDLINE | ID: mdl-32589541

RESUMO

Ocular complications in critical care patients are common. There has been a surge in intensive care admissions following the COVID-19 outbreak. The management of COVID-19 exposes patients to a number of specific risk factors for developing ocular complications, which include non-invasive ventilation, mechanical ventilation and prone positioning. Consequently, it is likely that there will be an increase in the number of ocular complications secondary to the management of COVID-19 patients in the intensive care unit setting, and these complications could lead to permanent visual loss and blindness. Increased awareness of eye care in the intensive care unit setting is therefore vital to help prevent visual loss and maintain quality of life for patients recovering from COVID-19.


Assuntos
Infecções por Coronavirus/terapia , Oftalmopatias/terapia , Unidades de Terapia Intensiva , Oftalmologia , Pneumonia Viral/terapia , Encaminhamento e Consulta , Doença Aguda , Betacoronavirus , Doenças da Túnica Conjuntiva/prevenção & controle , Doenças da Túnica Conjuntiva/terapia , Conjuntivite/prevenção & controle , Conjuntivite/terapia , Doenças da Córnea/prevenção & controle , Doenças da Córnea/terapia , Lesões da Córnea/prevenção & controle , Lesões da Córnea/terapia , Cuidados Críticos , Estado Terminal , Edema/prevenção & controle , Edema/terapia , Endoftalmite/prevenção & controle , Endoftalmite/terapia , Oftalmopatias/prevenção & controle , Glaucoma/diagnóstico , Glaucoma/terapia , Humanos , Ceratite/prevenção & controle , Ceratite/terapia , Lubrificantes/uso terapêutico , Pomadas/uso terapêutico , Pandemias , Transtornos da Visão/diagnóstico , Transtornos da Visão/terapia
6.
Clin Exp Optom ; 103(4): 418-424, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-32406140

RESUMO

The ocular surface has been suggested as a site of infection with Coronavirus-2 (SARS-CoV-2) responsible for the coronavirus disease-19 (COVID-19). This review examines the evidence for this hypothesis, and its implications for clinical practice. Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2), responsible for the COVID-19 pandemic, is transmitted by person-to-person contact, via airborne droplets, or through contact with contaminated surfaces. SARS-CoV-2 binds to angiotensin converting enzyme-2 (ACE2) to facilitate infection in humans. This review sets out to evaluate evidence for the ocular surface as a route of infection. A literature search in this area was conducted on 15 April 2020 using the Scopus database. In total, 287 results were returned and reviewed. There is preliminary evidence for ACE2 expression on corneal and conjunctival cells, but most of the other receptors to which coronaviruses bind appear to be found under epithelia of the ocular surface. Evidence from animal studies is limited, with a single study suggesting viral particles on the eye can travel to the lung, resulting in very mild infection. Coronavirus infection is rarely associated with conjunctivitis, with occasional cases reported in patients with confirmed COVID-19, along with isolated cases of conjunctivitis as a presenting sign. Coronaviruses have been rarely isolated from tears or conjunctival swabs. The evidence suggests coronaviruses are unlikely to bind to ocular surface cells to initiate infection. Additionally, hypotheses that the virus could travel from the nasopharynx or through the conjunctival capillaries to the ocular surface during infection are probably incorrect. Conjunctivitis and isolation of the virus from the ocular surface occur only rarely, and overwhelmingly in patients with confirmed COVID-19. Necessary precautions to prevent person-to-person transmission should be employed in clinical practice throughout the pandemic, and patients should be reminded to maintain good hygiene practices.


Assuntos
Betacoronavirus/isolamento & purificação , Conjuntivite/etiologia , Infecções por Coronavirus/etiologia , Olho/virologia , Pneumonia Viral/etiologia , Animais , Humanos , Pandemias , Peptidil Dipeptidase A/genética , Peptidil Dipeptidase A/fisiologia , Receptores Virais/fisiologia
9.
PLoS One ; 15(4): e0231966, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32330153

RESUMO

BACKGROUND: Rubella virus infection mainly causes illness with mild fever, rash, and lymphadenopathy in children; however, the clinical characteristics of adult rubella are not well-known. METHODS: An observational study was conducted to compare the characteristics between adult rubella and adult non-rubella among participants aged ≥18 years, with suspected symptomatic rubella. Participants were screened for rubella-specific IgM expression using an enzyme immune assay kit, at a tertiary care hospital in Japan during two outbreaks (January 2012-December 2013 and January 2018-March 2019). Adult rubella diagnosis followed strong positive or paired rubella-specific IgM expression or positive rubella-specific reverse-transcription-polymerase chain reaction. Patients aged <18 years or with clinically suspected rubella with weak or negative IgM expression were excluded. RESULTS: Overall, 82 adult rubella and 139 adult non-rubella, with a median age (interquartile range) of 31 (25-41) years and 34 (27-42) years, respectively, were included. Multivariate analysis showed that conjunctivitis (odds ratio 80.6; 95% confidence interval 13.4-486.3; P <0.001) and male sex (odds ratio 7.1; 95% confidence interval 1.8-28.1; P = 0.005) were significantly associated with adult rubella. Among men born from 1962 to 1979 (high-risk population, n = 68), conjunctivitis also showed a significant association with adult rubella in the multivariate analysis (odds ratio 24.2; 95% confidence interval 1.1-553.7; P = 0.046) as these patients were not included in the national vaccination program. There was no difference in the clinical characteristics between one-time vaccination (n = 11) and no vaccination (n = 8) patient in the adult rubella group. CONCLUSIONS: Conjunctivitis was the key clinical symptom associated with adult rubella. For the early diagnosis of adult rubella, clinicians should focus on assessing conjunctivitis in patients.


Assuntos
Conjuntivite/complicações , Surtos de Doenças/estatística & dados numéricos , Rubéola (Sarampo Alemão)/complicações , Rubéola (Sarampo Alemão)/epidemiologia , Adulto , Surtos de Doenças/prevenção & controle , Feminino , Humanos , Japão/epidemiologia , Masculino , Risco , Rubéola (Sarampo Alemão)/prevenção & controle , Vacinação/estatística & dados numéricos
12.
Clin Ter ; 171(3): e189-e191, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32323704

RESUMO

Little is known about the Covid-19 transmission through ocular tissue, and more research needs to be carried out in order to confirm its ability to infect ocular tissue and its pathogenic mechanisms. Covid-19 may be detected in the tears and conjunctival secretions in novel coronavirus pneumonia patients with conjunctivitis. This case report shows a severe viral conjunctivitis in a patient diagnosed with Covid-19 on the Diamond Princess ship, characterized by both red, irritated and swollen eyes, with transparent serous secretions, conjunctival chemosis, pseudomembranes of fibrin and inflammatory cells on the tarsal conjunctiva accompanied by preauricular lymph nodes and enlarged submaxillaries.


Assuntos
Conjuntivite/virologia , Infecções por Coronavirus/complicações , Pneumonia Viral/complicações , Navios , Idoso , Doenças Assintomáticas , Betacoronavirus , Técnicas de Laboratório Clínico , Túnica Conjuntiva/patologia , Túnica Conjuntiva/virologia , Infecções por Coronavirus/diagnóstico , Humanos , Masculino , Pandemias , Pneumonia Viral/diagnóstico , Lágrimas , Viagem
13.
Georgian Med News ; (298): 53-57, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-32141849

RESUMO

Atopic dermatitis represents one of the most prevalent manifestations of atopy in children, which is distinguished by the early onset and high frequency of chronicity. The aim of this study was to study the clinical features of atopic dermatitis in early childhood and to evaluate comorbid conditions. The prospective research was conducted to study the cohort of 68 patients, who were developed the atopic dermatitis under 2 years of age. It was revealed, that the age of onset of the disease and the clinical severity was determined by the genetic predisposition on the mother's side. According to the clinical severity of the disease there were revealed the series of peculiarities especially in the case of moderate course: the high frequency of comorbid allergic pathology (rhinitis, conjunctivitis, urticaria, allergic gastritis) and the co-existing gastroenterological disorders (colic, constipation and foaming). The use of CoMISSas a non-invasive tool assumes the great importance in respect of making timely diagnosis of the allergy to cow's milk protein.


Assuntos
Conjuntivite/epidemiologia , Dermatite Atópica/epidemiologia , Hipersensibilidade Alimentar/complicações , Urticária/epidemiologia , Idade de Início , Criança , Pré-Escolar , Comorbidade , Eczema/epidemiologia , Feminino , Gastrite/epidemiologia , Humanos , Imunoglobulina E , Lactente , Estudos Prospectivos , Rinite/epidemiologia
14.
15.
Int J Syst Evol Microbiol ; 70(2): 995-1006, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31738158

RESUMO

Three bacterial strains, HKU70T, HKU71T and HKU72T, were isolated from the conjunctival swab, blood and sputum samples of three patients with conjunctivitis, bacteraemia and respiratory infection, respectively, in Hong Kong. The three strains were aerobic, Gram-stain positive, catalase-positive, non-sporulating and non-motile bacilli and exhibited unique biochemical profiles distinguishable from currently recognized Tsukamurella species. 16S rRNA, secA, rpoB and groEL gene sequence analyses revealed that the three strains shared 99.6-99.9, 94.5-96.8, 95.7-97.8 and 97.7-98.9 % nucleotide identities with their corresponding closest Tsukamurella species respectively. DNA-DNA hybridization confirmed that they were distinct from other known species of the genus Tsukamurella (26.2±2.4 to 36.8±1.2 % DNA-DNA relatedness), in line with results of in silico genome-to-genome comparison (32.2-40.9 % Genome-to-Genome Distance Calculator and 86.3-88.9 % average nucleotide identity values]. Fatty acids, mycolic acids, cell-wall sugars and peptidoglycan analyses showed that they were typical of members of Tsukamurella. The G+C content determined based on the genome sequence of strains HKU70T, HKU71T and HKU72T were 69.9, 70.2 and 70.5 mol%, respectively. Taken together, our results supported the proposition and description of three new species, i.e. Tsukamurella sputi HKU70T (=JCM 33387T=DSM 109106T) sp. nov., Tsukamurella asaccharolytica HKU71T (=JCM 33388T=DSM 109107T) sp. nov. and Tsukamurella conjunctivitidis HKU72T (=JCM 33389T=DSM 109108T) sp. nov.


Assuntos
Actinobacteria/classificação , Bacteriemia/microbiologia , Conjuntivite/microbiologia , Filogenia , Infecções Respiratórias/microbiologia , Actinobacteria/isolamento & purificação , Técnicas de Tipagem Bacteriana , Composição de Bases , Sequência de Bases , DNA Bacteriano/genética , Ácidos Graxos/química , Genes Bacterianos , Hong Kong , Humanos , Ácidos Micólicos/química , Hibridização de Ácido Nucleico , Peptidoglicano/química , Pigmentação , RNA Ribossômico 16S/genética , Análise de Sequência de DNA
17.
Am J Ophthalmol ; 209: 3-9, 2020 01.
Artigo em Inglês | MEDLINE | ID: mdl-31560878

RESUMO

PURPOSE: To characterize the clinical features of patients with direct immunofluorescence (DIF)-negative mucous membrane pemphigoid (MMP). DESIGN: Retrospective case series. METHODS: Thirty-six patients who underwent a conjunctival biopsy for suspected MMP were included. Demographic and clinical information was collected. Main outcome measures included visual acuity, Foster stages, presence of extraocular involvement, history of autoimmune disease, and durations of follow-up. RESULTS: Thirty-two patients had a negative DIF. Of those, 2 had a positive DIF on repeat biopsy. Eleven showed progression of conjunctival scarring during a median follow-up of 42 months (range, 8-100 months) and were diagnosed with biopsy-negative MMP. Another 11 patients with a median follow-up of 54 months (range, 15-138 months) were diagnosed with cicatrizing conjunctivitis of other causes. The median visual acuity of patients with biopsy-negative MMP at presentation was significantly lower compared to patients with cicatrizing conjunctivitis of other causes (20/400 vs 20/40, P = .02). Conjunctival scarring score at presentation in both biopsy-positive and biopsy-negative MMP groups was significantly higher compared to patients with cicatrizing conjunctivitis of other causes (median Foster stage, 3 vs 1, P = .009; and 3 vs 1, P = .01, respectively). CONCLUSIONS: Patients with progressive cicatrizing conjunctivitis likely have MMP in the absence of alternate diagnoses. Our findings emphasize that suspicion for MMP must remain high for patients who have Foster stage 3 conjunctival scarring on presentation or worsening of scarring during follow-up, even in the setting of negative DIF.


Assuntos
Doenças Autoimunes/diagnóstico , Cicatriz/diagnóstico , Conjuntivite/diagnóstico , Técnica Direta de Fluorescência para Anticorpo/métodos , Penfigoide Mucomembranoso Benigno/diagnóstico , Adulto , Idoso , Idoso de 80 Anos ou mais , Antibióticos Antineoplásicos/uso terapêutico , Doenças Autoimunes/tratamento farmacológico , Doenças Autoimunes/fisiopatologia , Biópsia , Cicatriz/tratamento farmacológico , Cicatriz/fisiopatologia , Conjuntivite/tratamento farmacológico , Conjuntivite/fisiopatologia , Ciclofosfamida/uso terapêutico , Progressão da Doença , Feminino , Seguimentos , Humanos , Imunossupressores/uso terapêutico , Masculino , Pessoa de Meia-Idade , Ácido Micofenólico/uso terapêutico , Penfigoide Mucomembranoso Benigno/tratamento farmacológico , Penfigoide Mucomembranoso Benigno/fisiopatologia , Estudos Retrospectivos , Coloração e Rotulagem/métodos , Acuidade Visual/fisiologia
18.
Biomed Res Int ; 2019: 3981064, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31815136

RESUMO

Rhinoconjunctivitis is a public health problem that causes major illness and disability worldwide. Epidemiological studies intended to determine the burden of rhinoconjunctivitis in Kuwait are limited. Hence, this study sought to estimate the prevalence of rhinoconjunctivitis among adolescents in Kuwait and explore its association with different risk factors. Schoolchildren aged 11-14 years (n = 3,864) were enrolled in a cross-sectional study. Parents completed questionnaires regarding their children's clinical history and symptoms of rhinoconjunctivitis and relevant exposures. Associations were assessed using Poisson regression with robust variance estimation, and adjusted prevalence ratios (aPRs) and 95% confidence intervals (CIs) were estimated. The 12-month (current) prevalence estimates of rhinitis, rhinoconjunctivitis, and severe rhinoconjunctivitis were 28.6% (1,040/3,643), 13.5% (497/3,689), and 1.2% (44/3,689), respectively. The prevalence of current rhinoconjunctivitis symptoms was higher in boys compared to girls (aPR = 1.19, 95% CI: 1.01-1.41). Parental history of rhinitis and asthma showed positive associations with rhinoconjunctivitis in offspring. Trend analyses showed that rhinoconjunctivitis prevalence decreased with increasing numbers of total siblings (aPR = 0.92, P trend < 0.001) and older siblings (aPR = 0.90, P trend < 0.001). Rhinoconjunctivitis is common among adolescents in Kuwait and its epidemiology is similar to that found in western countries.


Assuntos
Conjuntivite/epidemiologia , Rinite/epidemiologia , Fatores de Risco , Adolescente , Asma/epidemiologia , Criança , Estudos Transversais , Feminino , Humanos , Kuweit/epidemiologia , Masculino , Pais , Prevalência , Irmãos , Inquéritos e Questionários
19.
Minerva Pediatr ; 71(6): 500-504, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31840969

RESUMO

BACKGROUND: Neonatal conjunctivitis is frequent and could benefit from daily cleansing with saline. Anyway super infections can occur and therefore antibiotics are frequently needed. Recently alternative therapies (e.g. Echinacea angustifolia) are used for neonatal conjunctivitis to try to reduce antibiotics therapy. The aim of the study was to verify if the use of gauze containing Echinacea angustifolia compared to standard sodium-chloride at the onset of conjunctivitis symptoms is effective in reducing the clinical symptoms and the risk for superinfections. METHODS: The study was randomized and controlled. Neonates admitted in a tertiary level Neonatal Intensive Care Unit (NICU), with clinical signs of conjunctivitis during hospital stay, were randomized in two groups: group A (3 times daily ocular cleansing for 48 h with sterile gauze; group B (3 times daily ocular cleansing for 48 h with Iridium® baby gauze (Neoox) containing Echinacea angustifolia and pineapple sativus). An eye swab for cultural analysis was taken at time of presentation (T0) prior to treatment and at the end of ocular cleansing (T1). RESULTS: Sixty-three neonates were enrolled (GrA=30 and GrB=33). At T0, eye specimen positivity was found in 16/30 (48%) in group A and in 18/33 (55%) in group B (P=0.9). No statistical differences among groups at T0 regarding culture positivity. After 48 h, babies in Gr A have significantly fewer positive swabs compared to group B (group A: 18/29, group B: 10/32; P=0.009). Neonates in group B who had negative swab at T0 had a significantly reduced risk to have positive culture at T1 (OR 0.28, CI: 0.10-0,80, P=0.01), also considering confounding factors (birth weight, gestational age, mode of delivery) (adjusted OR 0.15, CI: 0.03-0.52, P<0.01). No differences in regard to antibiotic needs (P=0.95) during the course of conjunctivitis between groups. CONCLUSIONS: Our data suggest that these gauzes containing Echinacea angustifolia might help in avoiding super-infections, contaminations and in reducing ocular bacterial load.


Assuntos
Conjuntivite/terapia , Echinacea/química , Doenças do Recém-Nascido/terapia , Cloreto de Sódio/administração & dosagem , Ananas/química , Bandagens , Humanos , Recém-Nascido , Unidades de Terapia Intensiva Neonatal , Preparações de Plantas/administração & dosagem , Resultado do Tratamento
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