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1.
Front Cell Infect Microbiol ; 12: 953750, 2022.
Article in English | MEDLINE | ID: mdl-36118044

ABSTRACT

Introduction: Recently, India witnessed an unprecedented surge of coronavirus disease 2019 (COVID-19)-associated mucormycosis (CAM) cases. In addition to patient management issues, environmental Mucorales contamination possibly contributed to the outbreak. A recent study evaluated environment contamination by Mucorales in the hospital setting. However, a considerable number of CAM patients were never admitted to a hospital before the development of the disease. The present study, therefore, planned to evaluate Mucorales contamination of patients' residences. Methods: The residential environment of 25 patients with CAM living in north India was surveyed. Air samples were collected from indoor and immediate outdoor vicinity of the patients' residence and cultured on Dichloran Rose-Bengal Chloramphenicol (DRBC) agar with benomyl for selective isolation of Mucorales. Surface swab samples were also collected from the air coolers fitted in those residences and cultured on DRBC agar. The isolates were identified by phenotypic and genotypic methods. Amplified fragment length polymorphism (AFLP) was employed to evaluate the genetic relatedness of the environmental and patients' clinical isolates. Results: The median spore count (mean ± SD, cfu/m3) of Mucorales in the air of patients' bedrooms was significantly higher than in the air in other rooms in those residences (3.55 versus 1.5, p = 0.003) or the air collected directly from the front of the air cooler (p < 0.0001). The Mucorales spore count in the environment did not correlate with either ventilation of the room or hygiene level of the patients' residences. Rhizopus arrhizus was isolated from the environment of all patients' residences (n = 25); other Mucorales species isolated were Cunninghamella bertholletiae (n = 14), Rhizopus microsporus (n = 6), Rhizopus delemar (n = 6), Syncephalastrum racemosum (n = 1), Lichtheimia corymbifera (n = 1), and Mucor racemosus (n = 1). Genetic relatedness was observed between 11 environmental isolates from the patients' bedrooms and respective clinical isolates from patients. Discussion: The study supported the view that the patients might have acquired Mucorales from the home environment during the post-COVID-19 convalescence period. Universal masking at home during patients' convalescence period and environmental decontamination could minimize exposure in those susceptible patients.


Subject(s)
COVID-19 , Mucorales , Mucormycosis , Agar , Amplified Fragment Length Polymorphism Analysis , Benomyl , Chloramphenicol , Convalescence , Humans , Mucorales/genetics , Mucormycosis/epidemiology
2.
J Tradit Chin Med ; 42(5): 803-809, 2022 Oct.
Article in English | MEDLINE | ID: mdl-36083489

ABSTRACT

OBJECTIVE: To evaluate the efficacy of the Shugan Jieyu capsule on improving sleep and emotional disorder during Coronavirus disease 2019 (COVID-19) convalescence. METHODS: We conducted a randomized, double-blind, placebo-controlled trial, and recruit 200 COVID-19 convalescence patients and then divide the subjects into two groups respectively: the experimental group ( 100) and the control group ( 100). Patients in the control group were given doses as a placebo, while those in the experimental group were given Shugan Jieyu capsule. The investigators mainly observed the differences between the two groups before and after treatment in terms of the rate of reduction and the rate of efficiency in Hamilton Depression Scale (HAMD-17) total scores from baseline, and recorded the scores of Hamilton Anxiety Scale (HAMA), Patient Health Questionnaire-15 (PHQ-15), Insomnia Severity Index (ISI) and Treatment Emergent Symptom Scale at 2 week, the 4 week and the 6 week respectively after treatment, and compared the differences between the groups. And the occurrence of adverse events was recorded. RESULTS: After 6-week treatment, there were statistically significant differences in the rate of reduction as well as efficiency in HAMD-17 scores, HAMA Total Scores, PHQ-15 Score, ISI Score from baseline in the experimental group and control group (< 0.05). There were 4 adverse events in the experimental group and 1 in the control group. CONCLUSION: Shugan Jieyu capsule could significantly improve sleep and emotional disorder in patients during COVID-19 convalescence.


Subject(s)
COVID-19 , COVID-19/drug therapy , Convalescence , Double-Blind Method , Humans , Sleep , Treatment Outcome
3.
Proc Natl Acad Sci U S A ; 119(34): e2117089119, 2022 Aug 23.
Article in English | MEDLINE | ID: mdl-35943976

ABSTRACT

The COVID-19 pandemic has incurred tremendous costs worldwide and is still threatening public health in the "new normal." The association between neutralizing antibody levels and metabolic alterations in convalescent patients with COVID-19 is still poorly understood. In the present work, we conducted absolutely quantitative profiling to compare the plasma cytokines and metabolome of ordinary convalescent patients with antibodies (CA), convalescents with rapidly faded antibodies (CO), and healthy subjects. As a result, we identified that cytokines such as M-CSF and IL-12p40 and plasma metabolites such as glycylproline (gly-pro) and long-chain acylcarnitines could be associated with antibody fading in COVID-19 convalescent patients. Following feature selection, we built machine-learning-based classification models using 17 features (six cytokines and 11 metabolites). Overall accuracies of more than 90% were attained in at least six machine-learning models. Of note, the dipeptide gly-pro, a product of enzymatic peptide cleavage catalyzed by dipeptidyl peptidase 4 (DPP4), strongly accumulated in CO individuals compared with the CA group. Furthermore, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccination experiments in healthy mice demonstrated that supplementation of gly-pro down-regulates SARS-CoV-2-specific receptor-binding domain antibody levels and suppresses immune responses, whereas the DPP4 inhibitor sitagliptin can counteract the inhibitory effects of gly-pro upon SARS-CoV-2 vaccination. Our findings not only reveal the important role of gly-pro in the immune responses to SARS-CoV-2 infection but also indicate a possible mechanism underlying the beneficial outcomes of treatment with DPP4 inhibitors in convalescent COVID-19 patients, shedding light on therapeutic and vaccination strategies against COVID-19.


Subject(s)
Antibodies, Neutralizing , Antibodies, Viral , COVID-19 , Convalescence , Cytokines , Dipeptides , Dipeptidyl-Peptidase IV Inhibitors , Animals , Antibodies, Neutralizing/blood , Antibodies, Viral/blood , Antibody Formation , COVID-19/blood , COVID-19/drug therapy , COVID-19/immunology , Cytokines/blood , Dipeptides/blood , Dipeptidyl Peptidase 4/metabolism , Dipeptidyl-Peptidase IV Inhibitors/therapeutic use , Humans , Machine Learning , Metabolome , Mice , SARS-CoV-2 , Vaccination
4.
J Clin Invest ; 132(15)2022 08 01.
Article in English | MEDLINE | ID: mdl-35912856

ABSTRACT

Hepatitis C virus (HCV) infection remains a worldwide public health issue despite direct-acting antivirals. A substantial proportion of infected individuals (15%-45%) spontaneously clear repeated HCV infections with genetically different viruses by generating broadly neutralizing antibodies (bNAbs). However, translating this response into an effective vaccine strategy has been unsuccessful. In this issue of the JCI, Frumento and colleagues report on their study of bNAb evolution longitudinally in convalescent individuals with repeated infections. Using pseudotyped viruses, well-characterized monoclonal antibodies, and complex modeling, the authors show that multiple exposures to antigenically related, antibody-sensitive viral envelope proteins induced potent bNAbs. This work provides valuable insight into the best strategies for developing HCV vaccines in the future that may successfully reproduce the immunity induced during natural exposures.


Subject(s)
Hepatitis C, Chronic , Hepatitis C , Vaccines , Viral Hepatitis Vaccines , Antibodies, Neutralizing , Antiviral Agents , Broadly Neutralizing Antibodies , Convalescence , Cues , Hepacivirus , Hepatitis C Antibodies , Humans , Vaccines/metabolism , Viral Envelope Proteins
5.
PLoS Negl Trop Dis ; 16(8): e0010724, 2022 08.
Article in English | MEDLINE | ID: mdl-35981059

ABSTRACT

Long Covid has raised awareness of the potentially disabling chronic sequelae that afflicts patients after acute viral infection. Similar syndromes of post-infectious sequelae have also been observed after other viral infections such as dengue, but their true prevalence and functional impact remain poorly defined. We prospectively enrolled 209 patients with acute dengue (n = 48; one with severe dengue) and other acute viral respiratory infections (ARI) (n = 161), and followed them up for chronic sequelae up to one year post-enrolment, prior to the onset of the Covid-19 pandemic. Baseline demographics and co-morbidities were balanced between both groups except for gender, with more males in the dengue cohort (63% vs 29%, p<0.001). Except for the first visit, data on symptoms were collected remotely using a purpose-built mobile phone application. Mental health outcomes were evaluated using the validated SF-12v2 Health Survey. Almost all patients (95.8% of dengue and 94.4% of ARI patients) experienced at least one symptom of fatigue, somnolence, headache, concentration impairment or memory impairment within the first week of enrolment. Amongst patients with at least 3-months of follow-up, 18.0% in the dengue cohort and 14.6% in the ARI cohort experienced persistent symptoms. The median month-3 SF-12v2 Mental Component Summary Score was lower in patients who remained symptomatic at 3 months and beyond, compared to those whose symptoms fully resolved (47.7 vs. 56.0, p<0.001), indicating that patients who self-reported persistence of symptoms also experienced functionally worse mental health. No statistically significant difference in age, gender distribution or hospitalisation status was observed between those with and without chronic sequelae. Our findings reveal an under-appreciated burden of post-infection chronic sequelae in dengue and ARI patients. They call for studies to define the pathophysiology of this condition, and determine the efficacy of both vaccines as well as antiviral drugs in preventing such sequelae.


Subject(s)
COVID-19 , Dengue , Respiratory Tract Infections , COVID-19/complications , Convalescence , Dengue/complications , Dengue/epidemiology , Disease Progression , Humans , Male , Pandemics , Respiratory Tract Infections/complications , Respiratory Tract Infections/epidemiology
6.
Multimedia | Multimedia Resources | ID: multimedia-9781

ABSTRACT

O vídeo apresenta conceitos de plasma e de pessoa convalescente. O aplicativo FioLibras é um projeto do Instituto de Comunicação e Informação Científica e Tecnológica em Saúde da Fundação Oswaldo Cruz (Icict/Fiocruz), em parceria com o Núcleo de Estudos em Diversidade e Inclusão de Surdos da Universidade Federal Fluminense (Nuedis/UFF), e conta com financiamento do Fundo de Inovação da Fiocruz e do Ministério da Saúde, por meio do Programa Fiocruz de Fomento à Inovação (Inova Fiocruz).


Subject(s)
Plasma , Convalescence , Coronavirus Infections , Information Dissemination , Sign Language , e-Accessibility
7.
Proc Natl Acad Sci U S A ; 119(30): e2203659119, 2022 07 26.
Article in English | MEDLINE | ID: mdl-35858456

ABSTRACT

This study analyzed whole blood samples (n = 56) retrieved from 30 patients at 1 to 21 (median 9) mo after verified COVID-19 to determine the polarity and duration of antigen-specific T cell reactivity against severe acute respiratory syndrome coronavirus 2-derived antigens. Multimeric peptides spanning the entire nucleocapsid protein triggered strikingly synchronous formation of interleukin (IL)-4, IL-12, IL-13, and IL-17 ex vivo until ∼70 d after confirmed infection, whereafter this reactivity was no longer inducible. In contrast, levels of nucleocapsid-induced IL-2 and interferon-γ remained stable and highly correlated at 3 to 21 mo after infection. Similar cytokine dynamics were observed in unvaccinated, convalescent patients using whole-blood samples stimulated with peptides spanning the N-terminal portion of the spike 1 protein. These results unravel two phases of T cell reactivity following natural COVID-19: an early, synchronous response indicating transient presence of multipolar, antigen-specific T helper (TH) cells followed by an equally synchronous and durable TH1-like reactivity reflecting long-lasting T cell memory.


Subject(s)
COVID-19 , Cytokines , SARS-CoV-2 , T-Lymphocytes, Helper-Inducer , Antibodies, Viral/blood , Antigens, Viral/immunology , COVID-19/blood , COVID-19/immunology , Convalescence , Cytokines/blood , Humans , Interferon-gamma/blood , Nucleocapsid Proteins/immunology , SARS-CoV-2/immunology , Spike Glycoprotein, Coronavirus/immunology , T-Lymphocytes, Helper-Inducer/immunology
8.
J Thromb Haemost ; 20(10): 2429-2438, 2022 Oct.
Article in English | MEDLINE | ID: mdl-35875995

ABSTRACT

BACKGROUND: Prolonged recovery is common after acute SARS-CoV-2 infection; however, the pathophysiological mechanisms underpinning Long COVID syndrome remain unknown. VWF/ADAMTS-13 imbalance, dysregulated angiogenesis, and immunothrombosis are hallmarks of acute COVID-19. We hypothesized that VWF/ADAMTS-13 imbalance persists in convalescence together with endothelial cell (EC) activation and angiogenic disturbance. Additionally, we postulate that ongoing immune cell dysfunction may be linked to sustained EC and coagulation activation. PATIENTS AND METHODS: Fifty patients were reviewed at a minimum of 6 weeks following acute COVID-19. ADAMTS-13, Weibel Palade Body (WPB) proteins, and angiogenesis-related proteins were assessed and clinical evaluation and immunophenotyping performed. Comparisons were made with healthy controls (n = 20) and acute COVID-19 patients (n = 36). RESULTS: ADAMTS-13 levels were reduced (p = 0.009) and the VWF-ADAMTS-13 ratio was increased in convalescence (p = 0.0004). Levels of platelet factor 4 (PF4), a putative protector of VWF, were also elevated (p = 0.0001). A non-significant increase in WPB proteins Angiopoietin-2 (Ang-2) and Osteoprotegerin (OPG) was observed in convalescent patients and WPB markers correlated with EC parameters. Enhanced expression of 21 angiogenesis-related proteins was observed in convalescent COVID-19. Finally, immunophenotyping revealed significantly elevated intermediate monocytes and activated CD4+ and CD8+ T cells in convalescence, which correlated with thrombin generation and endotheliopathy markers, respectively. CONCLUSION: Our data provide insights into sustained EC activation, dysregulated angiogenesis, and VWF/ADAMTS-13 axis imbalance in convalescent COVID-19. In keeping with the pivotal role of immunothrombosis in acute COVID-19, our findings support the hypothesis that abnormal T cell and monocyte populations may be important in the context of persistent EC activation and hemostatic dysfunction during convalescence.


Subject(s)
COVID-19 , Hemostatics , ADAMTS13 Protein , Angiopoietin-2 , COVID-19/complications , Convalescence , Humans , Neovascularization, Pathologic , Osteoprotegerin , Platelet Factor 4 , SARS-CoV-2 , Thrombin , von Willebrand Factor/metabolism
9.
Cells ; 11(15)2022 Jul 24.
Article in English | MEDLINE | ID: mdl-35892580

ABSTRACT

Amino acids and their metabolites are key regulators of immune responses, and plasma levels may change profoundly during acute disease states. Using targeted metabolomics, we evaluated concentration changes in plasma amino acids and related metabolites in community-acquired pneumonia (CAP, n = 29; compared against healthy controls, n = 33) from presentation to hospital through convalescence. We further aimed to identify biomarkers for acute CAP vs. the clinically potentially similar infection-triggered COPD exacerbation (n = 13). Amino acid metabolism was globally dysregulated in both CAP and COPD. Levels of most amino acids were markedly depressed in acute CAP, and total amino acid concentrations on admission were an accurate biomarker for the differentiation from COPD (AUC = 0.93), as were reduced asparagine and threonine levels (both AUC = 0.92). Reduced tryptophan and histidine levels constituted the most accurate biomarkers for acute CAP vs. controls (AUC = 0.96, 0.94). Only kynurenine, symmetric dimethyl arginine, and phenylalanine levels were increased in acute CAP, and the kynurenine/tryptophan ratio correlated best with clinical recovery and resolution of inflammation. Several amino acids did not reach normal levels by the 6-week follow-up. Glutamate levels were reduced on admission but rose during convalescence to 1.7-fold above levels measured in healthy control. Our data suggest that dysregulated amino acid metabolism in CAP partially persists through clinical recovery and that amino acid metabolism constitutes a source of promising biomarkers for CAP. In particular, total amino acids, asparagine, and threonine may constitute plasma biomarker candidates for the differentiation between CAP and infection-triggered COPD exacerbation and, perhaps, the detection of pneumonia in COPD.


Subject(s)
Community-Acquired Infections , Pneumonia , Pulmonary Disease, Chronic Obstructive , Asparagine , Biomarkers , Community-Acquired Infections/diagnosis , Convalescence , Humans , Kynurenine , Threonine , Tryptophan
10.
Hernia ; 26(4): 1009-1021, 2022 08.
Article in English | MEDLINE | ID: mdl-35768670

ABSTRACT

PURPOSE: The most recent international guideline on inguinal hernia management recommends a short convalescence after repair. However, surgeons' recommendations may vary. The objective of this study was to give an overview of the current convalescence recommendations in the literature subdivided on the Lichtenstein and laparoscopic inguinal hernia repairs. METHODS: In this systematic review, three databases were searched in August 2021 to identify studies on inguinal hernia repairs with a statement about postoperative convalescence recommendations. The outcome was convalescence recommendations subdivided on daily activities, light work, heavy lifting, and sport. RESULTS: In total, 91 studies fulfilled the eligibility criteria, and 50 and 58 studies reported about convalescence recommendations after Lichtenstein and laparoscopic repairs, respectively. Patients were instructed with a wide range of convalescence recommendations. A total of 34 Lichtenstein studies and 35 laparoscopic studies recommended resumption of daily activities as soon as possible. Following Lichtenstein repairs, the patients were instructed to resume light work after median 0 days (interquartile range (IQR) 0-0), heavy lifting after 42 days (IQR 14-42), and sport after 7 days (IQR 0-29). Following laparoscopic procedures, the patients were instructed to resume light work after median 0 days (IQR 0-0), heavy lifting after 14 days (IQR 10-28), and sport after 12 days (IQR 7-23). CONCLUSION: This study revealed a broad spectrum of convalescence recommendations depending on activity level following inguinal hernia repair, which likely reflects a lack of high-quality evidence within this field.


Subject(s)
Hernia, Inguinal , Laparoscopy , Convalescence , Hernia, Inguinal/surgery , Herniorrhaphy/adverse effects , Herniorrhaphy/methods , Humans , Laparoscopy/adverse effects , Laparoscopy/methods , Surgical Mesh , Treatment Outcome
11.
J Pediatr Gastroenterol Nutr ; 75(3): 276-285, 2022 Sep 01.
Article in English | MEDLINE | ID: mdl-35758426

ABSTRACT

OBJECTIVES: This is a descriptive study to characterize rates of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in pediatric solid organ transplant (SOT) recipients during the early days of the pandemic. We hypothesized that asymptomatic infection may represent a large proportion of SARS-CoV-2 infection in pediatric SOT recipients. METHODS: We queried Organ Transplant Tracking Record (OTTR) for all pediatric SOT recipients followed at our center and reviewed medical records to identify patients tested for SARS-CoV-2 between March 15, 2020 and June 30, 2021. Patients were tested by polymerase chain reaction (PCR): prior to planned procedures or because of symptoms; OR: tested by measurement of IgG to spike protein with their routine labs q 2-monthly. A positive PCR was called acute infection. A positive IgG with negative PCR was called convalescence. For immunologic studies, blood was obtained when the PCR or IgG was positive. Statistical comparisons were made between (1) acute infection versus convalescence; (2) acute infection versus SOT recipients without infection (called healthy controls); (3) liver transplant (LT) versus small bowel (SB)/multivisceral transplant (MVT); (4) positive versus negative test result. RESULTS: Of 257 LT recipients, 99 were tested: 6 were PCR positive, 13 were antibody positive. Of 150 SB/MVT recipients, 55 were tested: 4 were PCR positive, 6 were antibody positive. Of 8 simultaneous liver, kidney transplant recipients, 3 were tested: 1 was PCR positive. Symptoms when present were mostly mild. Patients with a positive test result were younger (6.3 vs 10.0 years; P = 0.017). We observed a rapid decline in viral load within 96 hours without a change in immunosuppression. Antibody lasted >8 months beyond the time it was monitored. Acute infection was associated with increased CD4 and CD8 T EM cell frequency ( P = 0.04, P = 0.03, respectively), decreased interferon (IFN)-γ production from T-cells (2.8% vs 11.3%; P = 0.006), and decreased CD8 TEMRA frequency (4.56% vs 11.70%; P = 0.006). CONCLUSIONS: Early in the pandemic, COVID-19 disease was mostly mild in pediatric SOT recipients with no rejection, patient death, or graft loss observed.


Subject(s)
COVID-19 , Organ Transplantation , COVID-19/diagnosis , COVID-19/epidemiology , Child , Convalescence , Humans , Immunoglobulin G , Organ Transplantation/adverse effects , SARS-CoV-2 , Transplant Recipients
12.
Wiad Lek ; 75(5 pt 2): 1342-1346, 2022.
Article in English | MEDLINE | ID: mdl-35758456

ABSTRACT

OBJECTIVE: The aim: To identify clinical and immunological features of acute rotavirus gastroenteritis occurring against the background of Epstein-Barr virus infection. PATIENTS AND METHODS: Materials and methods: The study involved examination of 56 children. Of them, 33 children (1 group) did not have a background infection and 23 patients (2 group) suffered from rotavirus infection on the background of the latent form of Epstein-Barr virus infection. Children in these groups were compared by gender, age, severity of the disease and other parameters. Quantitative data were presented as mean and standard deviation (M±SD). Differences at p <0.05 were considered statistically significant. RESULTS: Results: The data suggest that the presence of background Epstein-Barr virus in children with rotavirus infection leads to later hospitalization, lower temperature response rates, lower frequency of vomiting at the onset of the disease, and longer duration of fever and diarrhea. At the same time, in children infected with Epstein-Barr virus, the relative content of CD8+ T lymphocytes dominated both in the acute period of the disease and in the period of convalescence against the background of reduced relative content of CD16+, CD22+ T lymphocytes and IgM in the period of early convalescence. CONCLUSION: Conclusions: The study allowed to reveal the influence of latent EBV infection on the clinical and immunological parameters of rotavirus gastroenteritis.


Subject(s)
Epstein-Barr Virus Infections , Gastroenteritis , Rotavirus Infections , Child , Convalescence , Epstein-Barr Virus Infections/complications , Epstein-Barr Virus Infections/diagnosis , Gastroenteritis/complications , Herpesvirus 4, Human , Humans , Rotavirus Infections/complications
13.
PLoS One ; 17(6): e0269882, 2022.
Article in English | MEDLINE | ID: mdl-35700174

ABSTRACT

INTRODUCTION: Coronavirus Disease 2019 (COVID-19) has made a serious public health threat worldwide. Recent evidence has indicated that COVID-19 patients in convalescence frequently experience insomnia, which reduces their quality of life and causes unknown risks. The positive effect of cognitive behavior on insomnia has been well addressed in previous studies. Given the high infectivity and epidemicity of COVID-19, Internet-delivered intervention may be safer than face-to-face treatment. However, whether Internet-delivered cognitive behavioral therapy can effectively improve the insomnia of COVID-19 patients in convalescence has not been completely determined yet. Therefore, we conducted a meta-analysis and systematic review to evaluate the effects of Internet-delivered cognitive behavioral therapy on insomnia in COVID-19 patients in convalescence, with the aim to confer some guidance for its clinical application. METHODS AND ANALYSIS: This systematic review and meta-analysis has been registered in the International Prospective Register of Systematic Reviews (PROSPERO). Two researchers will retrieve the relevant literature on Internet-delivered cognitive behavioral therapy for insomnia in convalescent patients with COVID-19 in PubMed, Web of Science, Embase, MEDLINE, Cochrane Library, Clinical Trials gov, Chinese Biomedical Literature Database (CBM), and Chinese National Knowledge Infrastructure (CNKI) from inception to 11th of December. In addition, we will review the relevant trials and references of the included literature and manually searched the grey literature. The two researchers will independently extracted data and information and evaluated the quality of the included literature. The Review Manager software (version 5.3) and Stata software (version 14.0) will be used for data analysis. The mean difference or the standardized mean difference of 95% CI will be used to calculate continuous variables to synthesize the data. In addition, I2 and Cochrane will be used for heterogeneity assessment. TRIAL REGISTRATION: PROSPERO registration number CRD42021271278.


Subject(s)
COVID-19 , Cognitive Behavioral Therapy , Sleep Initiation and Maintenance Disorders , COVID-19/complications , COVID-19/therapy , Convalescence , Humans , Internet , Meta-Analysis as Topic , Quality of Life , Research Design , Sleep Initiation and Maintenance Disorders/complications , Sleep Initiation and Maintenance Disorders/therapy , Systematic Reviews as Topic
15.
Rev Med Suisse ; 18(786): 1205-1207, 2022 Jun 15.
Article in French | MEDLINE | ID: mdl-35703863

ABSTRACT

Inguinal hernia repair represents one of the most common operations in general surgery worldwide. It is performed either as open surgery using a transinguinal approach or as minimal invasive procedure using a preperitoneal (endoscopic) or transabdominal (laparoscopic) approach, respectively. A mesh is always placed to reinforce the abdominal wall of the groin. Most interventions are nowadays performed in an ambulatory setting, and a short convalescence with early return to daily activities and work is possible. However, postoperative care is not yet widely standardized, and subsequently, off work periods are still often prolonged up to several weeks. This article provides simple recommendations to shorten postoperative convalescence.


La chirurgie pour hernie inguinale est l'intervention la plus pratiquée en chirurgie viscérale. L'intervention s'effectue par voie endoscopique ou ouverte, avec mise en place d'une prothèse. Pratiquée généralement sur un mode ambulatoire, la cure de hernie inguinale permet un retour aux activités quotidiennes et professionnelles précoces avec un taux de complications faible. Toutefois, le suivi postopératoire est peu standardisé. L'objectif de cet article est de proposer des recommandations simples et pratiques à l'attention des médecins de famille.


Subject(s)
Hernia, Inguinal , Laparoscopy , Convalescence , Groin/surgery , Hernia, Inguinal/surgery , Herniorrhaphy/methods , Humans , Surgical Mesh
16.
Comput Intell Neurosci ; 2022: 3592145, 2022.
Article in English | MEDLINE | ID: mdl-35665277

ABSTRACT

This study aimed to explore the application value of multifeature fusion classification algorithm based on deep learning and Yishen Tiaodu acupuncture in the diagnosis and treatment of patients with cerebral infarction in convalescence. Methods. 62 patients with cerebral infarction were randomly classified into the experimental group and the control group, with 31 patients in each group. All patients received the functional magnetic resonance imaging (fMRI) examination. The image processing method was the multifeature fusion classification algorithm based on deep learning. DICE coefficient, accuracy, and sensitivity were used to evaluate the image processing performance of traditional and new algorithms. Patients in the experimental group were treated with Yishen Tiaodu acupuncture, while patients in the control group were treated with ordinary acupuncture. The evaluation of the cyberchondria severity scale (CSS) and the activities of daily living (ADL) was performed at enrollment, 15 days after treatment, 28 days after treatment, and 1 month after treatment. The results showed that the quality of fMRI images processed by multifeature fusion classification algorithm based on deep learning was signally improved. The clinical efficacy of the traditional Chinese medicine (TCM) syndrome score (86.7% vs. 60.9%) and neurological impairment score (83.4% vs. 53.5%) in the experimental group were remarkably higher compared with the control group (P < 0.05). After treatment, the TCM syndrome score of the experimental group was markedly lower than that of the control group, while the ADL score was higher (P < 0.05). Conclusion. The performance of multifeature fusion classification algorithm based on deep learning in fMRI image processing of patients with cerebral infarction is better than that of traditional algorithms. Yishen Tiaodu acupuncture has a good therapeutic effect on the recovery of motor and neurological function in patients with cerebral infarction at convalescence.


Subject(s)
Acupuncture Therapy , Magnetic Resonance Imaging , Activities of Daily Living , Algorithms , Cerebral Infarction/diagnostic imaging , Cerebral Infarction/therapy , Convalescence , Drugs, Chinese Herbal , Humans , Magnetic Resonance Imaging/methods
17.
Pediatrics ; 149(6)2022 06 01.
Article in English | MEDLINE | ID: mdl-35588188

ABSTRACT

OBJECTIVES: To examine the prevalence, characteristics, clinical course, and length of stay (LOS) among 4 groups of infants who were transferred for convalescence and subsequently discharged from the hospital; failed transfer for convalescence and were (a) either readmitted, or (b) transferred again; and were not transferred for convalescence. METHODS: Among very low birth weight infants hospitalized at US Vermont Oxford Network centers between 2006 and 2020, we examined the distribution of characteristics, delivery room and NICU usage measures, outcomes, and LOS among the 4 groups of infants. RESULTS: Among 641 712 infants, a total of 28 985 (4.5%) infants were transferred for convalescent care; of 28 186 infants, 182 (0.65%) died before hospital discharge and 2551 (9.1%) failed the transfer (1771 [6.3%] were readmitted and 780 [2.8%] were transferred again). There were major regional and NICU variations in the practice of the transfer for convalescence; New England (18.8%) had the highest whereas East South Central (2.2%) had the lowest percentage of transfer for convalescence. Infants who transferred for convalescence and were discharged from the hospital had a similar LOS and similar distribution of NICU usage measures and outcomes to infants who were not transferred for convalescence. Infants who failed the transfer for convalescence had a longer LOS than infants who were transferred for convalescence and then discharged from the hospital. CONCLUSIONS: The rates of transfer for convalescence and transfer for convalescence failure were low. Future studies should weigh the risks and benefits of transfer for convalescence, which might differ on the basis of geography.


Subject(s)
Convalescence , Intensive Care Units, Neonatal , Hospitalization , Humans , Infant , Infant, Newborn , Infant, Very Low Birth Weight , Length of Stay
18.
Sci Rep ; 12(1): 9045, 2022 05 31.
Article in English | MEDLINE | ID: mdl-35641545

ABSTRACT

Long-term antibody responses to SARS-CoV-2 have focused on responses to full-length spike protein, specific domains within spike, or nucleoprotein. In this study, we used high-density peptide microarrays representing the complete proteome of SARS-CoV-2 to identify binding sites (epitopes) targeted by antibodies present in the blood of COVID-19 resolved cases at 5 months post-diagnosis. Compared to previous studies that evaluated epitope-specific responses early post-diagnosis (< 60 days), we found that epitope-specific responses to nucleoprotein and spike protein have contracted, and that responses to membrane protein have expanded. Although antibody titers to full-length spike and nucleoprotein remain steady over months, taken together our data suggest that the population of epitope-specific antibodies that contribute to this reactivity is dynamic and evolves over time. Further, the spike epitopes bound by polyclonal antibodies in COVID-19 convalescent serum samples aligned with known target sites that can neutralize viral activity suggesting that the maintenance of these antibodies might provide rapid serological immunity. Finally, the most dominant epitopes for membrane protein and spike showed high diagnostic accuracy providing novel biomarkers to refine blood-based antibody tests. This study provides new insights into the specific regions of SARS-CoV-2 targeted by serum antibodies long after infection.


Subject(s)
Antibodies, Viral , COVID-19 , Convalescence , Antibodies, Viral/blood , COVID-19/blood , COVID-19/therapy , Coronavirus Nucleocapsid Proteins , Epitopes , Humans , Immunization, Passive , Phosphoproteins , SARS-CoV-2 , Spike Glycoprotein, Coronavirus
19.
J Healthc Eng ; 2022: 2654729, 2022.
Article in English | MEDLINE | ID: mdl-35463674

ABSTRACT

Objective: To investigate effects of all-inclusive and hierarchical rehabilitation nursing model combined with acupuncture on limb function and quality of life in elderly patients with cerebral infarction during convalescence. Methods: Eighty elderly patients with cerebral infarction who were treated in our hospital (February 2018-February 2020) and met the inclusion and exclusion criteria were chosen as the research objects, and their materials were analyzed in the way of retrospective study. They were equably randomized into observation group and reference group. Based on the acupuncture treatment, the patients in the observation group and the reference group were given routine rehabilitation nursing and all-inclusive and hierarchical rehabilitation nursing respectively for three months. The simplified Fugl-Meyer Assessment (FMA) scores, Modified Edinburgh-Scandinavian Stroke Scale (MESSS) scores, Activities of Daily Living Scale (ADL) scores, and Stroke-Specific Quality of Life Scale (SS-QOL) scores in the two groups before and after intervention were recorded, and the changes of limb function, neurological function, and living quality of the patients in the two groups were analyzed. Results: Compared with the reference group, the observation group after intervention achieved prominently higher FMA score (P < 0.001), markedly lower MESSS score (P < 0.001), and signally higher SS-QOL scores (P < 0.05). After intervention, the observation group achieved obviously higher ADL score than the reference group (68.88 ± 8.91 vs 59.00 ± 8.38, P < 0.001). Conclusion: The all-inclusive and hierarchical rehabilitation nursing model combined with acupuncture can accelerate the recovery of neurological function of the elderly patients with cerebral infarction, enhance the rehabilitation of their limb function, and markedly improve their quality of life. Therefore, this model has referential significance in clinic.


Subject(s)
Acupuncture Therapy , Rehabilitation Nursing , Stroke Rehabilitation , Stroke , Activities of Daily Living , Aged , Cerebral Infarction , Convalescence , Humans , Quality of Life , Retrospective Studies , Stroke/therapy , Treatment Outcome
20.
Front Immunol ; 13: 838132, 2022.
Article in English | MEDLINE | ID: mdl-35464396

ABSTRACT

The majority of COVID-19 patients experience mild to moderate disease course and recover within a few weeks. An increasing number of studies characterized the long-term changes in the specific anti-SARS-CoV-2 immune responses, but how COVID-19 shapes the innate and heterologous adaptive immune system after recovery is less well known. To comprehensively investigate the post-SARS-CoV-2 infection sequelae on the immune system, we performed a multi-omics study by integrating single-cell RNA-sequencing, single-cell ATAC-sequencing, genome-wide DNA methylation profiling, and functional validation experiments in 14 convalescent COVID-19 and 15 healthy individuals. We showed that immune responses generally recover without major sequelae after COVID-19. However, subtle differences persist at the transcriptomic level in monocytes, with downregulation of the interferon pathway, while DNA methylation also displays minor changes in convalescent COVID-19 individuals. However, these differences did not affect the cytokine production capacity of PBMCs upon different bacterial, viral, and fungal stimuli, although baseline release of IL-1Ra and IFN-γ was higher in convalescent individuals. In conclusion, we propose that despite minor differences in epigenetic and transcriptional programs, the immune system of convalescent COVID-19 patients largely recovers to the homeostatic level of healthy individuals.


Subject(s)
COVID-19 , Convalescence , Disease Progression , Humans , Leukocytes, Mononuclear , SARS-CoV-2
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