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1.
Emerg Med Clin North Am ; 39(4): 703-717, 2021 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-34600632

RESUMEN

Abdominal pain is the most common chief complaint in the Emergency Department. Abdominal pain is caused by a variety of gastrointestinal and nongastrointestinal disorders. Some frequently missed conditions include biliary pathology, appendicitis, diverticulitis, and urogenital pathology. The Emergency Medicine clinician must consider all aspects of the patient's presentation including history, physical examination, laboratory testing, and imaging. If no diagnosis is identified, close reassessment of pain, vital signs, and physical examination are necessary to ensure safe discharge. Strict verbal and written return precautions should be provided to the patient.


Asunto(s)
Dolor Abdominal/etiología , Diagnóstico Erróneo , Aneurisma de la Aorta Abdominal/diagnóstico , Apendicitis/diagnóstico , Colecistitis/diagnóstico , Cetoacidosis Diabética/diagnóstico , Servicio de Urgencia en Hospital , Femenino , Humanos , Masculino , Isquemia Mesentérica/diagnóstico , Neoplasias/diagnóstico , Nefrolitiasis/diagnóstico , Torsión Ovárica/diagnóstico , Alta del Paciente , Enfermedades Respiratorias/diagnóstico , Enfermedades de Transmisión Sexual/diagnóstico , Torsión del Cordón Espermático/diagnóstico , Infecciones Urinarias/diagnóstico
2.
Virol J ; 18(1): 202, 2021 10 09.
Artículo en Inglés | MEDLINE | ID: mdl-34627307

RESUMEN

BACKGROUND: The effect of SARS-CoV-2 on existing respiratory pathogens in circulation remains uncertain. This study aimed to assess the impact of SARS-CoV-2 on the prevalence of respiratory pathogens among hospitalized children. METHODS: This study enrolled hospitalized children with acute respiratory infections in Shenzhen Children's Hospital from September to December 2019 (before the COVID-19 epidemic) and those from September to December 2020 (during the COVID-19 epidemic). Nasopharyngeal swabs were collected, and respiratory pathogens were detected using multiplex PCR. The absolute case number and detection rates of 11 pathogens were collected and analyzed. RESULTS: A total of 5696 children with respiratory tract infection received multiplex PCR examination for respiratory pathogens: 2298 from September to December 2019 and 3398 from September to December 2020. At least one pathogen was detected in 1850 (80.5%) patients in 2019, and in 2380 (70.0%) patients in 2020; the detection rate in 2020 was significantly lower than that in 2019.The Influenza A (InfA) detection rate was 5.6% in 2019, but 0% in 2020. The detection rates of Mycoplasma pneumoniae, Human adenovirus, and Human rhinovirus also decreased from 20% (460), 8.9% (206), and 41.8% (961) in 2019 to 1.0% (37), 2.1% (77), and 25.6% (873) in 2020, respectively. In contrast, the detection rates of Human respiratory syncytial virus, Human parainfluenza virus, and Human metapneumovirus increased from 6.6% (153), 9.9% (229), and 0.5% (12) in 2019 to 25.6% (873), 15.5% (530), and 7.2% (247) in 2020, respectively (p < 0.0001). CONCLUSIONS: Successful containment of seasonal influenza as a result of COVID-19 control measures will ensure we are better equipped to deal with future outbreaks of both influenza and COVID-19.Caused by virus competition, the detection rates of Human respiratory syncytial virus, Human parainfluenza virus, and Human metapneumovirus increased in Shenzhen,that reminds us we need to take further monitoring and preventive measures in the next epidemic season.


Asunto(s)
Antibiosis , COVID-19/epidemiología , Enfermedades Respiratorias/epidemiología , SARS-CoV-2/aislamiento & purificación , Adenovirus Humanos/genética , Adenovirus Humanos/aislamiento & purificación , Adolescente , COVID-19/virología , Niño , Niño Hospitalizado , Preescolar , China , Enterovirus/genética , Enterovirus/aislamiento & purificación , Femenino , Humanos , Lactante , Virus de la Influenza A/genética , Virus de la Influenza A/aislamiento & purificación , Masculino , Metapneumovirus/genética , Metapneumovirus/aislamiento & purificación , Mycoplasma pneumoniae/genética , Mycoplasma pneumoniae/aislamiento & purificación , Nasofaringe/microbiología , Nasofaringe/virología , Prevalencia , Virus Sincitiales Respiratorios/genética , Virus Sincitiales Respiratorios/aislamiento & purificación , Enfermedades Respiratorias/microbiología , Enfermedades Respiratorias/virología , Respirovirus/genética , Respirovirus/aislamiento & purificación , SARS-CoV-2/genética
4.
Chem Biol Interact ; 348: 109637, 2021 Oct 01.
Artículo en Inglés | MEDLINE | ID: mdl-34506765

RESUMEN

Both communicable and non-communicable chronic respiratory conditions have accorded for suffering of millions of people of all ages and stated to be leading cause of death, morbidity, economic and social pressures, and disability-adjusted life-years (DALYs) worldwide. These illnesses impair patient's health and negatively impacts families and society, particularly in low and middle-income countries. Chronic respiratory diseases (CRDs) affect different organs of respiratory system, involving airways, parenchyma, and pulmonary vasculature. As the number of respiratory diseases are exponentially escalating but still the stakeholders are not paying attention towards its serious complications. Currently, the treatment being used primarily focusses only on alleviating symptoms of these illness rather delivering the therapeutic agent at target site for optimal care and/or prevention. Lately, extensive research is being conducted on airways and systemic inflammation, oxidative stress, airway, or parenchymal rehabilitation. From which macrophages, neutrophils, and T cells, as well as structural cells as fibroblasts, epithelial, endothelial, and smooth muscle cells have been found to be active participants that are involved in these chronic respiratory diseases. The pathogenesis of all these chronic respiratory diseases gets caused differently via mediators and proteins, including cytokines, chemokines, growth factors and oxidants. Presently, the target of prescription therapies is to reduce the inflammation of airways and relieve the airway contraction. In all studies, cytokines have been found to play an imperative role in fostering chronic airway inflammation and remodelling. Owing to the limitations of conventional treatments, the current review aims to summarize the current knowledge about the chronic respiratory disease and discuss further about the various conventional methods that can be used for treating this ailment. Additionally, it also highlights and discusses about the advanced drug delivery system that are being used for targeting the interleukins for the treatment of CRDs.


Asunto(s)
Interleucinas/metabolismo , Terapia Molecular Dirigida/métodos , Nanomedicina/métodos , Enfermedades Respiratorias/tratamiento farmacológico , Enfermedad Crónica , Humanos
5.
Nutrients ; 13(9)2021 Sep 10.
Artículo en Inglés | MEDLINE | ID: mdl-34579034

RESUMEN

The pivotal role of childhood nutrition has always roused a growing interest from the scientific community. Plant extracts and bioactive dietary components play a significant role in the maintenance of human health and wellness, with the potential to modulate risk factors and manage symptoms for a large number of common childhood disorders such as memory impairment, respiratory illnesses, gastrointestinal disorders, metabolic derangements, and pathologies related to the oral cavity. This review is designed to highlight the health benefits of botanical extracts and bioactive dietary components in children as evidenced by clinical trials, considering their safety with regards to childhood sensibilities. The supplementation of children with the herbal extracts or bioactive components mentioned in this review leads to the conclusion that they are useful for treating various ailments, with no serious adverse events being reported. However, for the limited number of investigations specifically focused on the safety of such products in children, time is needed to expand the literature data covering the safety of childhood supplementation with botanical extract and bioactive food components.


Asunto(s)
Fenómenos Fisiológicos Nutricionales Infantiles , Suplementos Dietéticos , Fitoquímicos/administración & dosificación , Extractos Vegetales/administración & dosificación , Adolescente , Niño , Preescolar , Dieta/métodos , Enfermedades Gastrointestinales/dietoterapia , Humanos , Lactante , Recién Nacido , Fitoterapia/métodos , Ensayos Clínicos Controlados Aleatorios como Asunto , Enfermedades Respiratorias/dietoterapia
6.
Edumecentro ; 13(3): 426-430, jul.-sept. 2021.
Artículo en Español | LILACS, MOSAICO - Salud integrativa | ID: biblio-1283607

RESUMEN

Las enfermedades respiratorias infecciosas afectan con frecuencia a los pacientes que acuden a consultas; constituyen una de las más incapacitantes e incluso, si no se atienden adecuadamente generan una evolución tórpida y pueden comprometer la vida del paciente. En su tratamiento se emplean medicamentos alopáticos, así como modalidades terapéuticas de medicina natural y tradicional. Teniendo en cuenta el desarrollo de la homeopatía en Cuba en los últimos años, se propone como objetivo enfatizar en la importancia de la superación por parte de los profesionales de la salud en el uso de esta modalidad terapéutica, a fin de utilizarla en los diferentes niveles de atención por su pertinencia en tiempos de pandemia.


Infectious respiratory diseases frequently affect patients who attend consultations; they constitute one of the most incapacitating and even, if they are not taken care properly they generate a torpid evolution and can jeopardize the life of the patient. In its treatment allopathic medications are used, as well as therapeutic modalities of herbal and folk medicine. Taking into account the development of homeopathy in Cuba in recent years, it is proposed as an objective to emphasize the importance of improvement by health professionals in the use of this therapeutic modality, in order to use it at different levels of care for its relevance in times of pandemic.


Asunto(s)
COVID-19 , Homeopatía , Enfermedades Respiratorias , Cuba , Medicina Tradicional
7.
Washington, D.C.; OPS; 2021-09-30.
No convencional en Español | PAHO-IRIS | ID: phr-54938

RESUMEN

Esta tercera edición del análisis de la situación general relacionada con el Virus de la influenza y otros virus respiratorios: Vigilancia en la Región de las Américas aporta datos regionales y datos específicos de los países, que se utilizan y valoran en los foros de la Región de las Américas y de otras regiones. Los datos de las tendencias regionales incluyen la vigilancia de la infección respiratoria aguda grave (IRAG), la enfermedad tipo influenza (ETI), la vacuna antigripal, los informes de FluNet/FluID y la participación en el Proyecto de la OMS de Evaluación Externa de la Calidad (EQAP). La segunda parte del informe presenta datos específicos de cada país sobre los indicadores socioeconómicos, los sistemas de vigilancia, los análisis virológicos, la capacidad en materia de laboratorio y las tendencias en la interfaz entre los seres humanos y los animales. Con el propósito de fortalecer las aptitudes de vigilancia de la Región, es importante comprender la capacidad actual de cada país y los aspectos que precisan atención en cada uno de ellos. Asimismo, es necesario evaluar los progresos con el transcurso del tiempo para documentar las tendencias regionales. Dado que desde el último análisis publicado varios indicadores han evolucionado, la OPS llevó a cabo una extensa encuesta con el objeto de recoger y recabar datos complementarios, variados y pormenorizados. El presente informe pone de relieve las complejidades de la vigilancia del virus de la influenza y otros virus respiratorios y destaca las diferencias en la capacidad de preparación de los países mediante diagramas, infografías, cuadros y descripciones breves.


Asunto(s)
Enfermedades Respiratorias , Gripe Humana , Control de Infecciones , Vacunas contra la Influenza , Américas
9.
Isr Med Assoc J ; 23(9): 569-575, 2021 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-34472232

RESUMEN

BACKGROUND: Aerodigestive clinics are run by interdisciplinary medical and surgical teams, and provide complex care coordination and combined endoscopies. OBJECTIVES: To describe the design and patient population of the first pediatric aerodigestive center in Israel. METHODS: A retrospective single-center cohort study was conducted describing patients followed in the aerodigestive clinic of Schneider Children's Medical Center of Israel, a tertiary pediatric hospital, between its inception in January 2017 and June 2020. RESULTS: During the study period, 100 patients were seen at the combined respiratory and digestive (NoAM) clinic, with a total of 271 visits. Median age at first assessment was 29.5 months (range 3-216). Fifty-six patients (56%) had esophageal atresia and tracheoesophageal fistula. Thirty-nine patients had an identified genetic disorder, 28 had a primary airway abnormality, 28 were oxygen dependent, and 21 were born premature. Fifty-two patients underwent triple endoscopy, consisting of flexible bronchoscopy, rigid bronchoscopy, and gastroscopy. In 33 patients, esophageal dilatation was necessary. Six patients underwent posterior tracheopexy at a median of 6 months of age (range 5 days to 8 years) all with ensuing symptom improvement. The total mean parental satisfaction score on a Likert-type scale of 1-5 (5 = highest satisfaction) was 4.5. CONCLUSIONS: A coordinated approach is required to provide effective care to the growing population of children with aerodigestive disorders. The cross fertilization between multiple disciplines offers a unique opportunity to develop high quality and innovative care. Outcome measures must be defined to objectively measure clinical benefit.


Asunto(s)
Enfermedades del Sistema Digestivo/terapia , Endoscopía/métodos , Grupo de Atención al Paciente/organización & administración , Atención al Paciente/métodos , Enfermedades Respiratorias/terapia , Adolescente , Niño , Preescolar , Estudios de Cohortes , Enfermedades del Sistema Digestivo/fisiopatología , Hospitales Pediátricos/organización & administración , Humanos , Lactante , Israel , Padres/psicología , Atención al Paciente/normas , Grupo de Atención al Paciente/normas , Satisfacción del Paciente , Calidad de la Atención de Salud , Enfermedades Respiratorias/fisiopatología , Estudios Retrospectivos , Centros de Atención Terciaria/organización & administración
10.
Swiss Med Wkly ; 151: w20544, 2021 08 02.
Artículo en Inglés | MEDLINE | ID: mdl-34375987

RESUMEN

Respiratory disease is common in children and strongly associated with lifestyle and environmental exposures. Thus, it is important to study the epidemiology locally. The LuftiBus in the School (LUIS) study was set up to assess the respiratory health of schoolchildren in the canton of Zurich, Switzerland. LUIS is a cross-sectional population-based study that was carried out 2013 to 2016. Children aged 6–17 years living in the canton of Zurich were eligible to participate. All schools in the canton were approached and the school head decided whether the school would participate and with which classes. Consenting parents answered a standardised questionnaire at home and assenting children completed a shorter questionnaire by interview at school. Trained technicians measured children’s lung function, including spirometry, double tracer gas single-breath washout (DTG-SBW) and fractional exhaled nitric oxide (FeNO). Address histories of participants were geocoded to be linked with area-based socioeconomic measures and environmental exposures such as spatiotemporal air pollution estimates for specific time periods and locations. A subgroup was seen again 12 months later using the same procedures to collect longitudinal data. The study included 3870 children at baseline and 655 at the 1-year follow-up. Median age was 12.7 years; 281 (8%) had wheezed in the past year. At baseline we collected 3457 (89%) parental and 3546 (92%) child questionnaires, and 3393 (88%) FeNO, 3446 (89%) spirometry, and 1795 (46%) DTG-SBW measurements. LUIS is a rich resource of health-related data, with information on lung function, environmental exposures and respiratory health on Swiss schoolchildren.


Asunto(s)
Enfermedades Respiratorias , Instituciones Académicas , Niño , Estudios Transversales , Exposición a Riesgos Ambientales , Humanos , Óxido Nítrico/análisis , Espirometría
11.
Nutrients ; 13(8)2021 Aug 17.
Artículo en Inglés | MEDLINE | ID: mdl-34444985

RESUMEN

BACKGROUND: Breastfeeding is recommended due to its beneficial effects on human health. However, the effect of breastfeeding on health differs, resulting in various childhood diseases. OBJECTIVE: Our purpose was to investigate the association between breastfeeding at least in the first 4 months and the subsequent development of 15 certainly defined childhood diseases until 10 years of age, the all-cause hospitalization rate and growth at 6-7 years of age. METHODS: Participants included propensity-score matched 188,052 children born between January 2008 and December 2009, who were followed up till 10 years of age. Data were taken from the National Investigation of birth Cohort in Korea study 2008 database. Risk ratios were obtained using a modified Poisson regression and weighted risk differences using binomial regression. RESULTS: Compared to formula feeding, breastfeeding was associated with decreased risks of febrile convulsion, attention deficit hyperactivity disorder and autism spectrum disorder, pneumonia, acute bronchiolitis, hypertrophic pyloric stenosis, asthma, all-cause hospitalization, overweight/obesity and short stature. Exclusive breastfeeding at 4 to 6 months of age had similar results to exclusive breastfeeding over 6 months of age. CONCLUSIONS: Breastfeeding in early infancy reduces the risk for various childhood diseases, all-cause hospitalization rate, obesity, and short stature during childhood.


Asunto(s)
Lactancia Materna , Salud del Niño , Leche Humana , Trastorno por Déficit de Atención con Hiperactividad/prevención & control , Trastorno del Espectro Autista/prevención & control , Niño , Preescolar , Femenino , Trastornos del Crecimiento/prevención & control , Hospitalización , Humanos , Lactante , Masculino , Obesidad/prevención & control , Oportunidad Relativa , Estenosis Hipertrófica del Piloro/prevención & control , República de Corea , Enfermedades Respiratorias/prevención & control , Factores de Riesgo
12.
Int J Mol Sci ; 22(16)2021 Aug 18.
Artículo en Inglés | MEDLINE | ID: mdl-34445609

RESUMEN

Respiratory disease is the leading cause of death in children under the age of 5 years old. Currently available treatments for paediatric respiratory diseases including bronchopulmonary dysplasia, asthma, cystic fibrosis and interstitial lung disease may ameliorate symptoms but do not offer a cure. Cellular therapy may offer a potential cure for these diseases, preventing disease progression into adulthood. Induced pluripotent stem cells, mesenchymal stromal cells and their secretome have shown great potential in preclinical models of lung disease, targeting the major pathological features of the disease. Current research and clinical trials are focused on the adult population. For cellular therapies to progress from preclinical studies to use in the clinic, optimal cell type dosage and delivery methods need to be established and confirmed. Direct delivery of these therapies to the lung as aerosols would allow for lower doses with a higher target efficiency whilst avoiding potential effect of systemic delivery. There is a clear need for research to progress into the clinic for the treatment of paediatric respiratory disease. Whilst research in the adult population forms a basis for the paediatric population, varying disease pathology and anatomical differences in paediatric patients means a paediatric-centric approach must be taken.


Asunto(s)
Tratamiento Basado en Trasplante de Células y Tejidos/métodos , Enfermedades Respiratorias/terapia , Niño , Humanos , Enfermedades Respiratorias/patología
13.
Respir Res ; 22(1): 237, 2021 Aug 26.
Artículo en Inglés | MEDLINE | ID: mdl-34446020

RESUMEN

Follow-up studies of COVID-19 patients have found lung function impairment up to six months after initial infection, but small airway function has not previously been studied. Patients (n = 20) hospitalised for a severe SARS-CoV-2 infection underwent spirometry, impulse oscillometry, and multiple measurements of alveolar nitric oxide three to six months after acute infection. None of the patients had small airway obstruction, nor increased nitric oxide concentration in the alveolar level. None of the patients had a reduced FEV1/FVC or significant bronchodilator responses in IOS or spirometry. In conclusion, we found no evidence of inflammation or dysfunction in the small airways.


Asunto(s)
COVID-19/complicaciones , COVID-19/fisiopatología , Enfermedades Respiratorias/fisiopatología , Adulto , Anciano , Femenino , Finlandia , Estudios de Seguimiento , Volumen Espiratorio Forzado , Humanos , Tiempo de Internación , Masculino , Persona de Mediana Edad , Óxido Nítrico/metabolismo , Alveolos Pulmonares/metabolismo , Pruebas de Función Respiratoria , Enfermedades Respiratorias/etiología , Espirometría , Sobrevivientes , Capacidad Vital
14.
Int J Mol Sci ; 22(16)2021 Aug 07.
Artículo en Inglés | MEDLINE | ID: mdl-34445208

RESUMEN

The transient receptor potential melastatin subtype 8 (TRPM8) is a cold sensor in humans, activated by low temperatures (>10, <28 °C), but also a polymodal ion channel, stimulated by voltage, pressure, cooling compounds (menthol, icilin), and hyperosmolarity. An increased number of experimental results indicate the implication of TRPM8 channels in cold thermal transduction and pain detection, transmission, and maintenance in different tissues and organs. These channels also have a repercussion on different kinds of life-threatening tumors and other pathologies, which include urinary and respiratory tract dysfunctions, dry eye disease, and obesity. This compendium firstly covers newly described papers on the expression of TRPM8 channels and their correlation with pathological states. An overview on the structural knowledge, after cryo-electron microscopy success in solving different TRPM8 structures, as well as some insights obtained from mutagenesis studies, will follow. Most recently described families of TRPM8 modulators are also covered, along with a section of molecules that have reached clinical trials. To finalize, authors provide an outline of the potential prospects in the TRPM8 field.


Asunto(s)
Frío , Canales Catiónicos TRPM , Sensación Térmica , Síndromes de Ojo Seco/tratamiento farmacológico , Síndromes de Ojo Seco/genética , Síndromes de Ojo Seco/metabolismo , Humanos , Obesidad/tratamiento farmacológico , Obesidad/genética , Obesidad/metabolismo , Enfermedades Respiratorias/tratamiento farmacológico , Enfermedades Respiratorias/genética , Enfermedades Respiratorias/metabolismo , Canales Catiónicos TRPM/química , Canales Catiónicos TRPM/genética , Canales Catiónicos TRPM/metabolismo , Enfermedades Urológicas/tratamiento farmacológico , Enfermedades Urológicas/genética , Enfermedades Urológicas/metabolismo
15.
Int J Mol Sci ; 22(16)2021 Aug 05.
Artículo en Inglés | MEDLINE | ID: mdl-34445113

RESUMEN

Nuclear factor erythroid 2-related factor (Nrf2) is a transcriptional activator of the cell protection gene that binds to the antioxidant response element (ARE). Therefore, Nrf2 protects cells and tissues from oxidative stress. Normally, Kelch-like ECH-associated protein 1 (Keap1) inhibits the activation of Nrf2 by binding to Nrf2 and contributes to Nrf2 break down by ubiquitin proteasomes. In moderate oxidative stress, Keap1 is inhibited, allowing Nrf2 to be translocated to the nucleus, which acts as an antioxidant. However, under unusually severe oxidative stress, the Keap1-Nrf2 mechanism becomes disrupted and results in cell and tissue damage. Oxide-containing atmospheric environment generally contributes to the development of respiratory diseases, possibly leading to the failure of the Keap1-Nrf2 pathway. Until now, several studies have identified changes in Keap1-Nrf2 signaling in models of respiratory diseases, such as acute respiratory distress syndrome (ARDS)/acute lung injury (ALI), chronic obstructive pulmonary disease (COPD), idiopathic pulmonary fibrosis (IPF), and asthma. These studies have confirmed that several Nrf2 activators can alleviate symptoms of respiratory diseases. Thus, this review describes how the expression of Keap1-Nrf2 functions in different respiratory diseases and explains the protective effects of reversing this expression.


Asunto(s)
Factor 2 Relacionado con NF-E2/metabolismo , Enfermedades Respiratorias/metabolismo , Animales , Antioxidantes/metabolismo , Humanos , Estrés Oxidativo/fisiología , Transducción de Señal/fisiología
16.
Biosens Bioelectron ; 193: 113546, 2021 Dec 01.
Artículo en Inglés | MEDLINE | ID: mdl-34391176

RESUMEN

We present a portable genetic analyzer with an integrated centrifugal disc which is equipped with a glass-filter extraction column for purifying nucleic acid (NA) and multiple reaction chambers for analyzing major feline upper respiratory tract disease (FURTD) pathogens. We targeted four kinds of FURTD including Feline herpesvirus 1 (FHV), Mycoplasma felis (MPF), Bordetella bronchiseptica (BDB), and Chlamydophila felis (CDF). The portable genetic analyzer consists of a spinning motor, two pairs of Peltier heaters, two Minco heater, fluorescent optics, a touchscreen, and software for data analysis, so loop-mediated isothermal amplification (LAMP) or polymerase chain reaction (PCR) can be performed. The overall size of the genetic analyzer was 28 cm × 28 cm × 26 cm and the weight was 10 kg, which was deliverable for point-of-care testing (POCT). Owing to the sophisticated microchannel design and spinning program, the serial injection of the sample solution, the washing solution, and the elution solution was executed through a glass filter membrane for nucleic acid (NA) extraction, and then the cocktail with the purified genome was aliquoted into 9 reaction chambers for LAMP or PCR. The whole process for the LAMP reaction or the PCR was completed within 1.5 h. The fluorescence profiles by a scanning mode showed the matched results between the LAMP and the PCR.


Asunto(s)
Técnicas Biosensibles , Enfermedades Respiratorias , Animales , Gatos , Chlamydia , Técnicas de Diagnóstico Molecular , Mycoplasma , Técnicas de Amplificación de Ácido Nucleico
17.
Pediatr Infect Dis J ; 40(9): e323-e332, 2021 09 01.
Artículo en Inglés | MEDLINE | ID: mdl-34397776

RESUMEN

BACKGROUND: Globally, very few childhood deaths have been attributed to coronavirus disease 2019 (COVID-19). We evaluated clinical, microbiologic and postmortem histopathologic findings in childhood deaths in whom severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was identified antemortem or postmortem. METHODS: Surveillance of childhood deaths was ongoing during the initial COVID-19 outbreak in South Africa from April 14, 2020, to August 31, 2020. All children hospitalized during this time had a SARS-CoV-2 test done as part of standard of care. Postmortem sampling included minimally invasive tissue sampling (MITS) of lung, liver and heart tissue; blood and lung samples for bacterial culture and molecular detection of viruses (including SARS-CoV-2) and bacteria. The cause of death attribution was undertaken by a multidisciplinary team and reported using World Health Organization framework for cause of death attribution. RESULTS: SARS-CoV-2 was identified on antemortem and/or postmortem sampling in 11.7% (20/171) of deceased children, including 13.2% (12/91) in whom MITS was done. Eighteen (90%) of 20 deaths with SARS-CoV-2 infection were <12 months age. COVID-19 was attributed in the causal pathway to death in 91.7% (11/12) and 87.5% (7/8) cases with and without MITS, respectively. Lung histopathologic features in COVID-19-related deaths included diffuse alveolar damage (n = 6, 54.5%), type 2 pneumocyte proliferation (n = 6, 54.5%) and hyaline membrane formation (n = 5, 36.4%). Culture-confirmed invasive bacterial disease was evident in 54.5% (6/11) of COVID-19 attributed deaths investigated with MITS. CONCLUSIONS: COVID-19 was in the causal pathway of 10.5% (18/171) of all childhood deaths under surveillance. The postmortem histopathologic features in fatal COVID-19 cases in children were consistent with reports on COVID-19 deaths in adults; although there was a high prevalence of invasive bacterial disease in the children.


Asunto(s)
COVID-19/mortalidad , SARS-CoV-2/aislamiento & purificación , Adolescente , COVID-19/complicaciones , COVID-19/patología , COVID-19/terapia , Niño , Preescolar , Femenino , Gastroenteritis/complicaciones , Humanos , Lactante , Recién Nacido , Masculino , Respiración Artificial , Enfermedades Respiratorias/complicaciones , Convulsiones/complicaciones , Sudáfrica/epidemiología
18.
Sci Rep ; 11(1): 16945, 2021 08 20.
Artículo en Inglés | MEDLINE | ID: mdl-34417513

RESUMEN

The patterns of respiratory virus illness are expressed differently between temperate and tropical climates. Tropical outbreaks often peak in wet seasons. Temperate outbreaks typically peak during the winter. The prevailing causal hypotheses focus on sunlight, temperature and humidity variations. Yet no consistent factors have been identified to sufficiently explain seasonal virus emergence and decline at any latitude. Here we demonstrate close connections among global-scale atmospheric circulations, IgE antibody enhancement through seasonal pollen inhalation, and respiratory virus patterns at any populated latitude, with a focus on the US. Pollens emerge each Spring, and the renewed IgE titers in the population are argued to terminate each winter peak of respiratory illness. Globally circulated airborne viruses are postulated to subsequently deposit across the Southern US during lower zonal geostrophic winds each late Summer. This seasonally refreshed viral load is postulated to trigger a new influenza outbreak, once the existing IgE antibodies diminish to a critical value each Fall. Our study offers a new and consistent explanation for the seasonal diminishment of respiratory viral illnesses in temperate climates, the subdued seasonal signature in the tropics, the annually circulated virus phenotypes, and the northerly migration of influenza across the US every year. Our integrated geospatial and IgE hypothesis provides a new perspective for prediction, mitigation and prevention of the outbreak and spread of seasonal respiratory viruses including Covid-19 pandemic.


Asunto(s)
COVID-19/epidemiología , Brotes de Enfermedades/estadística & datos numéricos , Gripe Humana/epidemiología , Infecciones por Virus Sincitial Respiratorio/epidemiología , Enfermedades Respiratorias/epidemiología , SARS-CoV-2/fisiología , Antígenos de Plantas , Atmósfera , Humanos , Inmunoglobulina E/metabolismo , Pandemias , Polen , Estaciones del Año , Estados Unidos/epidemiología
19.
Am J Med ; 134(10): 1247-1251, 2021 10.
Artículo en Inglés | MEDLINE | ID: mdl-34242620

RESUMEN

BACKGROUND: Masking, which is known to decrease the transmission of respiratory viruses, was not widely practiced in the United States until the coronavirus disease 2019 (COVID-19) pandemic. This provides a natural experiment to determine whether the percentage of community masking was associated with decreases in emergency department (ED) visits due to non-COVID viral illnesses (NCVIs) and related respiratory conditions. METHODS: In this observational study of ED encounters in a 11-hospital system in Maryland during 2019-2020, year-on-year ratios for all complaints were calculated to account for "lockdowns" and the global drop in ED visits due to the pandemic. Encounters for specific complaints were identified using the International Classification of Diseases, version 10. Encounters with a positive COVID test were excluded. Linear regression was used to determine the association of publicly available masking data with ED visits for NCVI and exacerbations of asthma and chronic obstructive pulmonary disease (COPD), after adjusting for patient age, sex, and medical history. RESULTS: There were 285,967 and 252,598 ED visits across the hospital system in 2019 and 2020, respectively. There was a trend toward an association between the year-on-year ratio for all ED visits and the Maryland stay-at-home order (parameter estimate = -0.0804, P = .10). A 10% percent increase in the prevalence of community masking was associated with a 17.0%, 8.8%, and 9.4% decrease in ED visits for NCVI and exacerbations of asthma exacerbations and chronic obstructive pulmonary disease, respectively (P < .001 for all). CONCLUSIONS: Increasing the prevalence of masking is associated with a decrease in ED visits for viral illnesses and exacerbations of asthma and COPD. These findings may be valuable for future public health responses, particularly in future pandemics with respiratory transmission or in severe influenza seasons.


Asunto(s)
COVID-19/prevención & control , Control de Enfermedades Transmisibles , Servicio de Urgencia en Hospital/estadística & datos numéricos , Máscaras , Enfermedades Respiratorias/epidemiología , Virosis/epidemiología , Femenino , Humanos , Masculino , Maryland/epidemiología , Pandemias , Estudios Retrospectivos , SARS-CoV-2
20.
Environ Res ; 201: 111652, 2021 10.
Artículo en Inglés | MEDLINE | ID: mdl-34246637

RESUMEN

Ambient temperature is an important contributor to mortality burden worldwide, most of which is from cold exposure. However, little is known about the cold impact on life expectancy loss. This paper aimed to estimate cold-related life expectancy loss from cause-, age-, and gender-specific cardiovascular and respiratory diseases. Daily deaths from cardiovascular and respiratory diseases and weather records were acquired for Hong Kong, China during 2000-2016. Years of life lost (YLL) that considers life expectancy at the time of death was calculated by matching each death by age and sex to annual life tables. Using a generalized additive model that fits temperature-YLL association, we estimated loss of years in life expectancy from cold. Cold was estimated to cause life expectancy loss of 0.9 years in total cardiovascular disease, with more years of loss in males than in females and in people aged 65 years and older than in people aged up to 64 years. Cold-related life expectancy loss in total respiratory diseases was 1.2 years, with more years of loss in females than in males and comparable years of loss in people aged up to 64 years and in people aged 65 years and older. Among cause-specific diseases, we observed the greatest life expectancy loss in pneumonia (1.5 years), followed by ischaemic heart disease (1.2 years), COPD (1.1 years), and stroke (0.3 years). Between two periods of 2000-2007 and 2008-2016, cold-related life expectancy loss due to cardiovascular disease did not decrease and cold-related life expectancy loss due to respiratory disease even increased by five times. Our findings suggest an urgent need to develop prevention measures against adverse cold effects on cardiorespiratory disease in Hong Kong.


Asunto(s)
Enfermedades Cardiovasculares/epidemiología , Frío , Esperanza de Vida , Enfermedades Respiratorias/epidemiología , Anciano , China/epidemiología , Femenino , Hong Kong/epidemiología , Humanos , Masculino , Persona de Mediana Edad , Proyectos de Investigación
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