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3.
ACS Chem Neurosci ; 11(24): 4012-4016, 2020 12 16.
Artigo em Inglês | MEDLINE | ID: mdl-33244974

RESUMO

The current pandemic of coronavirus disease 2019 (COVID-19) has gained increased attention in the neuroscience community, especially taking into account the neuroinvasive potential of its causative agent, the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), and the impact of its infection on the structure and function of the brain. Apart from the neurotropic properties of SARS-CoV-2, it is likewise important the observation that virus infection may perturb specific cellular processes that are believed to play an important role in the pathogenesis of diverse neurological disorders, particularly in Parkinson's disease (PD). In this scenario, viral infection-induced colon inflammation, gut microbial imbalance, and α-synuclein upregulation are of particular interest with regard to the interplay between the gastrointestinal tract and the central nervous system (microbiome-gut-brain axis). In this Perspective, we present a critical view on the different hypotheses that are recently being raised by neuroscientists about the relationship between SARS-CoV-2 infection and long-lasting neurodegenerative disorders, opening the question of whether COVID-19 might represent a risk factor for the development of PD.


Assuntos
Disbiose/virologia , Doenças Neurodegenerativas/virologia , Viroses/virologia , Encéfalo/patologia , Encéfalo/virologia , Disbiose/complicações , Microbioma Gastrointestinal/fisiologia , Humanos , Doenças Neurodegenerativas/patologia , Viroses/complicações , Viroses/patologia
4.
PLoS Negl Trop Dis ; 14(10): e0008677, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-33035209

RESUMO

BACKGROUND: Diarrhea is one of the leading causes of childhood morbidity and mortality in lower- and middle-income countries. In such settings, access to laboratory diagnostics are often limited, and decisions for use of antimicrobials often empiric. Clinical predictors are a potential non-laboratory method to more accurately assess diarrheal etiology, the knowledge of which could improve management of pediatric diarrhea. METHODS: We used clinical and quantitative molecular etiologic data from the Global Enteric Multicenter Study (GEMS), a prospective, case-control study, to develop predictive models for the etiology of diarrhea. Using random forests, we screened the available variables and then assessed the performance of predictions from random forest regression models and logistic regression models using 5-fold cross-validation. RESULTS: We identified 1049 cases where a virus was the only etiology, and developed predictive models against 2317 cases where the etiology was known but non-viral (bacterial, protozoal, or mixed). Variables predictive of a viral etiology included lower age, a dry and cold season, increased height-for-age z-score (HAZ), lack of bloody diarrhea, and presence of vomiting. Cross-validation suggests an AUC of 0.825 can be achieved with a parsimonious model of 5 variables, achieving a specificity of 0.85, a sensitivity of 0.59, a NPV of 0.82 and a PPV of 0.64. CONCLUSION: Predictors of the etiology of pediatric diarrhea can be used by providers in low-resource settings to inform clinical decision-making. The use of non-laboratory methods to diagnose viral causes of diarrhea could be a step towards reducing inappropriate antibiotic prescription worldwide.


Assuntos
Infecções Bacterianas/complicações , Diarreia/etiologia , Viroses/complicações , Infecções Bacterianas/microbiologia , Estudos de Casos e Controles , Interpretação Estatística de Dados , Humanos , Lactente , Modelos Biológicos , Estudos Prospectivos , Viroses/virologia
6.
Public Health Rep ; 135(6): 805-812, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33080142

RESUMO

OBJECTIVE: The International Agency for Research on Cancer has classified 13 infectious agents as carcinogenic or probably carcinogenic to humans. We aimed to estimate the percentage (ie, population-attributable fraction) and number of incident cancer cases in Texas in 2015 that were attributable to oncogenic infections, overall and by race/ethnicity. METHODS: We calculated population-attributable fractions for cancers attributable to human papillomavirus (HPV), Helicobacter pylori, hepatitis C virus (HCV), hepatitis B virus (HBV), and human herpesvirus 8 (HHV-8) infections using prevalence estimates from National Health and Nutrition Examination Survey laboratory data and relative risks associated with infection from previous epidemiological studies. The Texas Cancer Registry provided cancer incidence data. RESULTS: We estimated that 3603 excess cancer cases, or 3.5% of all cancers diagnosed in 2015, among adults aged ≥25 in Texas were attributable to oncogenic infections. Hispanic adults had the highest proportion of cancer cases attributable to infections (5.6%), followed by non-Hispanic Black (5.4%) and non-Hispanic White (2.3%) adults. HPV infection caused the highest proportion of all cancer cases (1.8%) compared with other oncogenic infections (HCV, 0.8%; H pylori, 0.5%; HBV, 0.3%; HHV-8, 0.1%). Hispanic adults had the highest proportions of all cancers caused by HPV infection (2.6%) and H pylori (1.1%), and non-Hispanic Black adults had the highest proportions of all cancers caused by HCV infection (1.7%), HBV infection (0.7%), and HHV-8 (0.3%). CONCLUSION: Preventable oncogenic infections contribute to cancer incidence in Texas and may affect racial/ethnic minority groups disproportionately. Infection control and prevention should be stressed as an important component of cancer prevention.


Assuntos
Grupos Étnicos/estatística & dados numéricos , Infecções por Helicobacter/complicações , Grupos Minoritários/estatística & dados numéricos , Neoplasias/etnologia , Neoplasias/etiologia , Viroses/complicações , Adulto , Idoso , Feminino , Helicobacter pylori , Humanos , Masculino , Pessoa de Meia-Idade , Inquéritos Nutricionais , Texas/epidemiologia
8.
Pediatrics ; 146(4)2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32883808

RESUMO

BACKGROUND: Children with isolated neutropenia (absolute neutrophil count [ANC] <1500/µL) are frequently referred to pediatric hematology and oncology clinics for further diagnostic evaluation. Scant literature exists on interventions and outcomes for isolated neutropenia. We hypothesized that children will have resolution of their neutropenia without the need for intervention(s) by a pediatric hematologist and oncologist. METHODS: We performed a 5.5-year institutional review board-approved retrospective chart review of children referred to our pediatric hematology and oncology clinics for isolated neutropenia. Neutropenia was categorized as mild (ANC of 1001-1500/µL), moderate (ANC of 500-1000 µL), severe (ANC of 201-500/µL), or very severe (ANC of ≤200/µL). RESULTS: Among 155 children referred with isolated neutropenia, 45 (29%) had mild neutropenia, 65 (42%) had moderate neutropenia, 30 (19%) had severe neutropenia, and 15 (10%) had very severe neutropenia. Only 29 (19%) children changed to an ANC category lower than their initial referral category. At a median follow-up of 12 months, 101 children had resolution of neutropenia, 40 children had mild neutropenia, 10 children had moderate neutropenia, 3 children had severe neutropenia, and 1 patient had very severe neutropenia. A specific diagnosis was not identified in most (54%) children. The most common etiologies were viral suppression (16%), autoimmune neutropenia (14%), and drug-induced neutropenia (8%). Black children had a 3.5 higher odds of having persistent mild neutropenia. Six (4%) children received granulocyte colony-stimulating factor therapy. CONCLUSIONS: Most children referred for isolated neutropenia do not progress in severity and do not require subspecialty interventions or hospitalizations.


Assuntos
Neutropenia/epidemiologia , Encaminhamento e Consulta/estatística & dados numéricos , Adolescente , Afro-Americanos/estatística & dados numéricos , Anticorpos Antinucleares/análise , Americanos Asiáticos/estatística & dados numéricos , Doenças Autoimunes/complicações , Neutropenia Febril Induzida por Quimioterapia/epidemiologia , Criança , Pré-Escolar , Progressão da Doença , Grupo com Ancestrais do Continente Europeu/estatística & dados numéricos , Feminino , Seguimentos , Fator Estimulador de Colônias de Granulócitos/uso terapêutico , Hematologia , Hospitalização/estatística & dados numéricos , Humanos , Lactente , Recém-Nascido , Masculino , Oncologia , Neutropenia/diagnóstico , Neutropenia/tratamento farmacológico , Neutropenia/etiologia , Remissão Espontânea , Estudos Retrospectivos , Viroses/complicações
9.
Pan Afr Med J ; 36: 28, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32774605

RESUMO

The aim of this study is to report a challengeable and rare case of autoimmune hypophysitis possibly induced by viral infections. A young pregnant female developed optic neuropathy due to enlarged sellar mass responsible for hypopituitarism. Investigations exclude neoplasia and systemic diseases. High level of sedimentation rate and magnetic resonance imaging (MRI) findings supported the diagnosis of autoimmune hypophysitis. The patient reported a history of bronchitis treated with antibiotics and corticosteroids and positive serologies for hepatitis B antigen (Hbs antigen), herpes simplex 1 and rubella. Final examination showed complete recovery of visual function and sellar archnoidocele after antiviral treatment and mild dose of corticosteroids.


Assuntos
Hipofisite Autoimune/diagnóstico , Complicações na Gravidez/diagnóstico , Viroses/complicações , Corticosteroides/administração & dosagem , Adulto , Antivirais/administração & dosagem , Hipofisite Autoimune/tratamento farmacológico , Hipofisite Autoimune/virologia , Feminino , Humanos , Imagem por Ressonância Magnética , Gravidez , Complicações na Gravidez/tratamento farmacológico , Complicações na Gravidez/virologia , Viroses/diagnóstico , Viroses/tratamento farmacológico
10.
Med Hypotheses ; 143: 110125, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32763657

RESUMO

The novel coronavirus (SARS-CoV-2) is primarily a respiratory pathogen and its clinical manifestations are dominated by respiratory symptoms, the most severe of which is acute respiratory distress syndrome (ARDS). However, COVID-19 is increasingly recognized to cause an overwhelming inflammatory response and cytokine storm leading to end organ damage. End organ damage to heart is one of the most severe complications of COVID-19 that increases the risk of death. We proposed a two-fold mechanism responsible for causing acute coronary events in patients with COVID-19 infection: Cytokine storm leading to rapid onset formation of new coronary plaques along with destabilization of pre-existing plaques and direct myocardial injury secondary to acute systemic viral infection. A well-coordinated immune response is the first line innate immunity against a viral infection. However, an uncoordinated response and hypersecretion of cytokines and chemokines lead to immune related damage to the human body. Human Coronavirus (HCoV) infection causes infiltration of inflammatory cells that cause excessive production of cytokines, proteases, coagulation factors, oxygen radicals and vasoactive molecules causing endothelial damage, disruption of fibrous cap and initiation of formation of thrombus. Systemic viral infections also cause vasoconstriction leading to narrowing of vascular lumen and stimulation of platelet activation via shear stress. The resultant cytokine storm causes secretion of hypercoagulable tissue factor without consequential increase in counter-regulatory pathways such as AT-III, activated protein C and plasminogen activator type 1. Lastly, influx of CD4+ T-cells in cardiac vasculature results in an increased production of cytokines that stimulate smooth muscle cells to migrate into the intima and generate collagen and other fibrous products leading to advancement of fatty streaks to advanced atherosclerotic lesions. Direct myocardial damage and cytokine storm leading to destabilization of pre-existing plaques and accelerated formation of new plaques are the two instigating mechanisms for acute coronary syndromes in COVID-19.


Assuntos
Síndrome Coronariana Aguda/etiologia , Betacoronavirus , Infecções por Coronavirus/complicações , Modelos Cardiovasculares , Pandemias , Pneumonia Viral/complicações , Síndrome Coronariana Aguda/fisiopatologia , Linfócitos T CD4-Positivos/imunologia , Quimiocinas/fisiologia , Doença da Artéria Coronariana/etiologia , Doença da Artéria Coronariana/fisiopatologia , Vasos Coronários/metabolismo , Infecções por Coronavirus/imunologia , Infecções por Coronavirus/fisiopatologia , Síndrome da Liberação de Citocina/etiologia , Síndrome da Liberação de Citocina/fisiopatologia , Citocinas/fisiologia , Humanos , Imunidade Inata , Placa Aterosclerótica/etiologia , Placa Aterosclerótica/fisiopatologia , Ativação Plaquetária , Pneumonia Viral/imunologia , Pneumonia Viral/fisiopatologia , Vasoconstrição , Viroses/complicações , Viroses/imunologia
11.
Thorax ; 75(12): 1119-1129, 2020 12.
Artigo em Inglês | MEDLINE | ID: mdl-32839286

RESUMO

Asthma attacks (exacerbations) are common, accounting for over 90 000 UK hospital admissions per annum. They kill nearly 1500 people per year in the UK, have significant associated direct and indirect costs and lead to accelerated and permanent loss of lung function. The recognition of asthma as a heterogeneous condition with multiple phenotypes has revolutionised the approach to the long-term management of the condition, with greater emphasis on personalised treatment and the introduction of the treatable traits concept. In contrast asthma attacks are poorly defined and understood and our treatment approach consists of bronchodilators and systemic corticosteroids. This review aims to explore the current limitations in the description, assessment and management of asthma attacks. We will outline the risk factors for attacks, strategies to modify this risk and describe the recognised characteristics of attacks as a first step towards the development of an approach for phenotyping and personalising the treatment of these critically important events. By doing this, we hope to gradually improve asthma attack treatment and reduce the adverse effects associated with recurrent courses of corticosteroids.


Assuntos
Asma/etiologia , Exacerbação dos Sintomas , Alérgenos/efeitos adversos , Asma/tratamento farmacológico , Asma/fisiopatologia , Infecções Bacterianas/complicações , Humanos , Inflamação/etiologia , Pico do Fluxo Expiratório , Fenótipo , Medição de Risco , Fatores de Risco , Viroses/complicações
12.
J Immunother Cancer ; 8(2)2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-32611687

RESUMO

The present review summarizes up-to-date evidence addressing the frequently discussed clinical controversies regarding the use of immune checkpoint inhibitors (ICIs) in cancer patients with viral infections, including AIDS, hepatitis B and C, progressive multifocal leukoencephalopathy, influenza, and COVID-19. In detail, we provide available information on (1) safety regarding the risk of new infections, (2) effects on the outcome of pre-existing infections, (3) whether immunosuppressive drugs used to treat ICI-related adverse events affect the risk of infection or virulence of pre-existing infections, (4) whether the use of vaccines in ICI-treated patients is considered safe, and (5) whether there are beneficial effects of ICIs that even qualify them as a therapeutic approach for these viral infections.


Assuntos
Imunossupressores/uso terapêutico , Neoplasias/complicações , Viroses/terapia , Betacoronavirus , Infecções por Coronavirus/complicações , Infecções por Coronavirus/tratamento farmacológico , Infecções por Coronavirus/imunologia , Infecções por Coronavirus/terapia , Hepatite B/complicações , Hepatite B/tratamento farmacológico , Hepatite B/imunologia , Hepatite B/terapia , Hepatite C/complicações , Hepatite C/tratamento farmacológico , Hepatite C/imunologia , Hepatite C/terapia , Humanos , Influenza Humana/complicações , Influenza Humana/tratamento farmacológico , Influenza Humana/imunologia , Influenza Humana/terapia , Pandemias , Pneumonia Viral/complicações , Pneumonia Viral/tratamento farmacológico , Pneumonia Viral/imunologia , Pneumonia Viral/terapia , Viroses/complicações , Viroses/tratamento farmacológico , Viroses/imunologia
13.
Adv Exp Med Biol ; 1207: 229-235, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32671752

RESUMO

Direct damage and immune responses after viral infection lead to myocarditis. Autophagy is involved in both viral clearance and replication. In this chapter, we will briefly describe the role of autophagy in viral myocarditis. In addition, we will discuss the role of autophagy in dilated cardiomyopathy, hypertrophic cardiomyopathy, and diabetic cardiomyopathy.


Assuntos
Autofagia , Cardiomiopatias , Miocardite , Cardiomiopatia Dilatada , Cardiomiopatia Hipertrófica , Cardiomiopatias Diabéticas , Humanos , Miocardite/complicações , Miocardite/virologia , Viroses/complicações
14.
Ann Allergy Asthma Immunol ; 125(2): 156-162, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32454096

RESUMO

OBJECTIVE: To summarize the recent evidence in the treatment of viral-induced wheezing in the infant and preschool aged child. DATA SOURCES: Published literature obtained through PubMed database searches. STUDY SELECTIONS: Studies relevant to phenotypes and treatment of wheezing illnesses in infants and preschool children were included. RESULTS: Recurrent wheezing in preschool children is common and is frequently triggered by viral respiratory tract infections. Certain phenotypes may respond to treatments differently, depending on the risk factors identified. Inhaled corticosteroids, administered continuously or intermittently, reduce the risk of virus-induced wheezing episodes. The use of leukotriene modifying agents may have a role in wheezing episodes in a select group of preschool children. Early administration of azithromycin reduces the risk of severe lower respiratory tract illnesses in children. The effect of oral corticosteroids on wheezing episodes in young children varies by degree of episode severity. CONCLUSION: Recurrent viral-induced wheezing illnesses has been the focus of many clinical trials, which now provide an increasingly robust evidence base for management. Additional research is needed to define optimal strategies, to best match therapies to specific phenotypes and endotypes, and will eventually begin to include therapies directed specifically at the viral triggers.


Assuntos
Corticosteroides/uso terapêutico , Antiasmáticos/uso terapêutico , Asma/prevenção & controle , Viroses/tratamento farmacológico , Asma/etiologia , Pré-Escolar , Humanos , Imunomodulação , Lactente , Fenótipo , Recidiva , Sons Respiratórios/etiologia , Risco , Viroses/complicações
15.
Acta Otorrinolaringol Esp ; 71(6): 379-385, 2020.
Artigo em Espanhol | MEDLINE | ID: mdl-32466862

RESUMO

There is debate as to whether olfactory dysfunction should be considered a symptom of COVID-19 infection. We undertook a systematic literature review of the articles indexed in PubMed on olfactory disorders in viral respiratory tract conditions, with special emphasis on COVID-19. The main objective was to find evidence of clinical interest to support the relationship between anosmia and COVID-19. Olfactory disorders in upper respiratory tract infections are frequent, most caused by obstruction due to oedema of the nasal mucosa. Occasionally, post-viral sensorineural olfactory dysfunction occurs, with a variable prognosis. The evidence on anosmia in COVID-19 patients is extremely limited, corresponding to a level 5 or D of the Centre for Evidence-Based Medicine. According to the available evidence, it seems reasonable to apply isolation, hygiene and social distancing measures in patients with recent olfactory disorders as the only symptom, although the usefulness of diagnostic tests for this type of patient should be studied.


Assuntos
Betacoronavirus , Infecções por Coronavirus/complicações , Infecções por Coronavirus/epidemiologia , Transtornos do Olfato/etiologia , Pneumonia Viral/complicações , Pneumonia Viral/epidemiologia , Técnicas de Laboratório Clínico , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/transmissão , Humanos , Higiene , Transtornos do Olfato/diagnóstico , Mucosa Olfatória/anatomia & histologia , Pandemias , Isolamento de Pacientes , Pneumonia Viral/diagnóstico , Pneumonia Viral/transmissão , Guias de Prática Clínica como Assunto , Prognóstico , Quarentena , Infecções Respiratórias/complicações , Infecções Respiratórias/virologia , Viroses/complicações
16.
J Infect ; 81(2): 266-275, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32473235

RESUMO

OBJECTIVES: In previous influenza pandemics, bacterial co-infections have been a major cause of mortality. We aimed to evaluate the burden of co-infections in patients with COVID-19. METHODS: We systematically searched Embase, Medline, Cochrane Library, LILACS and CINAHL for eligible studies published from 1 January 2020 to 17 April 2020. We included patients of all ages, in all settings. The main outcome was the proportion of patients with a bacterial, fungal or viral co-infection. . RESULTS: Thirty studies including 3834 patients were included. Overall, 7% of hospitalised COVID-19 patients had a bacterial co-infection (95% CI 3-12%, n=2183, I2=92·2%). A higher proportion of ICU patients had bacterial co-infections than patients in mixed ward/ICU settings (14%, 95% CI 5-26, I2=74·7% versus 4%, 95% CI 1-9, I2= 91·7%). The commonest bacteria were Mycoplasma pneumonia, Pseudomonas aeruginosa and Haemophilus influenzae. The pooled proportion with a viral co-infection was 3% (95% CI 1-6, n=1014, I2=62·3%), with Respiratory Syncytial Virus and influenza A the commonest. Three studies reported fungal co-infections. CONCLUSIONS: A low proportion of COVID-19 patients have a bacterial co-infection; less than in previous influenza pandemics. These findings do not support the routine use of antibiotics in the management of confirmed COVID-19 infection.


Assuntos
Infecções Bacterianas/virologia , Coinfecção/microbiologia , Coinfecção/virologia , Infecções por Coronavirus/virologia , Pneumonia Viral/virologia , Infecções Bacterianas/complicações , Infecções Bacterianas/epidemiologia , Betacoronavirus , Coinfecção/epidemiologia , Infecções por Coronavirus/complicações , Infecções por Coronavirus/epidemiologia , Humanos , Micoses/complicações , Micoses/epidemiologia , Micoses/virologia , Pandemias , Pneumonia Viral/complicações , Pneumonia Viral/epidemiologia , Viroses/complicações , Viroses/epidemiologia , Viroses/microbiologia
17.
Int J Pediatr Otorhinolaryngol ; 134: 110057, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32388322

RESUMO

OBJECTIVES: Children admitted with stridor and respiratory distress comprise a complex patient group that requires the otolaryngologist to decide when to assess and intervene with direct laryngoscopy and bronchoscopy (DLB). Historically, the diagnosis of viral upper respiratory tract infection (URTI) can lead to postponement of surgery due to concerns of perioperative complications related to acute illness. Respiratory viral panels (RVP) are often used to confirm the presence of recent or active viral infection and can affect the differential diagnosis of upper airway obstruction. This study examined whether positive RVP testing is associated with perioperative complications and operative findings in pediatric patients undergoing inpatient DLB. METHODS: A retrospective chart review of 132 pediatric patient encounters was performed. Viral testing results, DLB indication, DLB findings, and perioperative complications were compared. RESULTS: Sixty encounters (45.5%) involved a positive RVP, and 72 (54.5%) involved a negative RVP. Those with positive RVP were less likely to have a preoperative structural airway diagnosis (P =.0250) and more likely to have a history of recurrent upper respiratory infections (P =.0464). The most common reason for DLB was the need to assess the airway due to concern for structural pathology. Anatomic abnormalities were seen in a majority of encounters (77.3%) Laryngospasm occurred in 1 (1.7%) RVP positive and 1 (1.4%) RVP negative encounter, and 2 (2.8%) RVP negative encounters required reintubation. No other major complications were observed. No association was noted between RVP results and incidence of major or minor complication. CONCLUSIONS: Major perioperative complications after surgical intervention with DLB for the management of complex, inpatient children with stridor and respiratory distress are rare. RVP positivity, specific pathogens identified on RVP, and presence of URI symptoms were not associated with perioperative complications.


Assuntos
Insuficiência Respiratória/etiologia , Sons Respiratórios/etiologia , Anormalidades do Sistema Respiratório/diagnóstico por imagem , Infecções Respiratórias/diagnóstico , Viroses/diagnóstico , Broncoscopia/efeitos adversos , Pré-Escolar , Diagnóstico Diferencial , Feminino , Humanos , Lactente , Complicações Intraoperatórias/etiologia , Laringismo/diagnóstico por imagem , Laringismo/etiologia , Laringoscopia/efeitos adversos , Masculino , Complicações Pós-Operatórias/etiologia , Insuficiência Respiratória/cirurgia , Anormalidades do Sistema Respiratório/complicações , Infecções Respiratórias/complicações , Infecções Respiratórias/virologia , Estudos Retrospectivos , Medição de Risco , Viroses/complicações
18.
Virus Res ; 285: 198005, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32408156

RESUMO

Accumulating evidence shows that microbial co-infection increases the risk of disease severity in humans. There have been few studies about SARS-CoV-2 co-infection with other pathogens. In this retrospective study, 257 laboratory-confirmed COVID-19 patients in Jiangsu Province were enrolled from January 22 to February 2, 2020. They were re-confirmed by real-time RT-PCR and tested for 39 respiratory pathogens. In total, 24 respiratory pathogens were found among the patients, and 242 (94.2 %) patients were co-infected with one or more pathogens. Bacterial co-infections were dominant in all COVID-19 patients, Streptococcus pneumoniae was the most common, followed by Klebsiella pneumoniae and Haemophilus influenzae. The highest and lowest rates of co-infections were found in patients aged 15-44 and below 15, respectively. Most co-infections occurred within 1-4 days of onset of COVID-19 disease. In addition, the proportion of viral co-infections, fungal co-infections and bacterial-fungal co-infections were the highest severe COVID-19 cases. These results will provide a helpful reference for diagnosis and clinical treatment of COVID-19 patients.


Assuntos
Infecções Bacterianas/complicações , Betacoronavirus , Coinfecção , Infecções por Coronavirus/complicações , Micoses/complicações , Pneumonia Viral/complicações , Viroses/complicações , Adolescente , Adulto , Fatores Etários , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pandemias , Estudos Retrospectivos , Fatores de Tempo , Adulto Jovem
19.
Medicine (Baltimore) ; 99(15): e19744, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-32282734

RESUMO

RATIONALE: Tattooing is a procedure where ink is inserted typically in the intraepidermal space of the skin. Multiple incidences of viral infections following tattooing which lead to warts have been reported in recent years. The aim of this report was to show a relatively rare adverse effect after tattooing - verruca plana. PATIENT CONCERNS: A 27-year-old female presented to our department with complains of multiple verrucous papules over her 2-year-old tattoo without itch. DIAGNOSES: Pathological investigation confirmed the diagnosis as verruca plana. INTERVENTIONS: The patient was treated with 3 cycles of liquid nitrogen cryotherapy and 5% imiquimod cream for 5 months. OUTCOMES: A significant improvement in her lesions was observed after the combined treatment. LESSONS: Clinically, verruca plana post-tattooing is relatively less reported. We need to combine clinical manifestations with pathological results to arrive at a definitive diagnosis. Besides, there are a large numbers of post-tattoo complications and various routes of virus inoculation. Therefore, it is important for medical professionals to caution people before considering to have a tattoo.


Assuntos
Tatuagem/efeitos adversos , Viroses/complicações , Verrugas/patologia , Verrugas/terapia , Adjuvantes Imunológicos/administração & dosagem , Adjuvantes Imunológicos/uso terapêutico , Administração Tópica , Adulto , Terapia Combinada , Crioterapia/métodos , Feminino , Humanos , Imiquimode/administração & dosagem , Imiquimode/uso terapêutico , Resultado do Tratamento , Viroses/patologia , Verrugas/etiologia
20.
Harefuah ; 159(3): 191-194, 2020 Mar.
Artigo em Hebraico | MEDLINE | ID: mdl-32186790

RESUMO

INTRODUCTION: Spinal cord injury (SCI) etiology can be either traumatic or non-traumatic. Non-traumatic SCI is of growing importance, with studies indicating increased incidence, partly because of population aging. Approximately 9% of these injuries are secondary to an infectious cause. SCI has significant implications on the patient's quality of life. A successful rehabilitation process focuses on maximizing independence and setting achievable goals according to the patient's needs and desires. The medical staff should be familiar with the natural history of such injuries while taking into consideration the existing support systems available to the patient and minimizing the damage to life cycles as best possible with the aid of a transdisciplinary team approach. In this article, we will review the main viral causes of SCI injury. We will discuss the epidemiology, clinical aspects and the unique meanings of this subgroup in the rehabilitation process.


Assuntos
Traumatismos da Medula Espinal/virologia , Viroses/epidemiologia , Humanos , Incidência , Infecções , Qualidade de Vida , Traumatismos da Medula Espinal/epidemiologia , Traumatismos da Medula Espinal/etiologia , Viroses/complicações
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