Acute Respiratory Condition Research Articles

Establishment of a duplex TaqMan-based real time RT-PCR assay for simultaneous detection of BRSV and BVDV

Bovine respiratory disease complex (BRDC) represents a global acute respiratory condition that imposes substantial economic burdens on the cattle industry due to its high morbidity and mortality rates. Various factors contribute to the development of BRDC, including pathogen infections, environmental stresses, weaning of calves, and herd relocation. Viral pathogens, notably bovine respiratory syncytial virus (BRSV) and bovine viral diarrhea virus (BVDV), play a critical role in the etiology of BRDC, with single or combined viral infections being particularly clinically significant. In this study, we developed a duplex TaqMan-based real-time RT-PCR assay targeting the conserved regions of the F gene of BRSV and the 5′ UTR sequence of BVDV. The limits of detection for BRSV and BVDV were 6.83 copies/μL and 5.24 copies/μL, respectively. Our validation data suggest the assay has excellent sensitivity, specificity and reproducibility. Testing of clinical samples revealed prevalence of BRSV and BVDV in local farms in Jiangsu Province, China. This study provides an efficient diagnostic tool for the epidemiological investigation of BRDC.

Prevalence and Outpatient Clinical Diagnostic Approaches for Common Acute Respiratory Tract Infections in Children Under Five Years of Age: A Cross-Sectional Study.

Acute respiratory tract infections are among the leading causes of child morbidity and mortality worldwide. Although the diagnosis of acute respiratory tract infections requires simple outpatient medical techniques and care, it is still misdiagnosed among primary care physicians, leading to delayed treatment and increased mortality. This study described the prevalence of common acute respiratory tract infections and simple techniques that effectively detect and diagnose children presenting with acute respiratory symptoms to primary healthcare physicians in remote settings. This descriptive cross-sectional study was conducted at the pediatric outpatient clinic of a tertiary hospital in western Uganda in April, May and June 2019. A total of 896 children aged 2-59 months attending the clinic were recruited consecutively into the study and examined for the presence of acute respiratory infection. Participants' sociodemographic and clinical data were collected through history taking and clinical examination using a validated Uganda Ministry of Health Uganda outpatient clinical checklist (FORM 5). The outcome variable was the presence of an acute upper or lower respiratory condition. Data was analyzed using STATA version 13.0 (StataCorp, College Station, USA) and summarized using descriptive statistics. The overall period prevalence of acute respiratory tract infections among children aged 2 to 59 months was 36.9% (36,942 per 100,000 population). Upper respiratory tract infections with a prevalence of 24.8% were more common than lower respiratory tract infections. The most frequent upper respiratory tract infection in this setting was common cold (52%), followed by tonsillopharyngitis (10.7%), while pneumonia (26%) was the most frequent lower respiratory tract infection. Acute respiratory tract infections contribute to the high burden of disease in pediatric outpatient clinics. Simple, affordable, and approved diagnostic clinical techniques that involve physical examination of the upper and lower respiratory systems can precisely diagnose acute respiratory tract infections in resource-limited settings where there is no access to sophisticated diagnostic equipment.

Comparison of different sustained-release opioids and acute respiratory conditions in patients with cancer and chronic kidney disease.

Few data are available on the association between the use of oxycodone in patients with chronic kidney disease (CKD) and acute respiratory conditions. The aim of this study was to investigate whether oxycodone is associated with an increased risk of acute respiratory conditions in patients with cancer and CKD compared with other opioids. The data were obtained from a claims database in Japan. Patients with cancer and CKD who had received sustained-release opioids, including oral oxycodone, oral morphine, or transdermal fentanyl, between April 2014 and May 2021 were selected. The primary outcome was defined as an acute respiratory condition. Data for age and sex, morphine equivalent daily dose, concomitant use of specified medications, comorbidities defined based on the modified Charlson comorbidity index, substance use disorder, and lung cancer or metastatic lung cancer were investigated as covariates. Distribution of acute respiratory conditions was compared among the three sustained-release opioid groups using the log-rank test. Estimates of the incidence of acute respiratory conditions were compared among the groups using a Cox proportional hazards model with time-varying variables. A significant difference in the distribution of acute respiratory conditions was found among the three groups (p < 0.01). Cox regression analysis showed a significantly higher risk of acute respiratory conditions with morphine (hazard ratio [HR]: 3.04, 95% confidence interval [CI]: 1.07-8.65, p = 0.04) compared with oxycodone but no significant difference in risk with oxycodone (HR 0.67, 95% CI: 0.32-1.38, p = 0.27) compared with fentanyl. The findings suggest that the risk of acute respiratory conditions may be lower in patients with CKD who use oxycodone for cancer pain than in those who use morphine. Additionally, no difference in the risk of acute respiratory conditions was found between oxycodone and fentanyl use.

Structural Brain Injury on Brain Magnetic Resonance Imaging in Acute Respiratory Distress Syndrome.

Acute respiratory distress syndrome (ARDS) is an acute inflammatory respiratory failure condition that may be associated with brain injury. We aimed to describe the types of structural brain injuries detected by brain magnetic resonance imaging (MRI) among patients with ARDS. We retrospectively reviewed and collected data on brain injuries as detected by brain MRI during index hospitalization of all patients with ARDS at a single tertiary center in the United States from January 2010 to October 2018 (pre-COVID era). Structural brain injuries were classified as cerebral ischemia (ischemic infarct and hypoxic-ischemic brain injury) or cerebral hemorrhage (intraparenchymal hemorrhage, cerebral microbleeds, subarachnoid hemorrhage, and subdural hematoma). Descriptive statistics were conducted. Of the 678 patients with ARDS, 66 (9.7%) underwent brain MRI during their ARDS illness. The most common indication for brain MRI was encephalopathy (45.4%), and the median time from hospital admission to MRI was 10days (interquartile range 4-17). Of 66 patients, 29 (44%) had MRI evidence of brain injury, including cerebral ischemia in 33% (22 of 66) and cerebral hemorrhage in 21% (14 of 66). Among those with cerebral ischemia, common findings were bilateral globus pallidus infarcts (n = 7, 32%), multifocal infarcts (n = 5, 23%), and diffuse hypoxic-ischemic brain injury (n = 3, 14%). Of those with cerebral hemorrhage, common findings were cerebral microbleeds (n = 12, 86%) and intraparenchymal hemorrhage (n = 2, 14%). Patients with ARDS with cerebral hemorrhage had significantly greater use of rescue therapies, including prone positioning (28.6% vs. 5.8%, p = 0.03), inhaled vasodilator (35.7% vs. 11.5%, p = 0.046), and recruitment maneuver (14.3% vs. 0%, p = 0.04). Structural brain injury was not uncommon among selected patients with ARDS who underwent brain MRI. The majority of brain injuries seen were bilateral globus pallidus infarcts and cerebral microbleeds.

Acute respiratory distress syndrome or pneumonia? The role of lung ultrasound

Background. Neonatal Acute Respiratory Distress Syndrome (ARDS), although recognized for almost 34 years, is still difficult to define. An attempt was made to include this pathology in a set of criteria (The Montreux definition) that allows early diagnosis and appropriate therapeutic measures. Case report. We present one case of neonatal ARDS that was diagnosed using the Montreux definition. Two out of the five criteria were discovered while performing seriated lung ultrasounds. A term newborn (GA=39W6D) developed respiratory failure at 15 minutes after birth: rapid, labored, grunting respirations, suprasternal and substernal retractions. The suspected diagnosis was ARDS because all 5 criteria were met. The infant was transferred to the NICU where CPAP treatment and antibiotic prophylaxis were initiated. Lung ultrasounds were performed, showing congenital pneumonia as the primary acute respiratory condition so the antibiotics were changed. In the second day of life the patient was sedated and received mechanical ventilation support followed by 3 doses of surfactant. The patient’s status slowly improved and he was extubated after 56 hours. The lung ultrasounds began to show a normal pattern; blood cultures were negative, and CRP was decreasing. The patient was discharged at 8 days of life. Conclusions. When faced with a term newborn with respiratory distress it is important to consider ARDS as a possible diagnosis if all the criteria are met.

Anti-inflammatory effect and component analysis of Chaihu Qingwen granules

Ethnopharmacological relevanceAs prevalent acute respiratory condition in clinical practice, acute lung injury has a quick start and severe symptoms which can harm patients physically. Chaihu Qingwen granules (CHQW) is a classic formula for the treatment of respiratory diseases. Clinical observation shows that CHQW has good efficacy in treating colds, coughs, and fevers. Aim of the studyThe aim of this study was to investigate the anti-inflammatory effect of CHQW on lipopolysaccharide (LPS)-induced acute lung injury (ALI) model in rats and to explore its potential mechanism, as well as to clarify its substance composition. Materials and methodsMale SD rats were randomly divided into the blank group, the model group, the ibuprofen group, the Lianhua Qingwen capsule group and the CHQW group (2, 4 and 8 g/kg, respectively). The LPS-induced acute lung injury (ALI) model in rats was established after pre-administration. The histopathological changes in the lung and the levels of inflammatory factors in bronchoalveolar lavage fluid (BALF) and serum of ALI rats were observed. The inflammation-related proteins toll-like receptor 4 (TLR4), inhibitory kappa B alpha (IκBα), phospho-IκBα (p-IκBα), nuclear-factor-kappa B (NF-κB), and NLR family pyrin domain containing 3(NLRP3) expression levels were measured by western blotting analysis and immunohistochemical analysis. The chemical composition of CHQW was identified by liquid chromatography-quadrupole-time of flight-mass spectrometry (LC-Q-TOF-MS). ResultsCHQW significantly ameliorated lung tissue pathological injury in LPS-induced ALI rats and decreased the release of inflammatory cytokines (interleukin-1β, interleukin-17 and tumor necrosis factor-α) in BALF and serum. In addition, CHQW decreased the expression of TLR4, p-IκBα and NF-κB proteins, increased the level of IκBα, regulated the TLR4/NF-κB signaling pathway, and inhibited the activation of NLRP3. The chemical components of CHQW were analyzed by LC-Q-TOF-MS, and a total of 48 components were identified by combining information from the literature, mainly flavonoids, organic acids, lignans, iridoids and phenylethanoid glycosides. ConclusionThe results of this study showed that the pretreatment of CHQW had a strong protective effect on LPS-induced ALI in rats, reducing lung tissue lesions and decreasing inflammatory cytokines released in BALF and serum. The protective mechanism of CHQW may be related to the inhibition of the TLR4/NF-κB signaling pathway and NLRP3 activation. The main active ingredients of CHQW are flavonoids, organic acids, lignans, iridoids and phenylethanoid glycosides.

Knowledge and Practice of Medical Technologists on COVID-19 Infection Prevention in Laboratory

Background: COVID-19 is an acute respiratory condition caused by a virus and it is declared at pandemic condition. Health sector faced challenged and medical technologists are direct contact of infected patients and sample. Objective: The study was to assess the knowledge and practice of medical technologists on COVID-19 infection prevention in laboratory in tertiary level hospital and institute Dhaka city. Methodology: A descriptive cross-sectional study was conducted among purposive selected 221 medical technologists working in six hospital and institute (public hospital &amp; public institute) in Bangladesh. Data were collected by self-administrated structure questionnaire. Results: The study n-221 revealed that 100% respondents had knowledge about doing and doffing of PPE, 100% of the respondents had known that RT-PCR was confirm test for COVID-19 infection, 100% of the respondents had known about caused of COVID-19 by virus, 75.1% of the respondents were not getting training about COVID-19 sample packaging and 64.3% of the respondents were not getting training in laboratory safety against COVID-19 infection. Around 99.5% of respondents use color code bin for waste disposal, around 99.5% of the respondents were used respiratory safety cabinet and highest 96.8% of the respondents were used PPE during samples processing. Conclusion: Through periodic training and motivation, adequate supply of resources and infection prevention materials, quarantine facility for medical technologists should be available in hospital and institute that can improve overall knowledge and practice on COVID-19 infection prevention of medical technologists.

Hybrid model for early identification post-Covid-19 sequelae.

Artificial Intelligence techniques based on Machine Learning algorithms, Neural Networks and Naïve Bayes can optimise the diagnostic process of the SARS-CoV-2 or Covid-19. The most significant help of these techniques is analysing data recorded by health professionals when treating patients with this disease. Health professionals' more specific focus is due to the reduction in the number of observable signs and symptoms, ranging from an acute respiratory condition to severe pneumonia, showing an efficient form of attribute engineering. It is important to note that the clinical diagnosis can vary from asymptomatic to extremely harsh conditions. About 80% of patients with Covid-19 may be asymptomatic or have few symptoms. Approximately 20% of the detected cases require hospital care because they have difficulty breathing, of which about 5% may require ventilatory support in the Intensive Care Unit. Also, the present study proposes a hybrid approach model, structured in the composition of Artificial Intelligence techniques, using Machine Learning algorithms, associated with multicriteria methods of decision support based on the Verbal Decision Analysis methodology, aiming at the discovery of knowledge, as well as exploring the predictive power of specific data in this study, to optimise the diagnostic models of Covid-19. Thus, the model will provide greater accuracy to the diagnosis sought through clinical observation.

Qigong, obesity, and immunity dynamics and its application to long COVID-19 syndrome

COVID-19, an acute respiratory condition resulting in high rates of excess mortality, particularly among adults in later life remains challenging to prevent uniformly and is now found to induce a series of long term adverse health impacts termed ‘long COVID’ syndrome. But can more be done to avert the risk of COVID-19 and its observed long term impact in older adults? This mini review strove to examine, summarize and synthesize the research base concerning the key risk factors underpinning later life acquisition of COVID-19 and whether an ancient mind body technique known as Qigong may be one possible largely overlooked strategy for promoting immunity and minimizing the related health correlate of obesity that can both raise the risk for severe COVID-19 infections and delay its recovery among older adult survivors. A second was to provide related intervention directives for health professionals working or who are likely to work with this vulnerable population in the future. Using the PUBMED and other leading electronic data bases and the key words: Qigong, Immunity, COVID-19, Long COVID-19, Obesity, Older Adults, a fair number of articles indicate that the practice of Qigong may be very useful as an adjunctive intervention strategy for raising immunity levels and fostering weight control among older adults, especially those survivors suffering from long COVID syndrome who remain at risk for second infections.

Machine Learning-Based Prediction Models of Acute Respiratory Failure in Patients with Acute Pesticide Poisoning

The prognosis of patients with acute pesticide poisoning depends on their acute respiratory condition. Here, we propose machine learning models to predict acute respiratory failure in patients with acute pesticide poisoning using a decision tree, logistic regression, and random forests, support vector machine, adaptive boosting, gradient boosting, multi-layer boosting, recurrent neural network, long short-term memory, and gated recurrent gate. We collected medical records of patients with acute pesticide poisoning at the Soonchunhyang University Cheonan Hospital from 1 January 2016 to 31 December 2020. We applied the k-Nearest Neighbor Imputer algorithm, MissForest Impuer and average imputation method to handle the problems of missing values and outliers in electronic medical records. In addition, we used the min–max scaling method for feature scaling. Using the most recent medical research, p-values, tree-based feature selection, and recursive feature reduction, we selected 17 out of 81 features. We applied a sliding window of 3 h to every patient’s medical record within 24 h. As the prevalence of acute respiratory failure in our dataset was 8%, we employed oversampling. We assessed the performance of our models in predicting acute respiratory failure. The proposed long short-term memory demonstrated a positive predictive value of 98.42%, a sensitivity of 97.91%, and an F1 score of 0.9816.

In silicoDrug Repurposing for the Identification of Antimalarial Drugs as Candidate Inhibitors of SARS-CoV-2

Background:Coronavirus disease (COVID-19) is a severe acute respiratory condition that has affected millions of people worldwide, indicating a global health emergency. Despite the deteriorating trends of COVID-19, no drugs are validated to have substantial efficacy in the potential treatment of COVID-19 patients in large-scale trials.Methods:This study aimed at identifying potential antimalarial candidate molecules for the treatment of COVID and evaluating the possible mechanism of action by in silico screening method. In silico screening studies on various antimalarial compounds, like amodiaquine, chloroquine, hydroxychloroquine, mefloquine, primaquine, and atovaquone, were conducted using PyRx and AutoDoc 1.5.6 tools against ACE 2 receptor, 3CL protease, hemagglutinin esterase, spike protein of SARS HR1 motif, and papain-like protease virus proteins.Results:Based on PyRx results, mefloquine and atovaquone were found to have higher docking affinity scores against virus proteins compared to other antimalarial compounds. Screening report of atovaquone exhibited affirmative inhibition constant for spike protein of SARS HR1 motif, 3CL protease, and papain-like protease.Conclusion:In silico analysis reported atovaquone as a promising candidate for COVID 19 therapy.

Abstract TP114: High Prevalence Of Acute Cerebrovascular Injury On Brain Magnetic Resonance Imaging In Acute Respiratory Distress Syndrome

Background: Acute Respiratory Distress Syndrome (ARDS) is an acute inflammatory respiratory failure condition that may be associated with secondary cerebrovascular injury. We aimed to describe the prevalence and types of cerebrovascular injuries detected by brain MRI among ARDS patients. Methods: We reviewed a single-center ARDS registry data from a tertiary medical center from January 2010 to October 2018. Patients who underwent brain MRI during their index hospitalization were identified. MRIs were reviewed by two independent reviewers. Acute cerebrovascular injuries were classified as acute cerebral ischemia (ischemic infarct and hypoxic ischemic brain injury [HIBI]) or intracranial hemorrhage (ICH) including intraparenchymal hemorrhage, subarachnoid hemorrhage, subdural hematoma, and cerebral microbleeds (CMBs). Descriptive statistics were conducted. Results: Of the 678 ARDS patients, 66 (9.7%) underwent brain MRI during their ARDS illness. The median time from hospital admission to MRI was 10 days (interquartile range 4-17). Of 66, 31 (47%) had MRI evidence of acute cerebrovascular injuries including acute cerebral ischemia in 33% (22/66) and ICH in 21% (14/66). Among those with cerebral ischemia, common findings were bilateral globus pallidus infarcts (n=7), multifocal ischemic infarcts (n=5), and HIBI (n=3). Twelve (86%) with CMBs constituted the most common type of ICH, followed by intraparenchymal hemorrhage (14%). Patient demographics, Charlson Comorbidity Index, or disease severity as measured by the presence of sepsis/sepsis shock, cardiac arrest, extracorporeal membrane oxygenation use, admission Acute Physiology and Chronic Health Evaluation III Score, Sequential Organ Failure Assessment Score, or admission PaO 2 /FiO 2 ratio did not differ among patients with and without cerebrovascular injury including cerebral ischemia or ICH. In-hospital mortality was significantly greater in ARDS patients with acute cerebral ischemia compared to those without ischemia (55% vs 27%, p=0.03). Conclusion: Among selected patients with ARDS who underwent brain MRI, a half had secondary cerebrovascular injury including acute cerebral ischemia and CMBs.

An Investigation on COVID-19 in Nigeria and Relationship with Age Groups

Objective: Coronavirus disease 2019 (COVID-19) was first reported in Wuhan China in December 2019 and has immediately spread to essentially almost every area of the world. The infection is caused by a serious kind of acute respiratory condition known as coronavirus 2 (SARSCoV-2).Aim: The investigation was carried out to determine the knowledge, awareness, and relationship between Coronavirus and different age groups among Nigerians.Materials and Methods: The study recruited nine hundred and ninetyeight (998) participants who were of Nigerian origin and, aged 20 years or more who understood the substance of the banner who looked at its evaluation. A two-page enlistment flag was posted/reposted to groups in Whatsapp, Twitter and, Facebook. This banner contained a short presentation on the establishment, objective, reasoning, purposeful nature of help, attestations of mystery, and security similarly as the association of the practical reaction code of the online survey.Result and Discussion: The outcomes indicated that the majority of the respondents had sound information on COVID-19, 911(91.3%), in this manner knowing it to be a viral contamination. It was additionally observed that a large portion of the respondents, 850 (85.2%) concurred coming up next are manners by which one could get tainted with COVID-19; these among others include; shaking of hands with infected people, contacting objects contacted by infected people and sneezing or coughing by infected people. The outcome further portrays a huge relationship that existed between the members’ age and questions raised on COVID-19 (p&lt;0.001).Conclusion: It is along these lines that it is suggested that all partners ought to heighten their exertion in sharpening the overall population just as network base refinement program be done in other for the residents to comprehend and follow every single prudent step to curb COVID-19 in Nigeria.International Journal of Human and Health Sciences Vol. 05 No. 03 July’21 Page: 292-296

Alternative Medicine for Fight against Covid-19/Coronavirus and “Alternative” Treatments

The most recent severe acute respiratory condition corona infection outburst has overwhelmed an ill-equipped nature among a festival season. It was first appeared on December 1, 2019, Wuhan (China) and recognized as a coronavirus and has spread worldwide. The manifestations are fever, discomfort and cough which resolve in a couple of days yet may advance to an extreme in most of the cases, but if any comorbidity exists in the form of diabetes, hypertension or any other debilitating systemic disease, then it can lead to grave prognosis. It spread mainly from one person to another through air droplet. Although no vaccines have been discovered yet but still scientists are working relentlessly to find one. Thus, the society has must think about the complementary and alternative medicinal system. India has its traditional medicine “AYUSH”, which comprises of Ayurveda, Yoga, Unani, Siddha, and Homeopathy. This review mainly aims to summarize the point’s alternative to allopathy. AYUSH helps in immune system boosting, act as an antiviral, anti-inflammatory, stress release. It has been reported in the literature that it has no side effect and is safe to use. So this current situation provides an opportunity to employ ancient traditional medicine to take part and try to deal in the best way to withstand covid-19.

Clincal implications of orthodontic patients during covid -19 pandemic: A review article

Introduction: Corona-virus 2019 also known as COVID-19 is highly contagious and rapidly growing disease. A severe acute respiratory condition syndrome SARS-COV-2 affected more than 200 countries. The quick advancing of the pandemic has gripped the entire community making it as Public Health Emergency. Dentists, including Orthodontist are at a very high risk of acquiring and transmission of infection. The transmission mainly occurs through respiratory tract, aerosol and droplets. Clinical symptoms mainly vary from mild, moderate and severe type of sickness. So, the objective of this review is to give an expansive overview of the clinical implications of orthodontic patients during COVID-19 pandemic and to increase awareness about the strategies for infection control and prevention. Methods: A comprehensive literature from orthodontic relevant sources and information was searched with the help of Pubmed, Medline, Google scholar, Scopus, World Health Organization and various National Orthodontic associations. Results: Due to rapidly evolving nature of disease, this review mainly emphasizes on the strategies for infection control measures, minimizing aerosol production, restricting appointments to emergencies only during the outbreak. Conclusion: During the outbreak, electric orthodontic treatment should be suspended and should only be resumed when allowed by the state, local health regulatory authorities. Emergency orthodontic treatment should be followed with the help of proper strict control measures and guidelines. Minimizing personal contact and aerosol production are keys to prevent contamination with the orthodontic settings.

Inactivación potencial del coronavirus SARS-CoV2: ¿qué agentes germicidas se proponen?

La enfermedad por coronavirus 2019 (COVID-19), una afección respiratoria aguda causada por el SARS-CoV2, ha sido clasificada como pandemia por la Organización Mundial de la Salud (OMS) una vez que se ha expandido a 215 países del mundo, ha infectado a más de 7.800.000 personas y cerca de 440.000 personas han muerto por su causa1. El SARS-CoV2 es un coronavirus tipo β de características genómicas similares al MERS-CoV y al SARS-CoV1 los cuales afectaron a más de 10.000 personas en las últimas dos décadas2,3. Debido a la alta tasa de contagio y propagación del SARS-CoV2, diversas medidas de mitigación han sido empleadas. Entre las medidas adoptadas se encuentran la cuarentena, el distanciamiento físico, la limpieza de superficies y aerosoles, así como el uso de equipos de protección personal (EPP)2–6

Early management of critically ill patients with COVID-19.

Coronavirus disease 2019 (COVID‐19) is associated with a severe acute respiratory condition requiring respiratory support and mechanical ventilation. Based on the pathophysiology and clinical course of the disease, a therapeutic approach can be adapted. Three phases have been identified, in which different strategies are recommended in a stepwise invasiveness approach. In the second or acute phase, patients are frequently admitted to the ICU for severe pneumonia and hypoxemia with evidence of a proinflammatory and hypercoagulable state. This stage is an opportunity to intervene early in the disease. Medical strategies and mechanical ventilation should be individualized to improve outcomes.

Laryngeal chondritis in two Dorper sheep

Laryngeal chondritis is an acute obstructive upper respiratory condition characterised by severe dyspnoea and laryngeal stridor, considered an uncommon disease in sheep. In this study, we describe detailed clinical evolution,...

Influenza AH1N1 y coinfección de Blastocystis Hominis en un paciente pediátrico

La influenza H1N1 que causó la primera pandemia de influenza en 40 años, asociada a 151 700 a 575 400 casos de muerte a nivel mundial, ha seguido circulando todas las temporadas hasta la fecha, las medidas de prevención y control han mantenido el progreso significativo. En el 2019 Ecuador mostro un aumento de estos casos en establecimientos educativos,por lo que debemos seguir atentos frente a casos registrados por la influencia H1N1, en este contexto se presenta un caso pediátrico en torno a un brote notificado en un hospital público militar de la ciudad de Guayaquil, se establece diagnostico asociado a un parasito protozoo como el Blastocystis Hominis con evolución favorable de cara al tratamiento oportuno. La primera atención se dio en área de emergencia con medicación ambulatoria frente a síntomas respiratorios, la segunda por control donde ingresa por persistencia de un cuadro respiratorio agudo incesante más dolor abdominal intenso y cuadro diarreico.

Exercise training for adults hospitalized with an acute respiratory condition: a systematic scoping review

Objective: In adults hospitalized with an acute or chronic respiratory condition, to determine what has been reported regarding exercise programmes in terms of content, tolerability, evaluation and adverse events. Data sources: A systematic search was conducted of electronic databases (PubMed, EMBASE, CINAHL, PEDro, The Cochrane Library), trial registries and conference abstracts (Thoracic Society of Australia and New Zealand Annual Scientific Meeting, the European Respiratory Society Congress, the American Thoracic Society International Conference). Review methods: Studies were included if they (1) recruited adults hospitalized with an acute or chronic respiratory condition, (2) described an exercise programme that targeted peripheral muscles and (3) reported that ⩾80% of the sample had initiated training within 72 hours of hospitalization. Results: The last search was conducted on 2 June 2019. Of the 6282 records identified, 20 met the study criteria. These described 18 separate studies (2018 participants). Studies were conducted in adults hospitalized with an exacerbation of chronic obstructive pulmonary disease or with community-acquired pneumonia. The content of exercise programmes included aerobic and/or resistance training, neuromuscular electrical stimulation, whole-body vibration or movement out of bed. In eight studies (44%), the initial session was prescribed using objective measures of exercise capacity, peripheral muscle force and the ability to undertake activities of daily living. Across 7420 training sessions, seven adverse events were reported. Conclusion: Methods used to prescribe and titrate exercise programmes in adults hospitalized with an acute or an exacerbation of a chronic respiratory condition were disparate. When reported, programmes were well tolerated and adverse events were infrequent.