Onset Of Cough Research Articles

Fever among Pertussis Cases Reported through Enhanced Pertussis Surveillance, 2015–2022

Abstract Fever is not considered a typical presentation of pertussis. We characterized fever among 7,840 pertussis from CDC’s Enhanced Pertussis Surveillance with cough onset from 2015–2022. Ten percent of cases had a reported fever. The presence of fever should not rule out pertussis as a cause of cough illness.

P-710. Epidemiology of RSV infections in a birth cohort of healthy children, PREVAIL Cohort 2017-2020

Abstract Background Acute bronchiolitis due to respiratory syncytial virus (RSV) is the leading cause of hospitalizations in infants in the United States. Most available data on RSV epidemiology were obtained from hospital cohorts or medically attended illnesses, focusing on symptomatic children. We examined the PREVAIL Cohort (2017–2020) of healthy, term infants in Cincinnati, Ohio to understand the epidemiology of RSV infections in a birth cohort under weekly surveillance. Table 1 Medical attendance by age group, PREVAIL Cohort, Cincinnati, Ohio, 2017–2020 Methods Children who were at least 70% adherent to the weekly sample protocol were included in this analysis. Weekly, mid-turbinate nasal swabs were tested using the Luminex Respiratory Pathogen Panel PCR test. Child serum samples were collected at birth, 6 weeks, and 6, 12, 18, and 24 months of age. Symptoms status and medical visits were obtained weekly via SMS text messaging. RSV detection was defined as a swab positive for RSV (A or B) or an increase in RSV pre-fusion log10 IgG ( >0.32) or IgA ( >0.20) F-antibody levels. Medical charts were reviewed for unreported medical visits. Asymptomatic infection was defined as no reported fever or cough onset within 7 days of the first PCR positive result. Figure 1 Cumulative incidence of RSV detections by nasal swab and serology, PREVAIL Cohort, Cincinnati, Ohio, 2017–2020 Results Overall, 137 infections were identified in 74/101 (73%) children: 66% (n=91) of infections were identified by PCR (48 (35%) RSV A, 43 (31%) RSV B) and 34% (n=46) were identified only by serology (subtype unknown). Two-year cumulative incidence was 65% by PCR only and increased to 73% when including serology; annual incidence was 0.71 infections/child year. Reinfections were common, with 48 (35%) second and 15 (11%) third infections by 2 years of age. Of the 91 PCR-identified infections, 24 (26%) were asymptomatic, 22 (24%) were symptomatic but not medically attended, and 45 (50%) were medically attended, of which 8 (18%) were hospitalized or seen in the emergency department. Seasonality of infection peaked between November and January, although infections were identified in the spring and summer months. Seasonality of RSV infections throughout the study period (2017-2020) grouped by RSV subtype, PREVAIL Cohort, Cincinnati, Ohio Conclusion RSV infections were common in the PREVAIL cohort; most infections were symptomatic, but few were severe. Calculating RSV incidence using only medically attended cases of RSV underestimates disease burden and overestimates the proportion of severe cases. Disclosures Mary A. Staat, MD, MPH, Cepheid: Grant/Research Support|Merck: Grant/Research Support|Pfizer: Grant/Research Support|Up-To-Date: Honoraria

SARS-CoV-2 coinfections among pertussis cases identified through the Enhanced Pertussis Surveillance system in the United States, January 2020-February 2023.

Bacterial and viral respiratory coinfections are common, but the prevalence of SARS-CoV-2 infections among pertussis cases has not been estimated. We examine the prevalence and temporality of SARS-CoV-2 infections among pertussis patients and describe pertussis clinical severity among patients with and without SARS-CoV-2 coinfections. Confirmed and probable pertussis cases among individuals with cough onset between January 1, 2020 and February 15, 2023 were identified through surveillance in seven Enhanced Pertussis Surveillance (EPS) sites. Pertussis cases with a laboratory-confirmed SARS-CoV-2 infection detected within 30 days before or after pertussis cough onset were defined as coinfections. We describe patient demographics, symptoms, and severe complications and outcomes (seizures, encephalopathy, pneumonia, hospitalization, or death) by coinfection status. Among 765 pertussis cases reported during the study period, the prevalence of SARS-CoV-2 coinfections was 0.78% [6/765]. Among the six patients meeting the coinfection definition, the majority (83.3% [5/6]) had SARS-CoV-2 infections detected following pertussis cough onset. Compared to those with no known coinfection, a higher proportion of those with coinfections reported severe complications or outcomes (50.0% [3/6] vs. 5.2% [36/694]). Although the prevalence of pertussis patients with SARS-CoV-2 coinfections was low, patients with coinfections reported more severe complications and outcomes compared to those with pertussis alone. Given the decline in reported pertussis cases during the COVID-19 pandemic, continued monitoring of pertussis incidence alongside respiratory viral infections will be important as the pertussis burden returns to pre-pandemic levels.

PERFIL CLÍNICO-RADIOLÓGICO DE PACIENTES PEDIÁTRICOS DIAGNOSTICADOS COM PNEUMONIA COMUNITÁRIA COMPLICADA ATENDIDOS NO PRONTO SOCORRO DO HOSPITAL REGIONAL DE TAGUATINGA

Complicated community-acquired pneumonia (CACP) results from localized complications - pleural effusion and/or empyema, necrotizing pneumonia or lung abscess - or systemic complications. A British report states that 3% of pneumonias in children progress to CACP. Diagnosis requires imaging tests - chest X-ray (X-ray), chest ultrasound (USG) and chest tomography (CT). Treatment is based on empirical antibiotic therapy, with Streptococcus pneumoniae (SP) as the most frequent agent. The objective of the study is to identify patients treated at the Pediatric Emergency Room of the Taguatinga Regional Hospital (HRT), Federal District, diagnosed with CACP between March 1, 2022 and March 1, 2024. The total sample consisted of 51 patients with CACP. It can be inferred that the profile of patients is healthy, male children under five years of age. The characteristic symptoms - cough, tachypnea and fever - were present in most cases at admission. Persistent fever beyond 48-72h after the start of treatment or its reappearance after an afebrile period, persistent and/or onset of tachypnea and/or cough, decreased and/or abolished breath soun ds on auscultation and hypoxemia provided the most frequent clinical pattern of evolution. Chest X-ray was the most frequently performed imaging exam, with the predominant radiological presentation being isolated consolidation and radiological signs of the complications presented. Two cases with PS as the etiological agent were identified. The therapeutic definition was variable and the outcome was favorable in all cases. The clinical and radiological profile of the patients was compatible with the data in the literature. However, there is a lack of strategies regarding uniform management of the institution for the care of patients with CCAP.

Impact of the US Maternal Tetanus Toxoid, Reduced Diphtheria Toxoid, and Acellular Pertussis (Tdap) Vaccination Program on Preventing Pertussis in Infants 2 to

To protect infants aged <2 months against pertussis, the United States recommends Tdap (tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis) vaccination during each pregnancy. Data are limited on the strategy's effectiveness against pertussis in infants aged ≥2 months. Pertussis case infants aged 2 to <6 months with cough onset between 1 January 2011 and 31 December 2014 were identified in 6 US states. Controls were 2 to <6 months of age, hospital matched, and selected by birth certificate. Mothers were interviewed to collect demographic and healthcare information. Provider-verified vaccination history was obtained for infants and mothers. Adjusted odds ratios (aORs) were calculated using conditional logistic regression; overall vaccine effectiveness (VE) was estimated as (1 - aOR)×100. To describe maternal Tdap VE modified by infant DTaP (diphtheria and tetanus toxoids and acellular pertussis) doses, case-control sets were unmatched, and a time-to-event analysis was conducted through a generalized linear mixed model. A total of 335 cases and 927 controls were enrolled. The overall adjusted VE estimate for Tdap during pregnancy was 45.6% (95% confidence interval [CI], 5.8%-68.5%) and increased slightly, but not significantly, against infant hospitalization (55.7% [-116.8% to 90.9%]). Although point estimates were not significant, VE was modified by infant DTaP doses (58.8% [95% CI, -6.0% to 84.0%] for 0 DTaP doses, 30.5% [-21.4% to 60.2%] for 1 dose, and 3.2% [-170.8% to 65.4%] for 2 doses). Our study suggests that there is some benefit of maternal Tdap vaccination beyond the first 2 months of life, however, on-time vaccination of infants remains critical to maintain protection from pertussis.

Atypical presentation of PJP: hypercalcemia and kidney injury in an allogeneic stem cell transplant recipient

BackgroundPneumocystis jirovecii pneumonia (PJP) is an opportunistic infection that primarily affects immunocompromised individuals. Typical symptoms of PJP include the subacute onset of dyspnea, nonproductive cough, and low-grade fever. In hematology patients, particularly those who are allogeneic stem cell transplant recipients, the disease often presents with a more aggressive clinical course. While hypercalcemia has been documented as a manifestation of PJP in some solid organ transplant recipients, it has not been reported in hematology or stem cell transplant patients.Case presentationHere, we present a case of PJP in a 56-year-old male allogeneic stem cell transplant recipient, who developed hypercalcemia and renal failure during the late post-transplant period. The patient had a history of allogeneic stem cell transplantation due to acute myeloid leukemia. He presented with symptoms of fatigue and weakness. Laboratory tests revealed hypercalcemia (13.8 mg/dL) and elevated serum creatinine levels (2.3 mg/dL). The patient was hospitalized, and despite initial treatment with hydration and furosemide, the hypercalcemia persisted, leading to the administration of denosumab. During follow-up, hypoxia was detected, and a chest CT scan revealed mosaic attenuation and ground-glass opacities. Bronchoscopy was performed, and PCR testing confirmed the presence of Pneumocystis jirovecii. Other causes of hypercalcemia were ruled out, with PTH measured at 13.8 pg/mL (normal range 15–65 pg/mL), albumin at 3.71 g/dL, 1.25-dihydroxy vitamin D3 at 96 ng/dL (normal range 26–95 ng/dL), and 25-hydroxy vitamin D at 32.5 ng/mL (normal range 20–40 ng/mL). A PET-CT scan demonstrated no pathological FDG uptake, with the exception of findings suggestive of a pulmonary infection. Following treatment with trimethoprim-sulfamethoxazole and denosumab, the patient’s hypercalcemia and infection resolved.Conclusions Although rare, PJP can present with hypercalcemia and kidney injury in allogeneic stem cell transplant recipients. Early diagnosis and treatment can improve both PJP and hypercalcemia.

Effect of occupational exposure to ADCA on the incidence of allergic respiratory reactions - a literature review

1,1'-azodi(formamide) (azodicarbonamide - ADCA) is widely used as a blowing agent, a chemical substance designed to induce foaming processes. In Poland, ADCA is manufactured by a company specializing in the production of polyethylene foam bags and laminates used in various industries including home appliances, electronics, construction, furniture, automotive, and sports and leisure. The mechanism of action of ADCA involves thermal decomposition, resulting in nitrogen, carbon monoxide, as well as ammonia and carbon dioxide as the main gaseous decomposition products. These penetrate the polymer matrix, contributing to expansion and foaming properties. Most studies evaluating the relationship between occupational exposure and the development of allergic respiratory diseases focus on workers involved in ADCA production or its use as a blowing agent in plastics. The objective is to assess the respiratory sensitizing effects of ADCA in humans due to occupational exposure, based on literature data. The presented data confirm that long-term occupational exposure to ADCA can lead to persistent bronchial hyperreactivity symptoms in workers. 1,1'-azodi(formamide) can induce occupational asthma, with initial symptoms including nasal congestion, conjunctivitis, wheezing, and cough. Subsequently, symptoms such as chest tightness, dyspnea, and nocturnal cough attacks may appear, with a latency period of several years observed before symptom onset. In some cases, symptom progression was noted with continued ADCA exposure, while in others, exposure was discontinued after initial symptoms, preventing observation of symptom exacerbation. Prior exposure to allergens, such as working in bakeries, appears to accelerate symptom onset. Improvement in allergy symptoms has been noted during weekend breaks from work. There is no safe concentration identified for ADCA that would not result in adverse health effects for workers. A concentration of 0.036 mg/m3 is considered the lowest observed adverse effect concentration, causing critical reduction in lung spirometric parameters. Med Pr Work Health Saf. 2024;75(5):455-473.

Evaluation of Efficacy and Safety of Different Doses of Eladis® in the Therapy of Cough Against Acute Respiratory Viral Infection

Aim. Justification of the optimal dosage regimen regarding the efficacy and safety of Eladis®, film-coated tablets, 10 mg (Valenta Pharm JSC, Russia) in comparison with placebo in patients with non-productive cough due to acute respiratory viral infection (ARVI). Material and methods. A double-blind placebo-controlled randomized multicenter study was conducted in which 141 patients with non-productive cough on the background of acute respiratory viral infection took part. The study participants were randomized into 4 groups. Patients from the first group took 1 tablet of Eladis® 2 times a day (daily dose of 20 mg); patients from the second group took 2 tablets of Eladis® 2 times a day (daily dose of 40 mg); patients from the third group took 4 tablets of Eladis® 2 times a day (daily dose of 80 mg). Patients in the fourth group received placebo tablets in quantities corresponding to the first three groups. For this purpose, 3 subgroups of 12 people were allocated within group 4. The duration of therapy was 7–14 days. The effectiveness of therapy was assessed based on monitoring the frequency of cough attacks, changes in values on the day and night cough scales, a digital rating scale (DRS), and the time to achieve clinical cure of cough and ARVI symptoms was also taken into account. The safety of the studied drug was assessed based on monitoring of vital signs, laboratory parameters, and electrocardiogram (ECG) data. The number and severity of adverse events (AEs) and serious adverse events (SAEs) were assessed. Results. Analysis of data on the primary endpoint (reduction of cough attack frequency by ;)50% by the 5th day relative to the 1st visit) showed the superiority of Eladis® over placebo at a daily dose of 80 mg (P=0.00003). At the same time, the proportion of patients who reached the primary endpoint by day 5 when receiving Eladis® at a dose of 80 mg per day was 71.43%, while in the combined placebo group it was 22.22%. Conclusion. Evaluation of various dosage regimens of Eladis® has shown that a daily dose of 80 mg is optimal for the treatment of non-productive cough in patients with ARVIs, as it provides the greatest effectiveness with a safety profile comparable to other studied doses.

Aspiration From Dysphagia Associated With the Presence of Pantoea agglomerans in a Horse

Pantoea agglomerans is a gram-negative bacterium that usually lives in symbiosis in soil and plants. However, it may also lead to serious diseases in plants, animals and humans. We describe a case of aspiration from dysphagia associated with the isolation of P. agglomerans in a horse admitted to an Italian hospital. The patient was presented to the hospital for the onset of chronic cough after an acute episode of pulmonary hemorrhage during a race recorded two months before and was treated with dexamethasone and penicillin. The cough was accentuated during meals, leading to a suspicion of aspiration from dysphagia. A bronchoalveolar lavage was collected, and cytological examination showed the presence of vegetable fibers, rod bacteria, and a high macrophage population (89%). From the tracheal wash collected for bacteriological culture, P. agglomerans was isolated in monoculture, and the antimicrobial susceptibility test revealed that the isolate was susceptible to all tested antimicrobials except sulfonamide. The horse recovered well after 10 days of enrofloxacin treatment. The present report highlights the role of P. agglomerans as an opportunistic respiratory pathogen in horses, especially in the presence of plants or their parts.

Predictive value of clinico-radiological variables in the management of suspected foreign body aspiration in children: A ten-year retrospective cohort study

ABSTRACT Background: Definite history is not always present in children with foreign body aspiration (FBA), hence necessitating a high index of suspicion. Objective: To assess the predictive value of clinico-radiological variables among children presenting with features of suspected FBA and to document their course in a tertiary care teaching hospital. Materials and Methods: In this retrospective observational study, we included children aged below 15 years presenting with clinical features of suspected FBA. Data was obtained from case records. Multivariable binary logistic regression analysis (MVA) was performed to determine statistically significant predictors of FBA, and Weighted Risk Scores (WRS) were calculated to determine the significance of the model. Results: Of the 296 children included in the study and having undergone bronchoscopy, 84.5% were toddlers; 269 (90.87%) had a foreign body (FB) removed. Organic material was commonly found with 64.3% being peanut and right main bronchus, the commonest lodging site (50.6%). Of the 54 (18%) children with symptomatic but unwitnessed FBA, 45 (83.3%) had a FB retrieved. Choking with sudden onset cough, stridor, unilateral decreased breath sounds, abnormal chest radiograph, unilateral hyperinflation and mediastinal shift correlated with FBA (P &lt; 0.05). MVA confirmed statistical significance with choking with sudden onset cough to predict FBA (P = 0.024) with overall sensitivity and specificity of 60.9% and 77.8%, respectively. Total WRS with cut-off &gt;2 showed good power of discrimination with sensitivity, specificity and AUC of 60.2%, 77.8% and 0.704%, respectively. Conclusions: The proposed predictive value-based scoring system enhances accuracy in decision-making regarding bronchoscopy in children with suspected FBA.

Seroprevalence of B. pertussis infection and the changes of specific antibody levels in health care workers during the first two years of COVID-19 in Wuhu, China

BackgroundThe reported number of pertussis cases declined after the implementation of COVID-19 prevention and control measures, however, the burden of pertussis among adults in China remains largely unknown. Additionally, the waning of natural antibody level has also rarely been assessed. MethodsA total of 762 healthcare workers (HCWs) who had underwent the health examinations in 2021 and 2022 were included. Serum anti-PT IgG and IgA levels were determined by ELISA. Recent B. pertussis infection was defined as anti-PT IgG ≥100 IU/ml and/or anti-PT IgA ≥10 IU/ml. ResultsIn 2021, the seroprevalence of recent B. pertussis infection was 10.1 %, and those HCWs in outpatient department had a higher percentage (18.6 %), and geometric mean concentration (GMC) (6.3 IU/ml) than those in other departments. This seroprevalence decreased to 2.4 % in 2022, although the difference remained significant. In the 77 subjects with recent B. pertussis infection in 2021, anti-PT IgG was undetectable in 18 cases the following year. Majority (68/76) of the subjects with anti-PT IgA ≥10 IU/ml in 2021 no longer had detected this antibody in 2022. Among 95 pertussis cases, approximately 60.0 % of cases reported no history of cough. Among those with a documented cough history, 36 cases with suspected pertussis courses who had never been diagnosed. Prolonged cough with nocturnal exacerbation (29/38) was the most commonly reported clinical symptom, and whoop was confirmed in six cases. Uroclepsia and syncopes during the cough attacks were reported by three and one subjects, respectively. One case presented with subconjunctival hemorrhage and tensionic purpura during the course. ConclusionsThe results suggested a high prevalence of B. pertussis infection among HCWs. The presence of unrecognized adult pertussis cases and the rapid waning of antibody indicate the need to improve clinical management for suspected pertussis in adults, and to updated immunization schedule after childhood program.

20S-Ginsenoside Rh2, the major bioactive saponin in Panax notoginseng flowers, ameliorates cough by inhibition of NaV1.7 and TRPV1 channel currents and downregulation of TRPV1 expression

Ethnopharmacological relevancePanax notoginseng flowers, which are the buds of the traditional Chinese medicinal herb Sanqi, are widely used in China for their cough-ameliorating properties, with demonstrated therapeutic effects in the treatment of both acute and chronic coughs. However, both the antitussive mechanism and active compound basis of P. notoginseng flowers remain poorly understood. Aim of the studyWe investigated the antitussive effects of P. notoginseng flowers, identified the bioactive constituents responsible for alleviating cough symptoms, and elucidated the underlying pharmacological mechanisms. Materials and methodsWe analyzed the major chemical constituents of aqueous extracts of P. notoginseng flowers using liquid chromatography–mass spectrometry and quantitatively analyzed the key component, 20S-ginsenoside Rh2, using high-performance liquid chromatography. Using a cough reflex model in healthy mice and an ovalbumin-induced, highly sensitive guinea pig cough model, we verified the suppressive effects of P. notoginseng flowers and their saponin constituents on coughing. Furthermore, we explored the mechanisms of action of the key ion channels, NaV1.7 and TRPV1, using whole-cell patch-clamp techniques and molecular docking. Finally, the therapeutic mechanisms of P. notoginseng flowers on pathological cough were revealed using hematoxylin and eosin staining, immunohistochemistry, and western blotting. ResultsThe active components of P. notoginseng flowers were primarily protopanaxadiol-type saponins, among which 20S-ginsenoside Rh2 had the highest content (51.46 mg/g). In the mouse model, P. notoginseng flowers exhibited antitussive effects comparable to those of pentoxyverine citrate. Although its main saponin component, 20S-ginsenoside Rh2, showed slightly weaker effects, it still demonstrated concentration-dependent inhibition of channel activity. The whole-cell patch-clamp technique and virtual molecular docking showed that Rh2 might exert its effects by directly binding to the NaV1.7 and TRPV1 channels. In the guinea pig model, P. notoginseng flowers and their saponin components not only reduced cough frequency and prolonged the latency period before cough onset, but also significantly inhibited tracheal and pulmonary inflammation and the overexpression of TRPV1. Conclusions20S-Ginsenoside Rh2, the major bioactive saponin in P. notoginseng flowers, exhibits potent antitussive effects. The potential mechanism of action of 20S-Ginsenoside Rh2 in the treatment of cough may involve inhibiting NaV1.7 and TRPV1 channel currents through direct binding to core protein active sites and downregulating TRPV1 expression.

New medical technologies in cough therapy: results of a double-blind randomized placebo-controlled multicenter clinical trial

To study the efficacy and safety of Eladis® in comparison with placebo in patients with non-productive cough. A phase III clinical trial enrolled 250 patients aged 18-65 years with acute respiratory viral infection with upper respiratory tract involvement or acute bronchitis. Patients were randomized into 2 groups of 125 subjects: group 1 received Eladis® (40 mg tablets), group 2 received a matching placebo. The patients received the study drugs 1 tablet BID for 7-14 days. After the treatment, patients were followed up (day 7±2) to assess the effect of therapy on the frequency of coughing attacks, the frequency and severity of daytime and nocturnal cough, the severity of cough, the duration of clinical cough cure, and the effect on the severity of the main acute respiratory viral infection symptoms. The results of the study demonstrate the overall efficacy and statistically significant superiority of Eladis® over placebo: there were significant differences between the study groups in the proportion of patients who decreased the coughing attack frequency by ≥50% by day 5 (p<0.0001). In addition, the clinical cure of cough in the Eladis® group occurred 2 days earlier: the median time was 6 days, vs 8 days in placebo group. There was a decrease in the frequency of cough attacks and a decrease in its severity by more than 3.5 points by day 5 of treatment. All the effects were associated with high safety of the drug.

Empowerment of Family Medicinal Plants (TOGA) as an Investment in Public Health in Sojomerto Village

Can be planted in narrow land, TOGA (Family Medicinal Plant) or what is often called a live pharmacy can be one of the traditional solutions to keep public health when the flu and cough attack. Not only is it planting and caring for toga plants also tends to be easy. In this dedication the activities carried out are planting together with the villagers of Sojomerto while explaining the benefits of plants in the area. This planting is also intended as a medium of awareness related to land use, therefore activities are carried out in the land adjacent to the village hall in order to make it easier for citizens to care for, maintain and use plants.

Extracorporeal membrane oxygenation bridging for chemotherapy in obstructing mediastinal mass after cardiopulmonary arrest

BackgroundIn a sedated patient, airway compression by a large mediastinal mass can cause acute fatal cardiopulmonary arrest. Extracorporeal membrane oxygenation (ECMO) has been investigated to protect the airway and provided cardiopulmonary stability. The use of ECMO in the management of mediastinal masses was reported, however, the management complicated by cardiopulmonary arrest is poorly documented.Case presentation32-year-old female presented with acute onset of left arm swelling and subacute onset of dry cough. Further investigation showed a deep venous thrombosis in left upper extremity as well as a large mediastinal mass. She underwent mediastinoscopy with biopsy of the mass which was complicated by cardiopulmonary arrest secondary to airway obstruction by the mediastinal mass. Venoarterial ECMO was initiated, while concurrently treating with a chemotherapy. The mediastinal mass responded to the chemotherapy and reduced in size during 2 days of ECMO support. She was extubated successfully and decannulated after 2 days of ECMO and discharged later.ConclusionsExtracorporeal membrane oxygenation can serve as a viable strategy to facilitate cardiopulmonary support while concurrently treating the tumor with chemotherapy, ultimately allowing for the recovery of cardiopulmonary function, and achieving satisfactory outcomes.

Assessing the Impact of the 2020 Council of State and Territorial Epidemiologists Case Definition for Pertussis on Reported Pertussis Cases.

In 2020, the Council of State and Territorial Epidemiologists (CSTE) pertussis case definition was modified; the main change was classifying polymerase chain reaction (PCR)-positive cases as confirmed, regardless of cough duration. Pertussis data reported through Enhanced Pertussis Surveillance (EPS) in 7 sites and the National Notifiable Diseases Surveillance System (NNDSS) were used to evaluate the impact of the new case definition. We compared the number of EPS cases with cough onset in 2020 to the number that would have been reported based on the prior (2014) CSTE case definition. To assess the impact of the change nationally, the proportion of EPS cases newly reportable under the 2020 CSTE case definition was applied to 2020 NNDSS data to estimate how many additional cases were captured nationally. Among 442 confirmed and probable cases reported to EPS states in 2020, 42 (9.5%) were newly reportable according to the 2020 case definition. Applying this proportion to the 6124 confirmed and probable cases reported nationally in 2020, we estimated that the new definition added 582 cases. Had the case definition not changed, reported cases in 2020 would have decreased by 70% from 2019; the observed decrease was 67%. Despite a substantial decrease in reported pertussis cases in the setting of coronavirus disease 2019 (COVID-19), our data show that the 2020 pertussis case definition change resulted in additional case reporting compared with the previous case definition, providing greater opportunities for public health interventions such as prophylaxis of close contacts.

Investigating Pulmonary Hydatidosis: A Narrative Review

Context: Pulmonary hydatidosis (PH) is a zoonotic illness caused by infection with the Echinococcus tapeworm species. About 20% of the infected individuals have lung involvement in this disease, which is epidemiologically secondary to liver disease. Evidence Acquisition: A comprehensive literature search was performed via the Scopus, PubMed, Cochrane Library, and Google Scholar databases. Search terms were "pulmonary hydatidosis," "lung hydatidosis," "Pulmonary echinococcosis," "lung echinococcosis," "Pulmonary hydatid cyst," and "Lung hydatid cyst." The search period of 1980 to 2022 was chosen to compare research from different eras. Results: Echinococcal cysts most frequently develop in the liver and then in the lungs. After a cyst ruptures, the symptoms of lung infestation can cause a quick onset of hemoptysis, fever, coughing, and chest discomfort. Serology is added to radiology to support the diagnosis. The primary investigation for a pulmonary hydatid cyst is a chest x-ray and computed tomography. Surgery or medical treatment may be used to treat PH. The most favored form of treatment is surgical intervention, while medications might be helpful in certain individuals, with benzimidazoles, such as albendazole, as the most common drugs administered orally as part of pharmacotherapy. Conclusion: Given the significant negative effects of PH on individuals, prevention should be emphasized, especially in endemic regions.

Effect of furosemide in the treatment of high-altitude pulmonary edema

BackgroundHigh-altitude pulmonary edema (HAPE) refers to the onset of breathlessness, cough, and fever at rest after arriving at high altitudes. It is a life-threatening illness caused by rapid ascent to high altitudes. Furosemide is controversial in HAPE treatment but is routinely used in China. Further research is needed to assess its efficacy and impact on HAPE management and prognosis. The aim of this study is to determine the effectiveness of furosemide for HAPE.MethodsA retrospective was conducted to analysis of patients with HAPE admitted to the People’s Hospital of Shigatse City from January 2018 to September 2023. Patients were divided into furosemide group and non-furosemide group for further analysis. Clinical variables including demographic information, comorbidities, vital signs, inflammatory markers, biochemical analysis, CT severity score and prognostic indicators were collected.ResultsA total of 273 patients were enrolled, with 209 patients in the furosemide group and 64 patients in the non-furosemide group. The furosemide group showed a significantly decrease in CT severity scores compared to the non-furosemide group. Subgroup analysis showed that the longer the duration of furosemide use, the more pronounced the improvement in lung CT severity scores. But there were no significant differences in length of hospital stay and in-hospital mortality between the two groups.ConclusionFurosemide helps alleviate pulmonary edema in HAPE patients, but further research is needed to clarify its impact on prognosis.

Role of Virtual Bronchoscopy in Evaluation of Suspected Foreign Body in Children's Tracheobronchial Tree.

Introduction The presence of foreign bodies in the airways remain a diagnostic challenge to healthcare professionals. They can become life threatening emergencies that require immediate intervention or go unnoticed for weeks and even months. Prevention is best but early recognition remains a critical factor in treatment of foreign body inhalation in children. Objective To study the diagnostic advantages of virtual over rigid bronchoscopy in the evaluation of children with suspected foreign body in the tracheobronchial tree and plan for early management. Methods A crossectional study conducted at a tertiary care hospital & medical college in India. A total 24 patients (0-12-years-old) who presented with complaints of sudden onset of coughing, choking, and breathing difficulty were included during the 2-year duration, from January 2018 to December 2019. All patients underwent virtual and rigid bronchoscopy. Results In 8 patients, foreign bodies detected by virtual bronchoscopy were confirmed by rigid bronchoscopy. There was one case in which virtual bronchoscopy showed no foreign body, but rigid bronchoscopy detected it. In 15 cases virtual and rigid bronchoscopy did not show foreign bodies. The sensitivity, specificity, positive and negative predictive value of virtual bronchoscopy were 88.88, 100, 100, and 93.75%, respectively. Conclusions Virtual bronchoscopy is less invasive and does not require general anesthesia but cost and availability are limitations. It can be used as method of investigation in children with suspected foreign body aspiration.

Endovascular treatment of subdural haematoma in patient under anti-platelet therapy: a case report

Introduction: The incidence of chronic subdural haematoma (cSDH) is relatively high among the elderly population. Other known risk factors for cSDH include male sex, dependency on anti-platelet or anticoagulant medication, and chronic alcoholism. Although, the standard mode of treatment for cSDH is surgery, embolization of the middle meningeal artery (MMA), either upfront or as an adjunct to surgical evacuation can be used for the treatment of cSDH. Case presentation: The authors present a case of a 75-year-old female with prior history of posterior-lateral wall myocardial infarction (MI) eight years back presented to our centre with the chief complaints of a gradual onset of cough and headache for 2 months. The patient had no history of trauma, loss of consciousness, seizures, and vomiting. There was no history of diabetes, hypertension, pulmonary tuberculosis, and other chronic illness. Discussion: The concurrent use of anti- platelet drug during a surgical procedure can make the treatment challenging. Endovascular treatment can be a primary treatment modality in such situation. Conclusion: Elimination of blood supply by middle meningeal artery embolization is emerging as a safe, minimally invasive alternative to treat cSDH.