Difficulty In Breathing Research Articles

Successful management of a delayed presentation of traumatic descending thoracic aorta pseudoaneurysm: a literature review based on a case report

BackgroundBlunt traumatic aortic injury (BTAI) is the second leading cause of death due to traumas in young patients. The primary presentation might be chest or interscapular pain, difficulty in breathing, and, in severe cases, hypotension. Considering the rapid deterioration of these patients’ clinical conditions, prompt diagnosis and treatment initiation are crucial. In these injuries, the most involved parts of the aorta are the isthmus (distal to the left subclavian artery) and the descending part in the thorax. Therefore, the main diagnostic strategies include transthoracic echocardiography, CT angiography, and endovascular diagnostic approaches.Case presentationThe patient was a 19-year-old male presenting with the symptoms of chest pain, dyspnea, and extremities excruciating pain after a car turnover. The initial evaluation showed no abnormal cardiovascular finding except bilateral hemothorax, addressed with chest tubes. Twelve hours later, when the patient was under observation for orthopedic surgeries, his chest pain and dyspnea started, and TTE and CTA showed a grade three descending aneurysm of the aorta. The patient was treated immediately with an endovascular procedure of stent implantation. A delayed debranching surgery was also performed, which resulted in desirable outcomes and uneventful follow-up.ConclusionAlthough open thoracic surgery is the main and almost the only option for treating aneurysms of the aorta in hemodynamically unstable patients, the endovascular procedure has shown superior outcomes in selected patients with appropriate anatomy. Debranching surgery, which can be done simultaneously or with delay after the initial procedure, has proven protective against thromboembolic cerebral events.Clinical key pointPatients with an aneurysm of the aorta should be transported to a medical center with a multidisciplinary team for an urgent evaluation and treatment. The initial resuscitation and diagnosis are challenging, considering the fatal nature of these injuries, and the selection of the treatment is based on the patient's clinical condition and evaluated anatomy in cardiovascular imaging.

Sensing, feeling and regulating: investigating the association of focal braindamage with voluntary respiratoryand motor control.

Breathing is a complex, vital function that can be modulated to influence physical and mental well-being. However, the role of cortical and subcortical brain regions in voluntary control of human respiration is underexplored. Here we investigated the influence of damage to human frontal, temporal or limbic regions on the sensation and regulation of breathing patterns. Participants performed a respiratory regulation task across regular and irregular frequencies ranging from 6 to 60 breaths per minute (bpm), with a counterbalanced hand motor control task. Interoceptive and affective states induced by each condition were assessed via questionnaire, and autonomic signals were indexed via skin conductance. Participants with focal lesions to the bilateral frontal lobe, right insula/basal ganglia and left medial temporal lobe showed reduced performance relative to individually matched healthy comparisons during the breathing and motor tasks. They also reported significantly higher anxiety during the 60bpm regular and irregular breathing trials, with anxiety correlating with difficulty in rapid breathing specifically within this group. This study demonstrates that damage to frontal, temporal or limbic regions is associated with abnormal voluntary respiratory and motor regulation and tachypnoea-related anxiety, highlighting the role of the forebrain in affective and motor responses during breathing. This article is part of the theme issue 'Sensing and feeling: an integrative approach to sensory processing and emotional experience'.

Surgical treatment of diaphragmatic hernia in a 3-year-old child

BACKGROUND: Congenital diaphragmatic hernia (CDH) is a serious condition associated with abnormal development of the diaphragm. Its occurrence among newborns ranges from 1 per 2000 to 1 per 4000. Depending on location, CDH can be divided into four types: diaphragmatic-pleural, parasternal, diaphragmatic-pericardial, and hernias at the esophageal opening of the diaphragm. Hernias can be classified as true or false depending on the presence or absence of the hernia sac. In case of diaphragmatic-pleural hernias, when the intestine, spleen, and stomach almost completely protrude into the pleural cavity, symptoms manifest early in the form of severe cardiorespiratory and gastrointestinal disorders. CLINICAL CASE DESCRIPTION: The article discusses a case of a three-year-old child with a congenital diaphragmatic pleural hernia. From birth, the child experienced difficulty breathing at feeding, coughing; he also had recurrent pneumonia. X-ray examination and computed tomography of the chest revealed a left-sided hernia. Surgery was done via a left-sided thoracotomy, no complications. In four months after the surgery, X-ray examination showed straightened lungs and normal mediastinum; left diaphragm cupula was also normal. The child is considered to be completely healthy due to the absence of symptoms and normal chest X-ray findings. The authors' main goal was to raise awareness among doctors about rare congenital diseases such as CDH. Also, they would like to draw attention to the fact that congenital malformations of the lungs, intestines, and other organs can be unexpectedly manifested at any age. Children with frequent respiratory problems or cardiorespiratory conditions have to be X-rayed as soon as possible to detect congenital malformations of the diaphragm or other chest organs for timely surgical intervention. CONCLUSION: As the authors have noted, in recent years X-ray examination of children often reveals undiagnosed at an early age "findings" related to diaphragm pathology, such as false and true diaphragmatic hernias and dome relaxation. CDH is rare in children older than 3 years and has no specific symptoms. It often leads to delayed diagnostics, often visits to pediatricians because of respiratory infections, retardation in physical development and, as a result, to late surgical treatment.

Clinical characteristics and genetic analysis of two children with X-linked Centronuclear myopathy due to variants of MTM1 gene

To explore the clinical and genetic characteristics of two newborns with Central nuclear myopathy (CNM). Two newborns with CNM diagnosed clinically at Wuhan Children's Hospital Affiliated to Tongji Medical College, Huazhong University of Science and Technology in April 2019 and November 2021 were selected as the study subjects, and their clinical data was collected. Both newborns and their parents were subjected chromosomal karyotyping analysis and whole exome sequencing (WES). Candidate variants were verified by Sanger sequencing. Pathogenicity of the candidate variants was evaluated based on the guidelines from the American College of Medical Genetics and Genomics (ACMG). Patient 1 was a male neonate and Patient 2 was a 20-day-old male infant. Both newborns had featured difficulty in breathing and swallowing. WES revealed that both had harbored hemizygous variants of the MTM1 gene, which were verified by Sanger sequencing. Patient 1 had harbored a c.1261A>G variant. Based on the ACMG guidelines, it was rated as pathogenic (PVS1+PM2_Supporting+PP3). Patient 2 harbored a c.342delT variant, which was also rated as pathogenic (PVS1+PM2_Supporting+PP3). The c.1261A>G and c.342delT variants of the MTM1 gene probably underlay the pathogenesis of CNM in the two patients.

Medical oxygen production, supply, and infrastructure augmentation during the COVID-19 pandemic in India: A narrative review

According to the World Health Organization, the primary symptoms of COVID-19 include fever, cough, and fatigue, while more serious cases present with dyspnea (difficulty breathing) and chest pain. The medical use of oxygen therapy is a common life support treatment for numerous diseases at multiple levels of health care in India. An abrupt spike in medical oxygen demand (nearly 100 – 200 fold) has been observed in regions such as South America, Africa, and Asia, including India. Governments of the respective countries have implemented policy decisions to tackle medical oxygen shortage during the pandemic. In this narrative review, we describe and summarize the actions taken by the Indian government to manage the medical oxygen requirement during the deadly COVID-19 waves in India. Searches were conducted on PubMed, Scopus, Google Scholar databases, and websites of various ministries and departments of the Government of India, covering the period from January 2020 to January 31, 2023. Qualitative data were extracted using pre-defined themes from published documents related to medical oxygen supply during the COVID-19 pandemic in the Indian context. This narrative review summarizes the state of medical oxygen during the COVID-19 pandemic, focusing on medical oxygen production, supply, infrastructure augmentation, pressure swing adsorption plants, capacity building, web application, and monitoring mechanisms. The 76th World Health Assembly has also adopted the Access to Medical Oxygen Resolution to prevent deaths and ensure that no country faces an oxygen shortage, as seen during the COVID-19 pandemic.

Asthma Inception: Epidemiologic Risk Factors and Natural History Across the Life Course.

Asthma is a descriptive label for an obstructive inflammatory disease in the lower airways manifesting with symptoms including breathlessness, cough, difficulty in breathing, and wheezing. From a clinician's point of view, asthma symptoms can commence at any age, although most patients with asthma-regardless of their age of onset-seem to have had some form of airway problems during childhood. Asthma inception and related pathophysiologic processes are therefore very likely to occur early in life, further evidenced by recent lung physiologic and mechanistic research. Herein, we present state-of-the-art updates on the role of genetics and epigenetics, early viral and bacterial infections, immune response, and pathophysiology, as well as lifestyle and environmental exposures, in asthma across the life course. We conclude that early environmental insults in genetically vulnerable individuals inducing abnormal, pre-asthmatic airway responses are key events in asthma inception, and we highlight disease heterogeneity across ages and the potential shortsightedness of treating all patients with asthma using the same treatments. Although there are no interventions that, at present, can modify long-term outcomes, a precision-medicine approach should be implemented to optimize treatment and tailor follow-up for all patients with asthma.

Content validation of the National Comprehensive Cancer Network/Functional Assessment of Cancer Therapy Lymphoma Symptom Index-18 (NFLymSI-18) in indolent B-cell non-Hodgkin’s lymphoma

BackgroundThe NFLymSI-18 is a patient-reported outcome measure comprised of the highest priority symptoms, emotional concerns, treatment side effects, and other concerns identified by lymphoma patients and oncologists. This study assessed the content validity of the NFLymSI-18 for patients with indolent B-cell non-Hodgkin’s lymphoma (iNHL), with a focus on the Disease-Related Symptoms Physical (DRS-P) subscale.MethodsPatients with a confirmed iNHL diagnosis who had received one or more lines of treatment were recruited during clinic visits. Patients described their symptoms, treatment side effects, and emotional concerns related to iNHL in a semi-structured interview. Qualitative data were analyzed using NVivo10.ResultsData saturation was obtained by the 18th interview. Most participants (67%) had follicular lymphoma. 28% of participants had marginal zone lymphoma, and one participant had lymphoplasmacytoid lymphoma/Waldenström macroglobulinemia. Mean age of the 18 participants was 67 years. 56% of the sample was male. Most participants (67%) had a college or advanced degree. When asked to describe their iNHL symptoms, patients most often discussed swelling (n = 14), fatigue (n = 11), and pain (n = 8). The following symptoms were mentioned by three patients each: anxiety, appetite loss, rash, sleep disruption, trouble breathing, and malaise. Mapping of NFLymSI-18 content to these concerns showed the instrument includes all those most frequently mentioned symptoms.ConclusionsThis study supports the content validity of the NFLymSI-18, including its DRS-P Subscale, for patients with iNHL. The instrument shows strong validity for the most referenced symptoms of swelling, fatigue, and pain. The diversity of additional symptoms reported by patients is consistent with the heterogeneous symptomology of iNHL.

PULMONARY COMPLICATIONS OF DIABETES AND ITS PHYSIOTHERAPY MANAGEMENT

Background of the Study: Diabetes is a chronic metabolic disease, causing an overwhelming increase in global disability and mortality. Its widespread and devastating effects on the heart, kidneys, balance, and muscle strength are well known but its effects on pulmonary functions are not discussed as much. It can lead to various pulmonary complications like diabetic ketoacidosis (DKA), pulmonary infections, asthma, chronic obstructive pulmonary disease (COPD), and obstructive sleep apnea (OSA). These complications can cause breathing difficulties, coughing, chest pain, and wheezing. Methodology: Diabetes contributes to other health problems such as hypertension, cardiac conditions, and stroke. To reduce the risk of developing respiratory complications, people with diabetes should work closely with their healthcare team to manage their condition, maintain blood sugar control, quit smoking, and exercise regularly. Result: Physiotherapy plays a crucial role in reducing pulmonary complications and improving the health-related life quality of individuals. Conclusion: The current review will highlight the adverse effects of diabetes on the lungs, the respiratory comorbidities associated with diabetes, and physical therapy’s role in pulmonary complications.

The Role of Breastfeeding in Acute Respiratory Infections in Infancy.

Acute respiratory infections (ARIs) affect the respiratory tract, are often caused by viruses such as respiratory syncytial virus and rhinovirus, and present symptoms such as coughing, fever, respiratory distress, and breathing difficulty. The global adherence to exclusive breastfeeding (BF) for the first 6 months of life has reached 44%, supported by the World Health Organization and United Nations International Children's Emergency Fund efforts. BF provides vital nutrients and contributes to infant immune system development, protecting against infections. The role of BF in preventing and reducing complications of ARIs in infants is gaining attention, prompting a review of current data and future research needs. This review aims to summarize the evidence on the role of BF in reducing the risk and severity of ARIs in infants, elucidate the adaptations in breast milk composition during infections, and identify relevant research needs. Human milk (HM) is rich in immunoglobulins, antimicrobial peptides, and immunomodulatory factors that protect against various pathogens, including respiratory viruses. Several studies have demonstrated that BF is associated with a significant reduction in hospitalization, oxygen requirements, and mortality in infants with ARIs. The effectiveness of BF varies according to the specific respiratory virus, and a longer duration of exclusive BF appears to enhance its protective effect. It is documented that the composition of HM adjusts dynamically in response to infections, fortifying the infant's immune defenses. Specific immunological components of HM, including leukocytes and immunoglobulins, increase in response to infection in the infant, contributing to the enhancement of the immune defense in infants. Immune-boosting microRNAs enhance immune transfer to the infants and promote early gut maturation, and the HM microbiome along with other factors modifies the infant's gut microbiome and immune system. BF defends infants from respiratory infections, and the investigation of the microRNAs in HM offers new insights into its antiviral properties. The promotion of BF, especially in vulnerable communities, is of paramount importance in alleviating the global burden of ARIs in infancy.

Effect of BAL Lipoxin A4 Level in Children with Bronchiectasis on Disease Severity

Abstract Background A central feature of most cases of bronchiectasis is airway inflammation. The elevated neutrophil count has been strongly correlated with impaired lung function, bronchiectasis severity, and disease duration. There is a failure of resolution of inflammation in bronchiectasis, leading to irreversible damage and dilatation of the bronchial airways with loss of mucociliary function. Lipoxins were the first agents to be identified as anti-inflammatory endogenous lipid mediators involved in the resolution of inflammation. Aim of the Work This study aimed to measure Lipoxin A4 level in bronchoalveolar lavage (BAL) of children with Cystic Fibrosis bronchiectasis (CF) and Non-CF bronchiectasis as a prognostic marker for clinical and radiological severity in these children as regard Bronchiectasis severity score. Methods A cross-sectional study was conducted at Children’s Hospital, Ain Shams University from December 2020 to December 2021, on children following up at the Pediatric Pulmonology Clinic. The study included 15patients with cystic fibrosis (CF) bronchiectasis, 15 patients with non-CF bronchiectasis, and 30 control cases,without breathing difficulty or signs of RDS. Human Lipoxin A4 was measured in BAL by ELISA. Results There was a significant difference between patients and controls as regards Lipoxin A4 level (p = 0.002),being higher in control group, but no significant difference in its level between CF and non-CF bronchiectasischildren(p = 0.663). Conclusion Severe bronchiectasis is associated with decreased airway Lipoxin A4 levels as lowest level of lipoxinA4 was found in severe cases by bronchiectasis severity score.

Risk factors of postoperative airway obstruction complications in children with oral floor mass.

The aim of the present study was to explore the risk factors of postoperative airway complications in children with oral floor mass. The first choice of auxiliary examination method for children with oral floor mass is also proposed. This retrospective study included 50 children with floor-of-mouth (FOM) masses. Medical records were reviewed, and information on age of onset, functional impacts present, age at consultation, imaging findings, history of preoperative aspiration, pathology findings, properties of biopsied fluid, treatment modality, postoperative outcomes, and operation were recorded. A total of 20 patients exhibited functional impacts such as difficulty in breathing and feeding. Ultrasound examination was performed in 28 cases; and magnetic resonance imaging, in 38 cases. The diagnosis was lymphatic malformation in 12 cases, developmental cyst in 29 cases, and solid mass in 7 cases. There were 28 cases of surgical resection, 9 cases underwent multiple puncture volume reduction followed by surgery, 11 cases treated using sclerotherapy injection, and 1 case treated using sclerotherapy injection and surgical resection. Young age, functional impact, and high grade of lymphatic duct malformation increased the risk of surgical treatment. B-scan ultrasound is the first choice for the diagnosis of FOM masses in children.

Effect of Smoking on the Progression and Severity of COVID-19 Infection among Adult Males in Sullia Taluk of Dakshina Kannada

Abstract Context: Coronavirus disease 2019 (COVID-19) primarily targets pulmonary epithelial cells, causing viral pneumonia and acute respiratory distress syndrome. It progresses more severely in chronic obstructive pulmonary disease patients. Aims: The aim of the study was to assess the effects of smoking on the progression of COVID-19 infection among adult males in Sullia Taluk, Dakshina Kannada. Subjects and Methods: A cross-sectional study was carried out among 230 male subjects, aged 18 years and above diagnosed with COVID-19 from the records of the general hospital, Sullia. Necessary data were collected using a validated questionnaire comprised of three parts, Part A recorded basic demography, Part B recorded details of smoking history, and Part C recorded details of COVID-19 symptomatology. Descriptive measures and Chi-square tests were conducted separately for each variable to determine the association between various determinants of smoking and COVID-19. P < 0.05 was considered statistically significant. Results: The response rate of the study was 68.7%. Among the studied population, 20.3% were smokers. Analysis revealed that loss of taste or smell (73.91%), cough (52.17%), difficulty in breathing (52.17%), persistent pain in the chest (21.73%), and running nose (13.16%) were significantly higher among smokers compared to their nonsmoking counterparts. Conclusions: Results of the study support the hypothesis that smoking has an effect on the progression and severity of COVID-19 infection.

The effect of narrow band imaging in CO2 laser therapy in early-stage glottic cancer

Objective:To explore efficacy of narrow band imaging（NBI） technique in CO2laser therapy in Early-Stage Glottic cancer. Methods:The clinical data of patients with Early-Stage Glottic cancer who underwent CO2laser vocal cord resection from June 2011 to August 2022 were retrospectively analyzed. Among these, 27 patients who underwent surgery assisted by NBI were assigned to the observation group, while 25 patients who underwent conventional CO2 laser microsurgery with a suspension laryngoscope were assigned to the control group. The differences between the two groups were analyzed in terms of intraoperative frozen pathology results, postoperative recurrence rates, 5-year cumulative disease-free survival rates, complications, and voice recovery. Results:All 52 patients were operated successfully. Temporary tracheostomy and serious complications did not occur during the operation. The postoperative patient's pronunciation was satisfactory. One patient experienced vocal cord adhesion, but there were no severe complications such as breathing difficulties or bleeding, with an overall complication rate of 1.92%. Postoperative follow-up was 1-5 years. The 5 years recurrence free survival in the general group was 77.90％, and the 5 years recurrence free survival in the NBI group was 100％, the difference was statistically significant（P<0.05）. NBI endoscopy is safer and more accurate than the general group in determining the safe margin of tumor mucosal resection（P<0.05）. Among the patients who accepted the voice analysis, the difference was no statistically significant（P>0.05）. Conclusion:Compared with conventional CO2laser surgery under microscope, NBI guided laser resection of Early-Stage Glottic cancer is more accurate. NBI guided laser resection could improve 5 years recurrence free survival rate. In a word, narrow-band imaging endoscopy can has very high value in clinical application.

Post-COVID Conditions in US Primary Care: A PRIME Registry Comparison of Patients With COVID-19, Influenza-Like Illness, and Wellness Visits.

COVID-19 is a condition that can lead to other chronic conditions. These conditions are frequently diagnosed in the primary care setting. We used a novel primary care registry to quantify the burden of post-COVID conditions among adult patients with a COVID-19 diagnosis across the United States. We used the American Family Cohort, a national primary care registry, to identify study patients. After propensity score matching, we assessed the prevalence of 17 condition categories individually and cumulatively, comparing patients having COVID-19 in 2020-2021 with (1) historical control patients having influenza-like illness in 2018 and (2) contemporaneous control patients seen for wellness or preventive visits in 2020-2021. We identified 28,215 patients with a COVID-19 diagnosis and 235,953 historical control patients with influenza-like illness. The COVID-19 group had higher prevalences of breathing difficulties (4.2% vs 1.9%), type 2 diabetes (12.0% vs 10.2%), fatigue (3.9% vs 2.2%), and sleep disturbances (3.5% vs 2.4%). There were no differences, however, in the postdiagnosis monthly trend in cumulative morbidity between the COVID-19 patients (trend = 0.026; 95% CI, 0.025-0.027) and the patients with influenza-like illness (trend = 0.026; 95% CI, 0.023-0.027). Relative to contemporaneous wellness control patients, COVID-19 patients had higher prevalences of breathing difficulties and type 2 diabetes. Our findings show a moderate burden of post-COVID conditions in primary care, including breathing difficulties, fatigue, and sleep disturbances. Based on clinical registry data, the prevalence of post-COVID conditions in primary care practices is lower than that reported in subspecialty and hospital settings.

Life-threatening airway obstruction by Riedel's thyroiditis: a rare presentation and diagnostic dilemma.

Riedel's thyroiditis is the rarest form of thyroiditis, occasionally resulting in rapid thyroid enlargement and potential tracheal obstruction. Here, we detail the case of an 81-year-old woman with a medical history including Hodgkin lymphoma, Hashimoto's thyroiditis, and multinodular goiter. She presented to the emergency room with stridor, cervical swelling, and breathing difficulties for over 2 days. CT scans revealed substantial thyroid enlargement causing significant glottal and tracheal compression, to a minimum tracheal diameter of 7 mm. Due to the severity of the compressive symptoms, orotracheal intubation and mechanical ventilation were deemed necessary. Surprisingly, despite the initial suspicion of malignancy given the rapid growth in the elderly, subsequent cytological and histological evaluations indicated a benign form of invasive fibrous thyroiditis - Riedel's thyroiditis. Although surgical intervention was advised, the patient declined and opted for endobronchial treatment with a prosthetic stent and subsequent treatment with systemic glucocorticoids. Following successful treatment, she was discharged within a week and resumed normal activities without respiratory distress. This case is noteworthy for its rapid benign mass growth, rare emergent presentation, and the patient's advanced age. The rapid enlargement of the thyroid gland in elderly patients poses a diagnostic challenge, stemming from the higher occurrence of aggressive thyroid carcinomas. Despite the clinical presentation, a comprehensive diagnostic workup, including fine-needle aspiration and core-needle biopsy, is crucial for accurately distinguishing between benign and malignant causes of thyroid nodule enlargement. This case report illustrates diverse treatment options for Riedel's thyroiditis, and the importance of individualized treatment plans based on the degree of airway obstruction, patient preferences, and response to initial interventions. Clinicians should contemplate the inclusion of glucocorticoids in the therapeutic regimen for Riedel's thyroiditis, particularly in cases where surgical intervention is not feasible or declined by the patient.

Respiratory multiple infections by bacteria, viruses, fungi, and parasites in a COPD patient: A case report

SARS-CoV-2 is the causative agent of COVID-19, an infection that can manifest with mild to severe respiratory symptoms. A 70-year-old man with COVID-19 and COPD presented to a hospital complaining of breathing difficulties. A sample was taken, leading to the finding of the Acanthamoeba parasite. Stenotrophomonas maltophilia, a bacterium known for its resistance to most antibiotics and its significance as a nosocomial pathogen, was identified. Furthermore, for the first time, the Gloeotinia fungus was discovered as an endosymbiont of Acanthamoeba. The patient underwent successful treatment and was discharged from the hospital. Immunocompromised people should be concerned about the increasing incidence of nosocomial infections. The presence of Acanthamoeba should not be overlooked in respiratory disorders, as it has the potential to carry numerous pathogenic microorganisms as endosymbionts.

A rare case of lipemia retinalis in a 15-day-old neonate

Lipemia retinalis (LR) is characterized by creamy white discoloration of retinal vessels, a feature of chylomicronemia (triglyceride levels &gt;1000 mg/dL). We report a case of a 15-day-old neonate admitted to the pediatric ward with complaints of breathing difficulty and respiratory distress. Ophthalmological examination revealed a whitish optic disc with diffuse tortuous creamy retinal vessels bilaterally in peripheral and posterior poles and a salmon pink retinal background. A diagnosis of grade-III LR was made. The patient was advised exclusive breastfeeding and followed up.

Current Trends in the Treatment of Misophonia

Misophonia is a disorder characterized by emotional and physiological responses that occur in response to certain auditory stimuli. Visual, tactile, and olfactory stimuli, primarily oral and nasal sounds such as eating, nose, and respiratory sounds, reveal misophonic responses. People with misophonia may have difficulty in social interactions, and work or school performance may be adversely affected. Misophonia symptoms can also cause anxiety, depression, and other mental health problems. Physiological reactions in the body, such as pain, sweating, tachycardia, hot flashes, and breathing difficulties, negatively affect people's physical health. For this reason, people's physical and mental health and quality of life are significantly affected. The absence of agreed diagnostic criteria for the diagnosis of misophonia and the lack of sufficient data to classify it as a psychiatric disorder has led to the lack of validated treatment guidelines. However, there are treatment recommendations discussed in the literature for misophonia, which has a prevalence of 20% in a limited number of studies and negatively affects the functionality of the individual. In the management of misophonia, tinnitus re-education therapy (TRT) was used as audiological treatment, antidepressants, and anxiolytics were used as pharmacological treatment and cognitive behavioral therapies were used as therapy. Other suggested treatment recommendations are neural remodeling technique, sequential remodeling hypnotherapy, trauma prevention technique, and trauma and tension reduction exercises. This review aims to present the treatment approaches available in the literature together and to understand the need for experimental evidence for treatment methods.

First Molecular Identification and Clinical Presentation of Crenosomosis in a Dog from Slovakia

PurposeCrenosoma vulpis (Dujardin,1845) is a lungworm which has spread worldwide in canines and is associated with upper respiratory infections. In a majority of cases, the infections are accompanied with chronic cough. Diagnosis of lungworms is often underdiagnosed and can be misinterpreted as other respiratory diseases.MethodsThe Small Animal Clinic of the University Veterinary Hospital admitted an 11-month-old dog presented with persistent cough associated with difficulty in breathing and even asphyxia. Based on clinical symptoms, the patient underwent radiological and bronchoscopic examination. Bronchoscopy revealed the presence of lungworms obturating the branches of the tracheobronchial tree. Larvae were collected by bronchoscopic lavage and subjected to parasitological and molecular examination.ResultsMicroscopic detection and morphological identification of the worms removed during the bronchoscopy confirmed the presence of female adult worms. The subsequent molecular characterisation of the mitochondrial (cytochrome c oxidase subunit I gene (cox1) and 12S ribosomal DNA (rDNA)), nuclear (18S rDNA) genes, as well as the analysis of the second internal transcribed spacer (ITS-2) region of the ribosomal DNA, confirmed the Crenosoma vulpis species. Faecal samples were processed using the Baermann method, which confirmed the presence of the larval stage 1 of C. vulpis. The therapy with fenbendazole at a dose of 50 mg/kg of live weight once daily for the period of 7 days was initiated for the patient.ConclusionThis paper presents the first molecularly confirmed clinical case of a Crenosoma vulpis infection in an 11-month-old female dog of the Miniature Schnauzer breed in Slovakia.

Research Progress in the Degradation of Chemical Warfare Agent Simulants Using Metal-Organic Frameworks.

Chemical warfare agents primarily comprise organophosphorus nerve agents, saliva alkaloids, cyanides, and mustard gas. Exposure to these agents can result in severe respiratory effects, including spasms, edema, and increased secretions leading to breathing difficulties and suffocation. Protecting public safety and national security from such threats has become an urgent priority. Porous metal-organic framework (MOF) materials have emerged as promising candidates for the degradation of chemical warfare agents due to their large surface area, tunable pore size distribution, and excellent catalytic performance. Furthermore, combining MOFs with polymers can enhance their elasticity and processability and improve their degradation performance. In this review, we summarize the literature of the past five years on MOF-based composite materials and their effectiveness in degrading chemical warfare agents. Moreover, we discuss key factors influencing their degradation efficiency, such as MOF structure, pore size, and functionalization strategies. Furthermore, we highlight recent developments in the design of MOF-polymer composites, which offer enhanced degradation performance and stability for practical applications in CWA degradation. These composite materials exhibit good performance in degrading chemical warfare agents, playing a crucial role in protecting public safety and maintaining national security. We can expect to see more breakthroughs in the application of metal-organic framework porous materials for degrading chemical warfare agents. It is hoped that these innovative materials will play a positive role in achieving social stability and security.