Form Of Acute Respiratory Infection Research Articles

Unlocking Pneumonia Severity Diagnosis with Deep Learning

Pneumonia is a form of acute respiratory infection that affects the lungs. The lungs are made up of small sacs called alveoli, which is normally fill with air in a healthy person, but filled with pus and fluid in an individual with pneumonia thereby reduces oxygen intake and making breathing difficult Pneumonia is a fatal and leading cause of morbidity and mortality worldwide, especially among children five years and below; and the elderly 65 years and above especially those with weakened immune systems. Pneumonia can be caused by bacteria, virus, and fungi, and the severity ranges from mild to severe depending on the causative agent and the duration of the infection. Early diagnosis, particularly knowing the severity level of Pneumonia gains a paramount importance for saving lives. Medical diagnosis using artificial intelligence (AI) systems, is currently an active research area in medicine widely used in biomedical systems. Deep learning, a subset of Artificial intelligence provides a powerful tool that assist medical experts to analyze, model, and make sense of complex clinical image data across a broad range of medical applications. This paper proposes a deep learning technique of classifying X-ray images of pneumonia patients into their severity classes.

Incidence of non-invasive all-cause pneumonia in children in the United States before and after the introduction of pneumococcal conjugate vaccines: a retrospective claims database analysis

BackgroundPneumonia is the most serious form of acute respiratory infection and Streptococcus pneumoniae is a leading cause of pediatric bacterial pneumonia. Pneumococcal conjugate vaccines were introduced in the United States (US) in 2000 (7-valent [PCV7]) and 2010 (13-valent [PCV13]). This study estimated annual incidence rates (IRs) of all-cause pneumonia (ACP) among US children aged < 18 years before and after the introduction of PCV7 and PCV13.MethodsACP episodes were identified in the IBM MarketScan Commercial and Medicaid Databases using diagnosis codes. Annual IRs were calculated overall and by inpatient and outpatient settings as the number of episodes per 100,000 person-years (PY) for all children aged < 18 years and by age group (< 2, 2–4, and 5–17 years). National estimates of annual pneumonia IRs were extrapolated using Census Bureau data. Interrupted time series (ITS) analyses were used to assess immediate and gradual changes in monthly pneumonia IRs, adjusting for seasonality.ResultsIn the commercially-insured population, ACP IRs declined between the pre-PCV7 period (1998–1999) and late PCV13 period (2014–2018) from 5,322 to 3,471 episodes per 100,000 PY for children aged < 2 years, from 4,012 to 3,794 episodes per 100,000 PY in children aged 2–4 years but increased slightly from 1,383 to 1,475 episodes per 100,000 PY in children aged 5–17 years. The ITS analyses indicated significant decreases in monthly ACP IRs in the early PCV7 period (2001–2005) among younger children and in the early PCV13 period (2011–2013) among all children. Increases were observed in the late PCV7 period (2006–2009) among all age groups, but were only significant among older children. IRs of inpatient ACP decreased across all age groups, but outpatient pneumonia IRs remained stable during the study timeframe, even increasing slightly in children aged 5–17 years. More prominent declines were observed for Medicaid-insured children across all age groups; however, Medicaid IRs were higher than IRs of commercially-insured children during the entire study timeframe.ConclusionsACP disease burden remains high in US children of all ages despite overall reductions in incidence rates during 1998–2018 following the introduction of PCV7 and PCV13.

The morbidity rate of COVID-19 among medical workers: risk factors of getting infected and the development of severe clinical forms

Objective: The aim of the study was to assess non-professional risk factors for COVID-19 infection in medical workers and predictors of the development of severe clinical forms of the disease.Methods: The authors developed two online questionnaires to analyze the features of the clinical manifestations of COVID-19 and the impact of various risk factors on the employees of the Ministry of Defense. Questionnaires were filled out by 366 medical workers who had previously had a new coronavirus infection, and 306 employees who were intact for this disease.Results: When assessing the risk factors for SARS-CoV-2 infection, it was found that factors such as irregular preventive intake of vitamin D and multivitamins increased the risk of infection of employees of the Ministry of Defense by 1.5-2 times. The majority of employees (281 or 76.8%) suffered the disease in the form of acute respiratory infection (ARI) of mild or moderate severity, 23.2% (85 people) had a lesion of the pulmonary parenchyma in the form of interstitial pneumonia. The most severe clinical forms of COVID-19 occurred in employees in the age group older than 40 years, with a body mass index corresponding to overweight (more than 25.0), having chronic diseases of the genitourinary system, diabetes mellitus, and low physical activity.Conclusions: According to the results of the conducted study, the main clinical manifestations of the new coronavirus infection among medical workers, their severity in various forms of the disease, the leading non-professional risk factors for infection and predictors of the development of more severe clinical forms of COVID-19 were determined.

Genetic diversity of enteroviruses in patients with respiratory infection

Enterovirus genetic variability underlies the variety of clinical forms of diseases they cause. The aim of the presented study was to establish the genetic diversity of enteroviruses (EVs) that caused acute respiratory infection (ARI) in 2016–2019. Biological samples were obtained from 203 patients with various forms of ARI, EV detection was carried out by RT-PCR, followed by sequencing of the main capsid protein gene and phylogenetic reconstruction. EV RNA was detected in 34.4 % of samples, most often in children aged 1–6 years (53.1–54.8 %). Coxsackieviruses B were found in patients with respiratory enterovirus infection (EVI) significantly more often than other EVs, the dominant serotypes were Coxsackievirus B4, B5. Despite the significant genetic diversity of EVs identified in patients with ARI (three genetic lines of Coxsackievirus B5, two genotypes of Coxsackievirus B2, one genotype of Coxsackievirus B3, three genovariant Coxsackievirus B4, one genovariant Coxsackievirus B1), there is no evidence of their connection with the formation of the respiratory form of EVI.The high level of genetic variability of EVs requires regular molecular-epidemiological surveillance for the identification of emerging genetic variants and assessment of their epidemic potential.

Using zinc sulfate to improve pneumonia symptoms in children under 5 years of age: A case control study

Background: According to World Health Organization (WHO), Pneumonia is a form of acute respiratory infection that affects the lungs. Pneumonia is considered as the most important infection-induced cause of child mortality. Aim: To investigate the effect of prescribing zinc sulfate on improving the clinical symptoms of pneumonia in 2-59 months old children. Materials and Methods: This case control study was performed on 120 children with age of 2-59 months and complaining of fever, coughs, and tachypnea. The patients were randomly assigned into control (n=60), and intervention (n=60) using double blinding method. In the control group placebo was prescribed, while the intervention group received oral zinc sulfate 10 mg (1 ml/ kg in children younger than 12 months, and 20 mg/kg every 12 hours for children of 13-59 months. During hospitalization, every 12 hours the clinical symptoms of both groups including tachypnea, duration of fever, coughs, intercostal retraction, hypoxia, crackles-wheezing, and duration of hospitalization were recorded. At the beginning and end of the treatment, two blood samples were taken for determining the serum level of zinc. Results: The findings indicated that the serum level of zinc sulfate after the intervention increased significantly in the intervention group. There was a significant difference in the duration of fever and tachypnea between the intervention and control groups 36 hours post-hospitalization. Conclusion: Supplemental administration of zinc can expedite the healing process and results in faster resolution of clinical symptoms in children with pneumonia.

The incidence of COVID-19 medical workers. The issues of biosafety and occupational risk factors

Relevance. During the pandemic of the new coronavirus infection (COVID-19), one of the most vulnerable and actively involved in the epidemic process categories of the population were medical workers. The study of the incidence of COVID-19 among medical workers, risk factors for infection and safety measures is an important area of research in modern conditions. The aim of the study is to assess the prevalence of COVID-19 among employees of medical organizations and occupational risk factors for infection in order to develop proposals for corrective measures. Materials and methods. To study the incidence of COVID-19 among employees of medical organizations, an anonymous online questionnaire developed by the authors was used, which was posted on the Google platform and distributed during the first wave of the pandemic among employees of medical organizations in several regions of the Russian Federation through corporate e-mail or specialized online resources adapted for health workers. The survey involved 1,872 medical workers of different genders, ages, positions and work experience. Results and discussion. Among the survey participants, 161 employees have already had a new coronavirus infection. In the majority (64.0%) of them, the disease occurred in the form of acute respiratory infection, in 28.6% - interstitial pneumonia, in 7.4% only the fact of isolation of the SARSCoV-2 antigen without clinical manifestations of infection was documented. The most affected contingents were secondary and junior medical personnel, mainly hospital staff. The likelihood of infection in the workplace was increased by factors such as providing care to patients with confirmed COVID-19, participating in procedures related to aerosol generation, working with biomaterials of patients with COVID-19, contact with surfaces in the environment of a COVID-19 patient, ignorance of infectious safety issues due to lack of instruction before admission to work. When assessing the efficiency of personal protective equipment (PPE) when they are used in the process, it was found that the highest value for the prevention of infection COVID-19 had a PPE for face protection, respiratory and eye, and hand hygiene. At the same time, many employees are faced with the problem of an insufficient number of protective equipment in the workplace. When assessing the availability of SARS-CoV-2 testing to employees, it was found that only 77.4% of survey participants had the opportunity to be tested for coronavirus infection in a timely manner. Conclusion. Thus, for more effective protection of employees of medical organizations, it is necessary to have a sufficient number of personal protective equipment, especially for the face, respiratory organs and vision, the availability of hygienic hand treatment during work, regular instruction on infectious safety, using interactive forms of training, and the organization of screening examinations of previously unvaccinated and unvaccinated employees.

Attention-Based Transfer Learning for Efficient Pneumonia Detection in Chest X-ray Images

Pneumonia is a form of acute respiratory infection commonly caused by germs, viruses, and fungi, and can prove fatal at any age. Chest X-rays is the most common technique for diagnosing pneumonia. There have been several attempts to apply transfer learning based on a Convolutional Neural Network to build a stable model in computer-aided diagnosis. Recently, with the appearance of an attention mechanism that automatically focuses on the critical part of the image that is crucial for the diagnosis of disease, it is possible to increase the performance of previous models. The goal of this study is to improve the accuracy of a computer-aided diagnostic approach that medical professionals can easily use as an auxiliary tool. In this paper, we proposed the attention-based transfer learning framework for efficient pneumonia detection in chest X-ray images. We collected features from three-types of pre-trained models, ResNet152, DenseNet121, ResNet18 as a role of feature extractor. We redefined the classifier for a new task and applied the attention mechanism as a feature selector. As a result, the proposed approach achieved accuracy, F-score, Area Under the Curve(AUC), precision and recall of 96.63%, 0.973, 96.03%, 96.23% and 98.46%, respectively.

Pleural Empyema in Children in Senegal-What’s New?

Introduction: Purulent pleurisy is a severe form of acute respiratory infection. They are a major concern in pediatric practice. The aim of our work is to study the epidemiological, clinical, therapeutic and progressive profile of purulent pleurisy (PP) in children in Senegal. Patients and methods: This is a retrospective and descriptive study, including children aged 0 to 15 years hospitalized for PP from January 2014 to December 2017 at the Albert Royer Hospital Center. The positive diagnosis of PP was retained in front of the purulent, cloudy or citrine aspect of the pleural puncture fluid with the presence of altered neutrophilic polymorphonuclear cells. Results: The hospital frequency of PP was 0.6%. Sex ratio 1.42. The average age was 49 months. The age group of 6 to 36 months was the most represented. Malnutrition was present in 13 patients. In 91% of cases pleurisy was unilateral and right in 59% of cases. Pneumonia was radiologically associated in 54 children and pneumothorax in 19 children. The lethality was 6.6% (8 patients). The low socioeconomic level (p=0.0001) and the appearance of frankly purulent pleural fluid (p=0.002) were statistically significant associated with this mortality. Conclusion: Purulent pleurisy is associated with significant morbidity and mortality. Prevention involves vaccination, strengthening strategies to combat malnutrition and supplementation with zinc and vitamin A.

Modern approaches to the prescription of mucolytics and expectorants in the daily pediatric practice

The article presents the clinical evidence of safety and efficacy of mucolytics and expectorants in the treatment of both productive and non-productive coughs in respiratory infections in childhood in all stages of the infectious-inflammatory process. The authors set a goal to study the efficacy and safety of mucolytics and expectorants in children with respiratory infection in the pediatric practice. Materials and methods. A total of 96 children undergoing inpatient treatment for various variants of acute respiratory infection were examined. The average age of the patients was 7.6 ± 0.9 years old (from 3 to 14 years old). All patients were divided into 3 groups. Primary outcomes. Using the investigational drugs in children with various forms of acute respiratory infection made it possible to quickly reduce the intensity and frequency of cough by Day 3-5 from the onset of the disease and therapy, and transform cough into productive wet cough. The study showed rapid positive dynamics in cases, when acetylcysteine was prescribed from the first days of the disease, with a consistent cough therapy using herbal products. Both investigational drugs showed no adverse drug effects during the study. The results of the analysis brings us to the conclusion that a multimodal approach to cough treatment provides a comprehensive effect, which potentiates the treatment effect and allows us to recommend them in everyday pediatric practice as effective symptomatic agents to treat inflammatory diseases of the respiratory tract. This method helps to prevent polypharmacy, minimizing the drug load on the child.

CHALLENGES IN THE DIAGNOSIS OF PEDIATRIC PNEUMONIA

Pneumonia is a form of acute respiratory infection that affects the lungs and it is the leading cause of illness and death in children worldwide. Pneumonia can occur at any age, but it is more common in younger children. The etiology of pneumonia is often difficult to identify and the diagnostic criteria is based on corroborating epidemiological, clinical, laboratory and radiologic investigations. The authors present three cases diagnosed with pneumonia at different ages, underlying the clinical, imagistic and evolutive particularities.

What We Know About S1Q3T3 Electrocardiographic Findings: A Case Report and Literature Review

SUMMARY The World Health Organization (WHO) defines pneumonia as a form of acute respiratory infection that affects the lung parenchyma and oxygenation. Diagnosis is based on clinical appearance confirmed by a chest X-ray (CXR) showing consolidation. The authors describe a patient who presented with a chief complain of an attack of dizziness and near syncope. Patient presented with headache, low-grade fever, non-productive cough and chest tightness. He was tachycardic with normal blood pressure and oxygen saturation (O2Sat) 97%. His ECG Showed S1Q3T3 pattern with a concern for pulmonary thromboembolism (PE) which prompt obtaining chest CT scan with IV contrast didn’t reveal pulmonary thromboembolism but showed a right-sided consolidation. Patient’s EKG findings resolved after treating pneumonia. This case demonstrates the cardiac electrographic findings of S1Q3T3 can be seen in patients with lobar pneumonia.

The Frequency of Using Antibiotic Therapy for Acute Nasopharyngitis (J00) Among Preschool Children in Outpatient Conditions in Yakutsk

Background. Acute respiratory infections (ARI) are leaders in the structure of general diseases of the population. In Russia, each year about 70 thousand ARI cases occur per 100 thousand child population. The maximum frequency of acute respiratory infections is noted at the age from 6 months to 6 years. Among this group, the highest incidence of acute respiratory infections is observed for children of preschool age. Viral infections are leading among the causes of acute respiratory disease (90%) and only a minor part of them consist of bacterial pathogens. Despite this, almost 25–85% of pediatricians prescribe to their patients antibiotics for acute respiratory infections. The Aim. Analysis of the spectrum of antibacterial drugs used in acute nasopharyngitis in preschool children in an outpatient setting. Methods. The study was formed by a representative group in the amount of 1248 outpatients preschool children. The article presents the nosological forms of acute respiratory infections to study the spectrum of applied systemic antibiotics in acute nasopharyngitis in preschool children in an outpatient setting. Results. In the structure of ARI for the period 2009–2010, the incidence of acute nasopharyngitis dominates and is more than 60%. During pharmacoepidemiological analysis the frequency of using systemic antibiotics in children with acute nasopharyngitis on an outpatient basis was established. It was found that antibiotic therapy was applied in 43 (2009) and 37% (2010) ARI cases. Most often it were aminopenicillins, combined penicillins, macrolides, cephalosporins of the III-rd generation. Conclusion. Given the prevalence of acute nasopharyngitis among ARI nosological forms, it should be emphasized that most of them are uncomplicated, which may serve as important basis for the rational use of systemic antibiotics on empirical choice in the conditions of outpatient care.

Clinical and epidemiological study of acute respiratory infection cases in children below twelve years of age in a tertiary care teaching hospital in Pune, India

Context: Pneumonia is the leading killer of children worldwide. AIMS: To study clinical and epidemiological factors associated with Acute Respiratory Infection (ARI) cases and find the case fatality rate. Setting and Design: Hospital-based cross-sectional study. Materials And Methods: Detailed clinical examination of all ARI cases were done in children below 12 years of age. The relevant socio-demographic and epidemiological information of the cases were collected by interviewing the parents/guardians of the children through a pre-tested proforma. Duration of the study was one year. Statistical Analysis Used: χ² test, P < 0.05 was considered as statistically significant. Results: There were 539 (11.3%) ARI cases from a total of 4,764 admissions. There were 317 males and 222 females. Out of 539 ARI cases, 455 (84.4%) were in the age group of 0-5 years. Malnutrition was associated with 360 (79.1%) of the 455 under-five cases. A total of 283 (62.2%) cases were incompletely immunized for age. Case fatality rate was 3.8% in males and 8.1% in females. Conclusion: Children who were incompletely immunized for age suffered from severe forms of ARI, and this was statistically significant. The case fatality rate was much higher in females, and this was statistically significant. The comorbid factors/illnesses with ARI, which were statistically significantly associated with mortality, were malnutrition, acute diarrheal illness, septicemia, meningitis, and congenital anomaly.

Conditionally pathogenic flora of the pharynx in acute respiratory infections in newborns

The microbial flora of the pharynx, the activity of lysozyme and the content of immunoglobulin M were studied in 132 newborns with acute respiratory infections. The frequency of detection of Klebsiella, Enterobacter and their associations with Staphylococcus aureus is different in complicated and uncomplicated forms of acute respiratory infections. The possibility of prolonged persistence of Klebsielli Escherichia in the pharynx (6-13 days) has been shown. The development of bacterial complications is determined by the state of reactivity.