Pneumonia Of Unknown Cause Research Articles

Phylogenetic Analysis and Mutation of Sars-Cov-2 in Bats in Karst Malang City, Indonesia

Introduction: A group of people in China were hospitalized with an initial diagnosis of pneumonia of unknown cause. The patients were linked to a wholesale wet seafood and animal market in Wuhan, Hubei Province, China. The disease has spread to other provinces in China, Thailand, Japan, and South Korea in less than a month. SARS-CoV-2 was found to originate from bats. Therefore, this research aims to analyze SARS-CoV-2 mutation in bats in Malang Karst, Indonesia. Methods: Other bat body parts used as research samples include the brain, liver, kidneys, intestines, pancreas, fetus, blood, lungs, and ectoparasites. The samples were taken separately and placed in a container containing 10% PBF. For further analysis, we used RNA Extraction, Real-Time PCR, Sequencing, and CoV Gisaid mutation analysis software to analyze the sequencing data. Then, EMBL software will be used to analyze the phylogenetically. Results and Discussion: There was 1 sample that showed a positive result for Covid-19, namely the intestine of the Cynoptera brachyotis species. There were differences between SARS-CoV-2 in bats in Malang Karst in Indonesia compared to SARS-CoV from 2000 to 2019. The spike protein's receptor binding domain (RBD) is the most variable part of the coronavirus genome. Conclusion: From the research results, one positive sample was obtained using Real-Time PCR, and based on mutation analysis, mutations were found in SARS-CoV-2 against the SARS-CoV virus from 2000-2019. Further research is needed, especially regarding SARS-CoV-2 as a vaccine.

The View Point of Covid-19: Update Information

At the end of December 2019, “pneumonia of unknown cause” occurred Later, the specialized cause was identified and coined as Severe Respiratory Disorders Coronavirus 2 (SARS-CoV-2), and the disease was named “Coronavirus Disease 2019” (COVID-19). This recent new pollution brought the world to a standstill in a short period of time. On March 11, 2020, the WHO announced that the novel coronavirus disease is widespread. Analysts from around the world are coming together to study the pathogenicity and transmissibility of SARS-CoV-2 and derive treatments to curb this contamination. Analysts and researchers are implementing a unique expression of medicine in a comprehensive journey to find safer ways to control the obsessive effects of this viral infection. Numerous clinical studies are currently underway in the allopathic and naturopathy sector. Furthermore, global approaches to cell therapy and nanomedicine practices need to be optimized to obtain better clinical outcomes and useful results. Additionally, paradigm shifts in cell therapy and nanomedicine protocols will need to be optimized to achieve better clinical and functional outcomes for individuals affected by COVID-19. This article provides a comprehensive overview of the pathogenesis of the outbreak and various treatments to combat COVID-19.

Immunological Similarities and Differences between Post-COVID-19 Lung Sequelae and Idiopathic Pulmonary Fibrosis.

Pulmonary fibrosis is an irreversible condition that may be caused by known (including viral triggers such as SARS-CoV-2) and unknown insults. The latter group includes idiopathic pulmonary fibrosis (IPF), which is a chronic, progressive fibrosing interstitial pneumonia of unknown cause. The longer the insult acts on lung tissue, the lower the probability of a complete resolution of the damage. An emerging clinical entity post-COVID-19 is pulmonary fibrosis (PCPF), which shares many pathological, clinical, and immunological features with IPF. The fibrotic response in both diseases-IPF and PCPF-is orchestrated in part by the immune system. An important role regarding the inhibitory or stimulatory effects on immune responses is exerted by the immune checkpoints (ICs). The aim of the present study was to analyse the similarities and differences between CD4+, CD8+, and NK cells in the peripheral blood of patients affected by fibrotic disease, IPF, and PCPF compared with sarcoidosis patients and healthy controls. The second aim was to evaluate the expression and co-expression of PD-1 and TIGIT on CD4, CD8, and NK cells from our patient cohort. One hundred and fifteen patients affected by IPF, PCPF, and sarcoidosis at the rare pulmonary disease centre of the University of Siena were enrolled. Forty-eight patients had an IPF diagnosis, 55 had PCPF, and 12 had sarcoidosis. Further, ten healthy controls were enrolled. PCPF patients were included between 6 and 9 months following hospital discharge for COVID-19. The peripheral blood samples were collected, and through flow cytometric analysis, we analysed the expression of CD4, CD8, NK cells, PD-1, and TIGIT. The results show a greater depletion of CD4 and NK cells in IPF patients compared to other groups (p = 0.003), in contrast with CD8 cells (p < 001). Correlation analysis demonstrated an indirect correlation between CD4 and CD8 cells in IPF and sarcoidosis patients (p < 0.001 = -0.87 and p = 0.042; r = -0.6, respectively). Conversely, PCPF patients revealed a direct correlation between CD4 and CD8 cells (p < 0.001; r = 0.90) accentuating an immune response restoration. The expression of PD-1 and TIGIT was abundant on T and NK cell subsets of the two lung fibrotic groups, IPF and PCPF. Analogously, the co-expression of PD-1 and TIGIT on the surfaces of CD4 and CD8 were increased in such diseases. Conclusions: Our study shines a spotlight on the immune responses involved in the development of pulmonary fibrosis, idiopathic and secondary to SARS-CoV-2 infection. We observed a significant imbalance not only in CD4, CD8, and NK blood percentages in IPF and PCPF patients but also in their functional phenotypes evaluated through the expression of ICs.

Immunohistochemical Expression of Angiotensin-Converting Enzyme 2 in the Skin of Patients Affected by COVID-19

Background: After many recorded cases of acute pneumonia of unknown cause, the World Health Organization announced COVID-19 as the start of a new coronavirus disease pandemic in 2019. Angiotensin-converting enzyme-2 (ACE2) is reduced by a protease known as transmembrane serine type 2 in the host cell, which then activates the S protein of SARS-CoV-2 regulating coronavirus entry into the host cells. Aim: The aim of this study was to assess the immunohistochemical expression of ACE 2 in the skin of patients affected by COVID-19 with and without cutaneous manifestations and to correlate ACE2 expression with clinical and pathologic parameters. Methods: Skin biopsies were obtained from skin lesions of 25 patients presenting with cutaneous manifestations and from the left forearm of 22 patients without cutaneous manifestations. The specimens were processed for evaluation of histopathologic changes and ACE2 immunohistochemical evaluation. Results: Positive ACE2 expression was significantly higher in patients without cutaneous manifestations (96%) than those with cutaneous manifestations (72.7%). Positive ACE2 expression in the skin of affected patients was significantly associated with the presence of comorbidities, positive family history, high ABCD score, elevated lactate dehydrogenase, high D-dimer, rapid respiratory rate, and low oxygen saturation. Conclusions: The skin could be involved in COVID-19 infection in the form of inflammatory changes, such as pityriasis rosea–like lesions. Patients with COVID-19 who presented with cutaneous manifestations are usually less severe. The presence of ACE2 in the skin of patients with COVID-19 is an indicator of worse status. Patients with COVID-19 without skin manifestations showed higher positivity for ACE2, which may explain the severity of the cases.

Menstrual Irregularities Following Covid-19 Vaccinations

Since 31 December 2019, when the WHO was informed of cases of pneumonia of unknown cause in Wuhan City, China; a novel coronavirus identified as the cause, has spread worldwide. With an urgent need to slow viral transmission, decrease disease severity, and reduce mortality, biopharmaceutical companies rapidly began investigating potential COVID-19 vaccinations. The American pharmaceutical company, Pfizer, in collaboration with the German company, BioNTech, developed a nucleoside-modified messenger RNA (modRNA) vaccine (BNT162b2), which was the first to receive an FDA permit for emergency use, with others following suit. Vaccine manufacturers provide a list of post-vaccination side effects with their preparations. Adverse vaccine reactions are evidence of the effectiveness of the vaccine and of increasing immunity against this disease. Interestingly, a growing number of women have reported menstrual irregularities after receiving COVID-19 vaccines. Those have been noted in post-authorization and post-licensure monitoring. This review provides evidence that women experience menstrual abnormalities, including menorrhagia, metrorrhagia, and polymenorrhea following COVID-19 vaccines. The importance of the issue has been recognized by the Pharmacovigilance Risk Assessment Committee of the European Medicines Agency which decided to list heavy menstrual bleeding as a side effect as a side effect of unknown frequency in the product information for the SARS-CoV-2 mRNA vaccines.

The impact of nintedanib and pirfenidone on lung function and survival in patients with idiopathic pulmonary fibrosis in real-life setting

BackgroundIdiopathic pulmonary fibrosis (IPF) is a chronic, fibrosing interstitial pneumonia of unknown cause that is associated with radiological and/or histological features of usual interstitial pneumonia (UIP). A mean survival of 2–5 years was reported previously to the advent of antifibrotics. According to clinical trials, nintedanib and pirfenidone induce a significant delay in functional decline, with a favorable impact on survival. MethodsA real-life retrospective and longitudinal study was conducted to assess the efficacy and tolerability of antifibrotics in IPF patients, between January 2014 and December 2020. Two groups (under nintedanib or pirfenidone) were analyzed at diagnosis through their clinical features and radiological patterns. Lung function was assessed at diagnosis (time 0) and after 6, 12 and 24 months of treatment. We also compared this antifibrotic cohort with an older naïve antifibrotic cohort, mainly treated with immunosuppressive drugs and/or N- acetylcysteine. Survival was analyzed and prognostic features were also studied. Statistical analysis was performed with IBM® SPSS®. ResultsA cohort of 108 patients under antifibrotics (nintedanib n = 54; pirfenidone n = 54) was assessed. Lung function analysis showed an overall stabilization in FVC and DLCO mean predicted percentages at 6, 12 and 24 months of treatment. The mean decline in FVC and DLCO, at 12 months, was −40.95 ± 438.26 mL and −0.626 ± 1.31 mL/min/mmHg, respectively. However, during this period, 34.2% of the patients died mostly due to acute exacerbation associated with a poorer lung function at diagnosis. Mean survival in the naïve antifibrotic cohort was significantly lower than in the antifibrotic cohort (39.9 months versus 58.2 months; p < 0.005). Regarding lung function evolution and survival, we found no differences between definitive or probable UIP radiological patterns, both on patients under nintedanib and pirfenidone (p = 0.656). ConclusionsIn this real-life observational study, the positive impact of antifibrotic therapy on the IPF clinical course and on survival was corroborated. Regarding efficacy, there was no difference between patients taking nintedanib or pirfenidone. The need for an early treatment was also demonstrated, since a worse outcome is clearly associated with lower lung volumes and lower diffusing capacity at diagnosis.

The Reliability of Ultrasound in Diagnosis of Idiopathic Pulmonary Fibrosis

Abstract Background Idiopathic pulmonary fibrosis (IPF) is defined as a specific form of chronic, progressive fibrosing interstitial pneumonia of unknown cause. IPF is the most common and severe form of idiopathic interstitial pneumonia, with an unpredictable and variable clinical course, and is associated with an extremely poor prognosis. Objective To determine role of Ultrasound in diagnosis of idiopathic pulmonary fibrosis. Patients and Methods This cross-sectional study was conducted at tertiary care hospital at Ain Shams University hospitals from May 2021 till November 2021 and performed on total 60 patients diagnosed with idiopathic pulmonary fibrosis and had previous clinical features, documented high-resolution computed tomography (HRCT) scan findings and comparing it with lung ultrasound findings. Results Consequently, B-lines number and Pleural lines thickness statistically had significant high diagnostic performance in the diagnosis of IPF with cut-off of ≥ 3.0 which indicates that B-lines number ≥3.0 and Pleural lines thickness ≥3.0 mm had perfect sensitivity and LR+, while Pleural lines interruption had perfect specificity. B-lines number ≥3.0 had highest diagnostic accuracy, Youden’s index and kappa. Our research study revealed that B-lines number and Pleural lines thickness statistically were significantly higher in multiple zones spread cases (p value&amp;lt;0.001). Pleural lines interruption statistically was significantly more frequent in multiple zones spread cases. Conclusion As evident from the current study, this study introduced and thoroughly evaluated lung US features, which showed a high correlation with the high-resolution CT findings. Chest ultrasound could constitute an additional monitoring tool for IPF, which is a rapidly progressive disease, usable by the pulmonologist at the patient’s bedside or during a consultation, easily available, non-irradiating, achievable in a short time and immediately informative, for a trained sonographer.

The Safety of Laparoscopic Cholecystectomy in Super-elderly Patients: A Propensity Score Matching Analysis.

Although reports on the safety of laparoscopic cholecystectomy (LC) exist, few have included patients aged ≥ 85 years. Hence, our study aimed to evaluate surgical outcomes of LC in patients aged ≥ 85 years. After excluding patients who underwent other types of surgeries, 583 patients who underwent LC between 2015 and 2022 were included. Patients were classified into two groups based on age: < 85 years (control group, n = 551) and ≥ 85 years (super-elderly group, n = 32). Propensity score matching (PSM) was performed based on preoperative clinical parameters, and intraoperative and postoperative outcomes were compared. After PSM, 28 patients were included in each group. Intraoperative blood loss (1 vs. 5 mL, respectively; P = .052) and frequency of serious postoperative complications (Clavien-Dindo class ≥ 2, 2/28 (7.1%) vs. 6/28 (21.4%), P = .252) were similar between the control and elderly groups. There was no significant difference in the length of postoperative stay (control group: 5 (4-24) days vs. super-elderly group: 7 (3-64) days, P = .236). Unfortunately, one case of pneumonia of unknown cause occurred postoperatively, resulting in the death of one patient in the super-elderly group. There were no clinically significant differences in the short-term outcomes of LC between super-elderly patients aged ≥ 85 years and patients aged < 85 years. Hence, LC may be relatively safe even in patients aged ≥ 85 years. However, owing to many pre-existing diseases and deterioration of physiological function, careful management during the perioperative period is desirable.

Physiotherapy and Cardiopulmonary Rehabilitation Approaches in SARS-CoV-2 Infection

An arising of infectious outbreaks lately December of 2019 has been reported as pneumonia of unknown cause appeared in Wuhan city, China which called SARS-CoV-2. Globally, 12 July 2023, there have been 767.972.961 confirmed cases of COVID-19, including 6.950.655 deaths, reported by WHO. As of 8 July 2023, a total of 13.474.185.140 vaccine doses have been administered. In 2013, the number of people has been died from cardiovascular disease more than 17.3 million and representing an increase from 1990 of 40.8%. Evaluating the effects on cardiopulmonary physiology has an important place among the parameters of the COVID-19 pandemic affecting public health. For this reason, we evaluated physiotherapy and rehabilitation approaches as a for CBRN threats and disaster risk management policies by associating cardiopulmonary physiology with the effects of the COVID-19 (SARS-CoV-2) pandemic

HucMSCs treatment prevents pulmonary fibrosis by reducing circANKRD42-YAP1-mediated mechanical stiffness.

Idiopathic pulmonary fibrosis (IPF) is a fibrosing interstitial pneumonia of unknown cause. The most typical characteristic of IPF is gradual weakening of pulmonary elasticity and increase in hardness/rigidity with aging. This study aims to identify a novel treatment approach for IPF and explore mechanism of mechanical stiffness underlying human umbilical cord mesenchymal stem cells (hucMSCs) therapy. Target ability of hucMSCs was examined by labeling with cell membrane dye Dil. Anti-pulmonary fibrosis effect of hucMSCs therapy by reducing mechanical stiffness was evaluated by lung function analysis and MicroCT imaging system and atomic force microscope in vivo and in vitro. Results showed that stiff environment of fibrogenesis caused cells to establish a mechanical connection between cytoplasm and nucleus, initiating expression of related mechanical genes such as Myo1c and F-actin. HucMSCs treatment blocked force transmission and reduced mechanical force. For further exploration of mechanism, ATGGAG was mutated to CTTGCG (the binding site of miR-136-5p) in the full-length sequence of circANKRD42. Wildtype and mutant plasmids of circANKRD42 were packaged into adenovirus vectors and sprayed into lungs of mice. Mechanistic dissection revealed that hucMSCs treatment repressed circANKRD42 reverse splicing biogenesis by inhibiting hnRNP L, which in turn promoted miR-136-5p binds to 3'-Untranslated Region (3'-UTR) of YAP1 mRNA directly, thus inhibiting translation of YAP1 and reducing YAP1 protein entering nucleus. The condition repressed expression of related mechanical genes to block force transmission and reduce mechanical forces. The mechanosensing mechanism mediated directly by circANKRD42-YAP1 axis in hucMSCs treatment, which has potential general applicability in IPF treatment.

Evolution and major changes of the diagnosis and treatment protocol for COVID‐19 patients in China 2020–2023

AbstractSince the identification of the first case of pneumonia of unknown cause in 2019, the COVID‐19 pandemic has spread the globe for over 3 years. As the most populous country in the world, China's disease prevention policies and response plans concern the health of the country's 1.4 billion people and beyond. During the course of the pandemic, scientific research has been accumulated and given evidence‐based support to the official guidance of COVID‐19 management. The National Health Commission of China have compiled, published, and updated a total of 10 versions of the “Diagnosis and Treatment Protocol for COVID‐19 Patients” to better inform clinical practitioners and staff to effectively screen, diagnose, manage, treat, and care for cases of severe acute respiratory syndrome coronavirus 2 infection. This paper compares and summarizes each version of the protocol in terms of etiology and epidemiology, clinical manifestation and diagnosis, treatment and nursing, disease control and management, presenting detailed changes, additions, deletions, and refinement of the protocols.

Wuhan 3years after the outbreak of the pandemic-cardiological insights and perspectives.

In November 2019, Wuhan, acity in Central China, became the center of an outbreak of pneumonia of unknown cause, which was later named "coronavirus disease 2019" (COVID-19). COVID-19 is caused by the novel severe acute respiratory distress syndrome coronavirus2 (SARS-CoV-2) infection. The emergence of novel SARS-CoV‑2 strains and mutations exerted aserious global public health threat. Although various vaccines have been developed, specific anti-SARS-CoV‑2 drugs are limited. As cardiologists, we believe that because SARS-CoV‑2 can bind to the angiotensin2 receptor on the surface of cardiomyocytes, it may also lead to cardiac injury. COVID-19-associated cardiac injury is not rare in clinical practice, and most of these cases are mild, while afew might progress to fulminant myocarditis (FM). Overactivated immune response and inflammatory storm represent the core pathogenesis of COVID-19-associated FM. Early identification and diagnosis of COVID-19-associated FM are critical for its treatment. Recently, Wuhan was hit by the Omicron variant again. We proposed managing COVID-19-associated cardiac injury according to the severity, which has had asignificant effect on outcome.

History of advances in genetic engineering of viruses before COVID-19 pandemic.

On December 31, 2019, the World Health Organization's China Country Office was alerted to cases of pneumonia of unknown cause detected in Wuhan City, Hubei Province of China. Due to the fact that to date, the question of the origin of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has not been resolved yet, the author analyzed the main advances in the development of genetic engineering of viruses that took place before the onset of the COVID-19 pandemic. The first artificial genetically modified viruses could appear in nature in the mid-1950s. The technique of nucleic acid hybridization was developed by the end-1960s. In the late 1970s, a method called the "reverse genetics" emerged to synthesize ribonucleic acid and deoxyribonucleic acid molecules. In the early 1980-s, it became possible to combine the genes of different viruses and insert the genes of one virus into the genome of another virus. Since that time, the production of vector vaccines began. At present, by modern technologies one can assemble any virus based on the nucleotide sequence available in the virus database or designed by a computer as a virtual model. Scientists around the world are invited to answer the call of Neil Harrison and Jeffrey Sachs of Columbia University, for a thorough and independent investigation into the origin of SARS-CoV-2. Only a full understanding of the origin of the new virus can minimize the likelihood of a similar pandemic in the future.

The Origins of Severe Acute Respiratory Syndrome-Coronavirus-2.

An outbreak of severe pneumonia of unknown cause was identified in Wuhan, China in December 2019: the causative agent was a novel betacoronavirus, severe acute respiratory syndrome-cotonavirus-2 (SARS-CoV-2), a virus that joins a list of coronaviruses causing severe (e.g., SARS and Middle East respiratory syndrome) or milder (e.g., 229E, OC43, NL63, and HKU1) respiratory tract infection. The World Health Organization (WHO) classified the spreading outbreak as a pandemic on March 11, 2020. Many SARS-related coronaviruses (SARSr-CoVs) have been identified in bats, particularly in Rhinolophus horseshoe bats, animals that are common in southern China and Southeast Asia. Many of the features of SARS-CoV-2 that facilitate human infection-the furin cleavage site, the receptor binding domain that binds to the human ACE2 receptor-can be identified in SARSr-CoVs. Related coronaviruses can be detected in pangolins and other animals, and human SARS-CoV-2 itself can infect various animals, some of which can transmit SARS-CoV-2 back to humans. Investigation by the WHO and others pointed to the initial outbreak being centered on the Huanan wet market in Wuhan where wild and farmed animals were sold, and where environmental testing revealed widespread SARS-CoV-2 contamination. This supports the hypothesis that bats, probably via an intermediate animal, are the origin of SARS-CoV-2. Other possible origins have been postulated, such as an accidental or deliberate laboratory leak, or virus present in frozen foods, but evidence for these ideas has not surfaced. Study of the origins of SARS-CoV-2 have been complicated by intense media and political commentary, features that may slow the studies required to understand the viral origins. Such studies are complex and may be slow: international openness and co-operation is vital. Origins explanations are needed to predict or prevent future pandemics and support the "One Health" approach to disease.

A Study To Assess The Knowledge Of Screening Protocol During Covid 19 Among Nurses Who Are Posted In High - Risk Areas In A Vijaya Hospital, Vadapalani

The COVID 19 pandemic in India is a World Wide pandemic corona virus disease 2019 cause by respiratory syndrome. A global coordinated effort is needed to stop the further spread of the virus. A pandemic is defined as occurring over a wide geographic area and affecting an exceptionally high proportion of the population. The last pandemic reported in the word was the H1N1 PANDEMIC IN 2019. On 31st December 2021, a clutter of case of pneumonia of unknown cause in the city of Wuhan, Hubei province in china , was reported to the World Health Organization . In 2020, previously unknown new virus was identified , subsequently named the 2019 novel corona virus , and samples obtained from cases analysis of the virus genetics indicated that was the cause of the outbreak . The novel corona virus was named corona virus disease 2019 (COVID 19) by WHO in February 2020. The virus is referred to SARS - COV 2 and the associated disease is COVID 19. As of 04.22 pm 9th December 2020, there have been 67,780,361 confirmed cause of COVID 19, including 1, 551, 14 deaths reported to WHO. The corona viruses are family of virus that cause illness such as respiratory disease or gastrointestinal diseases can range from the common cold to more severe disease. The viruses that cause COVID 19 infect people of all ages. However evidence to data suggest that group of people are at a higher risk of getting severe COVID 19 disease. Transmission can occur more easily the “three C'S " ( the risk of COVID 19 spreading higher in place where these " 3c's " overlap ) Close contact setting, especially where people have conversation to be between 2 to 14 days . This if a person remains well after 14 days being in contact with confirmed COVID 19, they are not infection. Confined and enclosed spaces with poor ventilation. A COVID 19 diagnostic testing kit has been developed and is available in clinical test in labs. The gold standard for testing for COVID 19 is refer transcription polymerase chain reaction (RT - PCR)

FLUOROFENIDONE ATTENUATES PULMONARY INFLAMMATION AND FIBROSIS BY INHIBITING THE IL-11/MEK/ERK SIGNALING PATHWAY.

Idiopathic pulmonary fibrosis is defined as a specific form of chronic, progressive fibrosing interstitial pneumonia of unknown cause. Interleukin (IL)-11 plays an important role in the pathogenesis of idiopathic pulmonary fibrosis. In this study, we explore whether a potential antifibrotic agent fluorofenidone (FD) exerts its anti-inflammatory and antifibrotic effects through suppressing activation of the IL-11/MEK/ERK signaling pathway in vivo and in vitro. Male C57BL/6 J mice were intratracheally injected with bleomycin or saline. Fluorofenidone was administered throughout the course of the experiment. Lung tissue sections were stained with hemotoxylin and eosin, and Masson trichrome. Cytokines were measured using the enzyme-linked immunosorbent assay. The α-smooth muscle actin (α-SMA), fibronectin, and collagen I were measured using immunohistochemistry, and the phosphorylated extracellular signal-regulated kinase, phosphorylated mitogen-activated protein kinase, IL-11RA, and gp130 were measured using Western blot. The RAW264.7 cells and the normal human lung fibroblasts were treated with IL-11 and/or FD, IL-11RA-siRNA, or MEK inhibitor. The expressions of phosphorylated extracellular signal-regulated kinase, phosphorylated mitogen-activated protein kinase, IL-11RA, gp130, α-SMA, fibronectin, and collagen I were measured using Western blot and/or real-time polymerase chain reaction, and the cytokines were measured using enzyme-linked immunosorbent assay. Results showed that FD markedly reduced the expressions of IL-8, IL-18, IL-11, monocyte chemotactic protein-1, α-SMA, fibronectin, and collagen I in mice lung tissues. In addition, FD attenuated IL-11-induced expressions of α-SMA, fibronectin, and collagen I and inhibited IL-11RA, gp130, and phosphorylation of the ERK and MEK protein expression, as well as reduced the expressions of IL-8, IL-18, and monocyte chemotactic protein-1 in vitro. This study demonstrated that FD attenuated bleomycin-induced pulmonary inflammation and fibrosis in mice by inhibiting the IL-11/MEK/ERK signaling pathway.

An audit on adherence to antimicrobial prescribing guidelines during Wave One of the SARS-CoV-2 pandemic

In December 2019, Wuhan, China became the centre of an outbreak of pneumonia of unknown cause, later designated coronavirus disease 2019 (COVID-19), due to isolation of a novel coronavirus from these individuals: SARS-CoV-2 [1].

Preventive measures significantly reduced the risk of nosocomial infection in elderly inpatients during the COVID-19 pandemic.

In December 2019, there was an outbreak of pneumonia of unknown causes in Wuhan, China. The etiological pathogen was identified to be a novel coronavirus, named severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2), which causes coronavirus disease 2019 (COVID-19). The number of infected patients has markedly increased since the 2019 outbreak and COVID-19 has also proven to be highly contagious. In particular, the elderly are among the group of patients who are the most susceptible to succumbing to COVID-19 within the general population. Cross-infection in the hospital is one important route of SARS-CoV-2 transmission, where elderly patients are more susceptible to nosocomial infections due to reduced immunity. Therefore, the present study was conducted to search for ways to improve the medical management workflow in geriatric departments to ultimately reduce the risk of nosocomial infection in elderly inpatients. The present observational retrospective cohort study analysed elderly patients who were hospitalised in the Geriatric Department of the First Affiliated Hospital with Nanjing Medical University (Nanjing, China). A total of 4,066 elderly patients, who were admitted between January and March in 2019 and 2020 and then hospitalised for >48 h were selected. Among them, 3,073 (75.58%) patients hospitalised from January 2019 to March 2019 were allocated into the non-intervention group, whereas the remaining 933 (24.42%) patients hospitalised from January 2020 to March 2020 after the COVID-19 outbreak were allocated into the intervention group. Following multivariate logistic regression analysis, the risk of nosocomial infections was found to be lower in the intervention group compared with that in the non-intervention group. After age stratification and adjustment for sex, chronic disease, presence of malignant tumour and trauma, both inverse probability treatment weighting and standardised mortality ratio revealed a lower risk of nosocomial infections in the intervention group compared with that in the non-intervention group. To rule out interference caused by changes in the community floating population and social environment during this 1-year study, 93 long-stay patients in stable condition were selected as a subgroup based on 4,066 patients. The so-called floating population refers to patients who have been in hospital for <2 years. Patients aged ≥65 years were included in the geriatrics program. The incidence of nosocomial infections during the epidemic prevention and control period (24 January 2020 to 24 March 2020) and the previous period of hospitalisation (24 January 2019 to 24 March 2019) was also analysed. In the subgroup analysis, a multivariate analysis was also performed on 93 elderly patients who experienced long-term hospitalisation. The risk of nosocomial and pulmonary infections was found to be lower in the intervention group compared with that in the non-intervention group. During the pandemic, the geriatric department took active preventative measures. However, whether these measures can be normalised to reduce the risk of nosocomial infections among elderly inpatients remain unclear. In addition, the present study found that the use of an indwelling gastric tube is an independent risk factor of nosocomial pulmonary infection in elderly inpatients. However, nutritional interventions are indispensable for the long-term wellbeing of patients, especially for those with dysphagia in whom an indwelling gastric tube is the most viable method of providing enteral nutrition. To conclude, the present retrospective analysis of the selected cases showed that enacting preventative and control measures resulted in the effective control of the incidence of nosocomial infections.

China and COVID-19: Assessing a State’s Image Repair Strategies in a Global Crisis

On 31 December 2019, China reported the emergence of a cluster of pneumonia of unknown cause in the city of Wuhan in the province of Hubei. As the novel disease turned into a global pandemic, China had to face a serious damage to its portrayed image of a responsible global power. Combining Benoit’s Image Repair Theory (IRT) with a contextual framework singling out cultural, societal and political variables that influence Chinese Communication Strategies (CCSs), the article pioneers the analysis of strategies adopted to respond to public image’s threats by adding an explicative nuance to their selection and reception.

An exploratory study to assess the knowledge and attitude of student nurses towards Covid-19 in college of nursing, Christian medical college and Hospital, Ludhiana, Punjab

On 31 December 2019, WHO was informed of cases of pneumonia of unknown cause in Wuhan City, China. A novel coronavirus was identified as the cause by Chinese authorities on 7 January 2020 and was temporarily named “2019-nCoV”. The official names COVID-19 and SARS-CoV-2 were issued by the WHO on 11 February 2020. All caregivers, including all student nurses, actively participated in the strengthening of care teams. The present study was conducted with the purpose to assess the knowledge and attitude of student nurses regarding COVID-19 with objectives: to assess the level of knowledge and attitude of student nurses related to COVID-19, to find out the correlation between knowledge and attitude , to find out the relationship of knowledge and attitude of student nurses regarding COVID-19 with selected variables like age, gender, training course, year of study, residential area, source of information, exposure with COVID-19 patient and Is any family member or neighbor had COVID-19. A Knowledge Assessment Tool and Attitude Assessment Scale on COVID-19 were developed and used. The pilot study was conducted to ensure the reliability of the tool and feasibility of the study. Data was collected from 230 student nurses of College of Nursing, Christian Medical College, Ludhiana, Punjab, by using non-probability, purposive sampling technique. Maximum number of student nurses 71.30% had good level of knowledge &amp; only 0.87% student nurses have below average level of knowledge and 90.87% student nurses has positive attitude regarding COVID-19. The coefficient of correlation between knowledge &amp; attitude score was 0.119 which shows weak positive correlation. Age, Gender and Training Course had significant impact on knowledge score and only one variable i.e., Is any family member or neighbor had COVID-19, had significant impact on attitude score of student nurses.