Respiratory Tract Symptoms Research Articles

Nursing Experience of Pulmonary Rehabilitation Applied to a Patient with Chronic Obstructive Pulmonary Disease

<p>本文探討一位罹患慢性阻塞肺病,首次因急性呼吸衰竭,放置氣管內管入住加 護病房之護理經驗,於 2017/12/18 至 2018/01/20 護理期間,以直接照護、觀察、 身體評估與家屬會談及病歷查閱等方式蒐集資料。運用羅氏適應模式進行整體性系 統評估,確立護理問題有:呼吸道清除功能失效、活動無耐力及家庭因應能力失 調。照護過程中,透過良好護病關係的建立,提供照護措施,在呼吸道清除功能失 效方面:教導正確呼吸且有效的咳嗽技巧及胸腔物理治療,以利清除痰液;在活動 無耐力方面:偕同跨領域團隊與個案及家屬規劃肺部復健運動,增強呼吸肌耐力, 順利拔除氣管內管;在家庭因應能力失調方面 : 安排家庭會議,增加家人間對後續返 家的共識及照護,增強其家庭因應能力。建議運用跨團隊合作建立一套國台語雙聲 帶的肺部復健運動多媒體影音光碟,在急重症等重負荷的工作下,短時有效的指導 此類個案,又能提升個案之學習成效,因此改善呼吸道症狀與減少急性發作次數及 再住院率,得以減輕家庭負擔,藉此照護經驗分享,以供臨床實務參考之用。</p> <p> </p><p>This paper aims to explore the nursing experience for a patient with chronic obstructive pulmonary disease who was hospitalized in an intensive care unit for the first time because of acute respiratory failure requiring endotracheal tube intubation. The data were collected through direct nursing care, observations,physical evaluations, interviews and reviews of medical record during the nursing period from December 18 2017 to January 20 2018. Roy’s adaptation model was applied to carry out comprehensive system assessments. The problems observed from the nursing process were as follows: ineffective airway clearance, activity intolerance and family adjustment disorders. During the nursing processes, good relationships were established between medical staff and the patient in order to provide necessary nursing measures. Regarding ineffective airway clearance, the patient was taught to breath in an appropriate way, effective coughing techniques and chest physical therapy for better sputum clearance. As to activity intolerance, an inter-professional collaborative team was invited to work with the patient and the family for planning pulmonary rehabilitation exercises in order to strengthen respiratory muscle endurance followed by smoothly removing the endotracheal tube. When it comes to improving family adjustment disorders, meetings with the family were arranged to enhance the family’s consensus and nursing skills for the patient after returning home. It is suggested that an inter-professional team can work together to produce a set of multimedia DVDs both in Chinese and Taiwan- ese to provide guidance on pulmonary rehabilitation exercise. This set of DVDs can help effectively instruct patients like this case for the short-term when there are heavy workloads from acute and severe diseases and then increase patients’learning results. Therefore, respiratory tract symptoms can be improved and the numbers of acute attacks and readmission rates can be reduced. After these steps, the burdens imposed on families can be relieved accordingly. This nursingexperi- ence is hereby shared and serves as a reference for clinical practices.</p> <p> </p>

Divergent age-related humoral correlates of protection against respiratory syncytial virus infection in older and young adults: a pilot, controlled, human infection challenge model

Respiratory viral infections are typically more severe in older adults. Older adults are more vulnerable to infection and do not respond effectively to vaccines due to a combination of immunosenescence, so-called inflamm-ageing, and accumulation of comorbidities. Although age-related changes in immune responses have been described, the causes of this enhanced respiratory disease in older adults remain poorly understood. We therefore performed volunteer challenge with respiratory syncytial virus (RSV) in groups of younger and older adult volunteers. The aim of this study was to establish the safety and tolerability of this model and define age-related clinical, virological, and immunological outcomes. In this human infection challenge pilot study, adults aged 18-55 years and 60-75 years were assessed for enrolment using protocol-defined inclusion and exclusion criteria. Symptoms were documented by self-completed diaries and viral load determined by quantitative PCR of nasal lavage. Peripheral blood B cell frequencies were measured by enzyme-linked immunospot and antibodies against pre-fusion and post-fusion, NP, and G proteins in the blood and upper respiratory tract were measured. The study was registered with ClinicalTrials.gov, NCT03728413. 381 adults aged 60-75 years (older cohort) and 19 adults aged 18-55 years (young cohort) were assessed for enrolment using protocol-defined inclusion and exclusion criteria between Nov 12, 2018, and Feb 26, 2020. 12 healthy volunteers aged 60-75 years and 21 aged 18-55 years were inoculated intranasally with RSV Memphis-37. Nine (67%) of the 12 older volunteers became infected, developing mild-to-moderate upper respiratory tract symptoms that resolved without serious adverse events or sequelae. Viral load peaked on day 6 post-inoculation and symptoms peaked between days 6 and 8. Increases in circulating IgG-positive and IgA-positive antigen-specific plasmablasts, serum neutralising antibodies, and pre-F specific IgG were similar younger and older adults. However, in contrast to young participants, secretory IgA titres in older volunteers failed to increase during infection and, unlike serum IgG, did not correlate with protection. Better understanding of age-related differences in clinical outcomes and immune correlates of protection can overcome reduction in vaccine efficacy with advancing age. We identify correlates of protection in older adults, revealing previously unrecognised factors which might have implications for targeted vaccine discovery and drug development in this vulnerable group. Medical Research Council and GlaxoSmithKline EMINENT Consortium.

Immunofluorescence-Mediated Detection of Respiratory Virus Infections in Human Airway Epithelial Cultures.

A diverse collection of viral pathogens target airway epithelial cells for infection, with effects ranging from mild upper respiratory tract symptoms to death of the infected individual. Among these pathogens are recently discovered and/or emergent viruses that sometimes fail to infect commonly used, immortalized cell lines and for which infection phenotypes in the respiratory tract remain unknown. Human airway epithelial cultures have been developed over the past several decades and have proven to be a useful model system in culturing hard‐to‐grow viruses and assaying various features of infection in a physiologically relevant setting. This article includes methods for the generation of well‐differentiated human airway epithelial cell cultures at air‐liquid interface that recapitulate the mucosal epithelium of the trachea/bronchus in vivo. We further detail inoculation of these cultures with respiratory viruses—specifically rhinovirus, influenza virus, and severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2)—and provide a protocol for the detection of double‐stranded RNA or viral antigen–positive cells by immunofluorescence microscopy. These techniques, together with a post‐imaging analysis, can be applied to characterize the efficiency of infection and kinetics of spread within the airway epithelium. Furthermore, these methods can be utilized in conjunction with antibodies against cellular targets to determine cell tropism and colocalization with specific host factors during infection. © 2022 The Authors. Current Protocols published by Wiley Periodicals LLC. Basic Protocol 1: Generation of human airway epithelial cultures at air‐liquid interface (HAE‐ALI) Basic Protocol 2: Viral inoculation of HAE‐ALI Basic Protocol 3: Immunofluorescence (IF)‐based detection of infected cells in HAE‐ALI

Retrospective evaluation of viral respiratory tract infections in a university hospital in Ankara, Turkey (2016-2019).

Viruses are responsible for two-thirds of all acute respiratory tract infections. This study aims to retrospectively detect respiratory tract viruses in patients from all age groups who visited the hospital. A total of 1592 samples from 1416 patients with respiratory tract symptoms were sent from several clinics to the Molecular Microbiology Laboratory at Gazi University Hospital from February 2016 to January 2019. Nucleic acid extraction from nasopharyngeal swabs, throat swabs or bronchoalveolar lavage (BAL) samples sent to our laboratory was done using a commercial automated system. Extracted nucleic acids were amplified by a commercial multiplex-real time Polymerase Chain Reaction (PCR) method, which can detect 18 viral respiratory pathogens. Among 1592 samples, 914 (57.4%) were positive for respiratory viruses. The most prevalent were rhinovirus (25.2%) and influenza A virus (12.1%), the least prevalent was the bocavirus (2.6%). Rhinovirus was the most detected as a single agent (21.2%, 194/914) among all positive cases, followed by coronavirus (9.3%, 85/914). The detection rates of coronavirus, human adenovirus, respiratory syncytial virus A/B, human parainfluenza viruses, human metapneumovirus-A/B, human parechovirus, enterovirus and influenza B virus were 9.9%, 8%, 7.7%, 5%, 3.4%, 3.1%, 3%, and 2.8%, respectively. The most detected viral agents in our study were influenza A virus and rhinovirus. Laboratory diagnosis of respiratory viruses is helpful to prevent unnecessary antibiotic use and is essential in routine diagnostics for antiviral treatment. Multiplex Real-time PCR method is fast and useful for the diagnosis of viral respiratory infections.

Relation Between Sex Hormones and Covid-19

Coronavirus is one of the major viruses that mainly attack human respiratory system . there are similarities in symptoms between COVID – 19 and earlier Coronavirus infections such as fever , dry cough , however , COVID – 19 showed unique clinical feature , that involve the targeting of the lower airways as evident by upper respiratory tract symptoms such as rhinorrhea , sneezing and sore throat . The severity of COVID- 19 as indicated by hospitalization , admission to intensive care unit , has been greater in men than women . Many hypotheses have been found to explain this difference in susceptibility and severity of the disease . The difference in immune response between sex is consider the main factor in outcomes of viral infection . Estrogen has immunoenhancing effect on the immune system , while testosterone has immunosuppressive role , also progesterone inhibits inflammatory innate immune response . In this review , its concluded that sex hormones have relation with COVID-19 severity .It was concluded that estrogen and progesterone reduce disease severity in contrast , testosterone increase the severity and susceptibility for COVID-19 . Keywords: sex hormones ; immunity ; Covid – 19

Māori Experiences and Beliefs about Antibiotics and Antimicrobial Resistance for Acute Upper Respiratory Tract Symptoms: A Qualitative Study.

Antimicrobial resistance (AMR) is a threat to public health. Addressing unnecessary antibiotic use provides an opportunity to reduce antibiotic consumption and to slow AMR. Understanding people’s beliefs is important for informing antimicrobial stewardship (AMS) initiatives. Within New Zealand, health inequities exist between Māori and non-Māori; however, no research has examined Māori beliefs about antibiotics and AMR. The aim of this study was to explore the experiences related to antibiotic use of Māori in New Zealand. In-depth, semi-structured interviews were conducted with 30 Māori adults recruited from primary care to explore the experiences, perceptions and beliefs that Māori have about antibiotics, and about AMR. Overall, 30 Māori adults (23% male; age range from 20 to 77 years) participated. Three themes emerged: systemic-, social-, and individual-related factors. From these themes, seven subthemes explained the factors that influenced antibiotic use and their perceptions of AMR in Māori: general practitioner (GP) times and ratios, effect of colonisation, lack of knowledge and information, access and poverty barriers, relationship with health professionals, illness perceptions, treatment beliefs and Whaakaro (thoughts), and beliefs pertaining to natural (rongoā) and Western medicine. Participants identified potential solutions to improve antibiotic use such as cultural support and involving Te Ao Māori; recognising these can inform future AMS initiatives.

Relation between Sex Hormones and COVID 19

Coronavirus is one of the major viruses that mainly attack human respiratory system . there are similarities in symptoms between COVID – 19 and earlier Coronavirus infections such as fever , dry cough , however , COVID – 19 showed unique clinical feature , that involve the targeting of the lower airways as evident by upper respiratory tract symptoms such as rhinorrhea , sneezing and sore throat . The severity of COVID- 19 as indicated by hospitalization , admission to intensive care unit , has been greater in men than women . Many hypotheses have been found to explain this difference in susceptibility and severity of the disease . The difference in immune response between sex is consider the main factor in outcomes of viral infection . Estrogen has immunoenhancing effect on the immune system , while testosterone has immunosuppressive role , also progesterone inhibits inflammatory innate immune response . In this review , its concluded that sex hormones have relation with COVID-19 severity .It was concluded that estrogen and progesterone reduce disease severity in contrast , testosterone increase the severity and susceptibility for COVID-19 . Keywords: sex hormones ; immunity ; Covid – 19

The Effect of Nasal Irrigation on COVID-19 Patient’s Mild Symptoms of Respiratory Tract

BACKGROUND OF THE STUDY: Severe Acute Respiratory Syndrome Corona virus-2 (SARS CoV-2) is a virus that causes covid-19. The initial symptoms put forward by WHO since 2020 is fever accompanied by cough and shortness of breath. Currently, the loss of smell and taste, accompanied by other symptoms, tends to be a strong predictor of COVID-19. The nose is the entrance for air, that's why the nose has an important role in the breathing process. In addition to warming, humidifying, and filtering incoming air, the nose can also maintain respiratory tract homeostasis. The use of nasal irrigation with isotonic saline solution (NaCl 0.9%) is a way to improve mucociliary clearance function by activating cilia as an olfactory sensory system.
 
 AIM OF THE STUDY: To evaluate the effect of nasal irrigation to covid patients who has mild symptoms in the upper respiratory tract
 
 METHODOLOGY: The purpose of this study was to see the effectiveness of nasal irrigation using 0.9% NaCl in COVID-19 patients with mild symptoms, by looking at the average duration of time complaints felt by patients compared to those without nasal irrigation intervention 
 
 RESULTS: This study found a significant difference (p-value = 0.000) between the control group and the intervention group where the mean duration of symptoms in the intervention group was shorter than the control group.
 
 CONCLUSION: anosmia is a symptom in covid-19 which is almost always accompanied by symptoms of loss of taste, various theories on the cause of anosmia have been put forward since the covid-19 pandemic broke out. Improvements in symptom duration were found to be shorter in COVID-19 patients who performed nasal irrigation using 0.9% NaCl independently for 10 days so that in the future it is hoped that nasal irrigation will become part of the comprehensive management of COVID-19 patients who have mild symptoms, especially symptoms related to nasal and upper respiratory complaints.
 

Taxonomical and functional changes in COVID‐19 faecal microbiome could be related to SARS‐CoV‐2 faecal load

SummarySince the beginning of the pandemic caused by the severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) the gastrointestinal (GI) tract has emerged as an important organ influencing the propensity to and potentially the severity of the related COVID‐19 disease. However, the contribution of the SARS‐CoV‐2 intestinal infection on COVID‐19 pathogenesis remains to be clarified. In this exploratory study, we highlighted a possible link between alterations in the composition of the gut microbiota and the levels of SARS‐CoV‐2 RNA in the gastrointestinal tract, which could be more important than the presence of SARS‐CoV‐2 in the respiratory tract, COVID‐19 severity and GI symptoms. As established by metaproteomics, altered molecular functions in the microbiota profiles of high SARS‐CoV‐2 RNA level faeces highlight mechanisms such as inflammation‐induced enterocyte damage, increased intestinal permeability and activation of immune response that may contribute to vicious cycles. Uncovering the role of this gut microbiota dysbiosis could drive the investigation of alternative therapeutic strategies to favour the clearance of the virus and potentially mitigate the effect of the SARS‐CoV‐2 infection.

Analysis of clinical characteristics and prognosis of 4 264 patients with asymptomatic and mild novel coronavirus infections in Shanghai

To analyze the clinical characteristics and prognosis of patients infected with novel coronavirus Omicron variant in Shanghai, as to provide a reference for epidemic prevention, clinical diagnosis, and treatment. Altogether 4 264 novel coronavirus Omicron variant-infected patients with positive results of nucleic acid admitted to Shanghai New International Expo Center N3 Mobile Cabin Hospital from April 2 to May 7, 2022, were included. The demographic and baseline clinical characteristics, treatment strategy, prognosis, and different factors affecting the length of hospital stay were analyzed. A total of 4 264 novel coronavirus variant Omicron-infected cases were collected, including 3 111 cases (73.0%) asymptomatic infections and 1 153 cases (27.0%) mild infections. The overall median age was 45 (33, 55) years old with a range from 2 years old to 81 years old. The male to female ratio was 1.37:1. Altogether 3 305 cases (77.5%) had been vaccinated, of which 3 166 cases completed more than 2 doses. The upper respiratory tract symptoms such as cough and expectoration were the most common clinical manifestations of these infected patients. During the course of the disease, patients with asymptomatic infection were mainly treated with traditional Chinese medicine (TCM, 55.1%) and clinical observation (36.8%), and those with mild infection were mainly treated with TCM (42.2%) or integrated Chinese and Western medicine (30.4%). All patients were cured and discharged. The overall median length of hospital stay and the negative conversion time of nucleic acid were 9 (6, 10) days and 8 (5, 9) days, respectively. Compared with the asymptomatic infected patients, the hospitalization duration and the nucleic acid negative conversion time of the mildly infected patients were slightly longer [days: 10 (8, 11) vs. 9 (5, 10); 8 (6, 10) vs. 7 (4, 9), both P < 0.001]. Multiple linear regression analysis showed that the increasing age and mild infection were associated with longer hospitalization duration, and the treatment of TCM or integrated Chinese and Western medicine was associated with shortened length of hospital stay (all P < 0.05). The current novel coronavirus Omicron variant epidemic in Shanghai mainly caused asymptomatic and mild infections. The young and middle-aged population had a relatively high infection rate. The upper respiratory tract symptoms such as cough and expectoration were the most common clinical symptoms. Elderly and confirmed patients had prolonged hospitalization duration, while for patients receiving TCM treatment, the hospitalization duration was shortened.

Neumonías bacterianas no neumocócicas (II). Infecciones por Mycoplasma y Chlamydia

Community-acquired pneumonia is one of the most common infectious diseases. Bacterial (non-pneumococcal) and viral pneumonias are included within the group called “atypical pneumonias.” It encompasses those caused by Mycoplasma spp. and Chlamydia spp., which will be covered in this update, as well as Legionella spp. and Coxiella burnetii in addition to other less common bacteria in which pneumonia is not the most common clinical presentation and which have been discussed in the other update in this thematic unit. They tend to produce mild lower respiratory tract symptoms and occasionally extrapulmonary manifestations. The analytical and radiological changes tend to be nonspecific. The microbiological diagnosis, when it is made, is done through serological or molecular techniques. The prognosis tends to be good.

Clinical, Radiographic And Bronchoscopic Findings of Tracheal Collapse in A Calf

A six-day-old calf was presented to the XXX University Veterinary Teaching Hospital with a history of wheezing (noisy respiration), dyspnea that worsens with exercise and drinking. The calf shown upper respiratory tract symptoms including extended head and neck, dilated nostrils, severe inspiratory stridor with characteristic “honking” sound, and exophthalmos. Upon these findings, we suspected upper airway obstruction and decided to perform cervical-thoracal radiography and bronchoscopy to obtain detailed visualization of the upper respiratory tract. On the thorax radiograph, significant tracheal narrowing was visible at the thoracic inlet, and it was beginning at the caudal cervical region (C5) and extending to the cranial thorax (T1). Also, severe dorsoventrally narrowing was displayed approximately 15 cm after entering the trachea using bronchoscopy. The tracheal collapse was diagnosed in this case based on clinical, radiographical, and bronchoscopy findings. It is important to remember that tracheal collapse should be considered in the differential diagnosis in calves that show upper respiratory tract symptoms such as extended head and neck, dilated nostrils, severe inspiratory stridor with characteristic “honking” sound.

Epidemiological and Clinical Characteristics of Pediatric COVID-19 in the Tertiary Care System in Thailand: Comparative Delta and pre-Delta Era.

BackgroundFew studies had focused on the epidemiological and clinical characteristics of pediatric COVID-19 (SARS-CoV-2) during Delta and pre-Delta eras in Asia, despite it being a pandemic.ObjectiveTo study the epidemiological and clinical characteristics of three waves of pediatric COVID-19 infections in a tertiary-care setting in Thailand.MethodsThis retrospective study reviewed all PCR-confirmed pediatric (0–18 years of age) COVID-19 infections between January 13, 2020, and October 31, 2021, in a tertiary care system in Thailand.Results1,019 patients, aged 0.02 – 18 years, 552 (54.2%) male, and 467 (45.8%) female, with a median age of 9.2 years, were enrolled. Asymptomatic cases accounted for 35.7%, of which 106 (18.9%) had abnormal chest X-ray findings. Most cases were classified as having mild clinical symptoms, with only 8 (0.8%) and 4 (0.4%) developing a severe and critical illness, respectively. There were no deaths. The Delta variant appeared more transmissible than previous ones, but we did not see any difference in disease severity. Upper respiratory tract symptoms were predominant, while few cases had lower respiratory tract involvement. The sensitivity and specificity of dyspnea symptoms to predict radiologically confirmed pneumonia were 14% and 95%, respectively, with a likelihood ratio of 3.37. The overall prognosis was good, with only 13 (1.3 %) needing respiratory support. All cases showed clinical improvement with a decent recovery.ConclusionPediatric COVID-19 during the Delta variant predominance era generally appeared more transmissible but benign. One-fifth of cases had pneumonia, but few cases needed respiratory support. Prevention remains important for disease control.

Prevalence and Otorhinological Symptoms of People with COVID-19 in Rivers State

Coronavirus disease 2019 (COVID-19) has dramatically spread all over the world, crossing the borders of all countries. It is presented mainly by lower respiratory tract symptoms such as fever, cough, dyspnea, and chest tightness. However, COVID-19 causes different upper respiratory tract-related symptoms including nasal congestion, sore throat, and olfactory dysfunction. Therefore, this study was aimed to evaluate the Prevalence and otorhinologic / Ear Nose and Throat ( ENT) Symptomatology of Individual with COVID-19 in Rivers State. The study was a prospective descriptive study of all consenting patients who received care through hospitals, designated for COVID-19 treatment in Rivers State. A total number of 2223 Samples consisting of 137 (6.16%) symptomatic and 2086 asymptomatic (93.84%) were taken in accordance with Nigerian protocol for samples collection and PCR Diagnosis for SARS COV-2. The age, sex, date onset of symptoms, and date of sample collection were documented. A diagnosis of COVID-19 infection was made according to the guidance developed by the NCDC using multiplex RT‑PCR which identified the E‑gene, RDRP‑gene, and N-gene using GeneFinder by Osang Korea. Results revealed that out of the total number of 2223 patients tested 206 were positive of COVID-19 and 2017 (91%) were tested negative. Out 206 positive cases recorded 110 patients were with symptoms, the most frequent recorded ENT manifestations were dry cough and fever (24.5%), loss of smell (24.5%), Difficulty in Breathing (11.8%),Headache (10.9%), Sore throat (7.3%), Nasal congestion (6.5%),,Loss of taste (6.4%),Sneezing (3.6%), dizziness (2.7%), and running nose (1.8%). The study has shown that the prevalence of COVID-19 among symptomatic and asymptomatic patients in the study location is high and a cause of epidemiologic concern as asymptomatic patients contribute a significant burden and carriers of COVID-19 infections. The study also revealed that ENT syndrome is the major symptoms associated with Covid 19.

Clinical features and upper airway symptoms in association with severity and outcome in patients with COVID-19

Objectives: To assess the relationship between the early occurrence of upper respiratory tract symptoms and the severity of SARS-COV-2 infection.Methods: A cohort observational study had been conducted on a total of 140 patients [60 mild, 40 moderate, 40 severe], diagnosed with SARS-CoV-2 between 4th of August and 31 of October 2020. Patients diagnosed by PCR or chest CT scan or both of them. A full history was taken from the patients and data including the age of the patient, gender, occupation, residence, height, weight, history of previous comorbidities {cardiovascular, Diabetes mellitus, Hypertension, chronic respiratory disease, chronic renal disease, malignancy, and other diseases}. Smoking and alcoholic history were also taken, clinical features {loss of smell/taste, sore throat, rhinorrhea, fever, cough, shortness of breath, headache, fatigue, myalgia, arthralgia, diarrhea, and vomiting} and temperature, SPO2, investigations, the need for respiratory support {O2, non-invasive ventilation, invasive ventilation} and any complications developed during illness.&#x0D; Results: Mean age of the patients was 51(range:17-82) Males were dominant; (57.1%) with male to female ratio of 1.33 to one, out of the 140 COVID-19 patients, 63 (45%) had upper respiratory symptoms. Regarding biomarkers of severity only S.LDH was significantly lower in cases who did have compared to those who did not have upper respiratory symptoms, 1.3 ± 1.4 vs. 1.7 ± 1.3, respectively. The mean SPO2% was significantly higher in patients with upper respiratory symptoms compared to those without. Percent of Pulmonary damage was significantly lower in patients with upper Respiratory symptom compared to those without. Mortalities were significantly lower in patients with upper respiratory symptoms compared to those without; among the 113 patients with upper respiratory symptom compared only 7(6.2%) died compared to 7 out of 27 (25.9%) patients with no upper respiratory symptom.Conclusion: Early occurrence of upper respiratory tract symptoms predicts less severe form of the disease.

Cross-Sectional Survey of Prophylactic and Metaphylactic Antimicrobial Use in Layer Poultry Farming in Cameroon: A Quantitative Pilot Study.

An evaluation of the patterns of antimicrobial use in livestock can help understand the increasing level of antimicrobial resistance worldwide. This study aimed at evaluating antimicrobial usage in modern layer poultry farms in the West Region of Cameroon. In this light, 70 layer poultry farms and 4 veterinary pharmacies were surveyed. Data on antimicrobial use were collected through interviews using a quantitative-frequency questionnaire and consultation of medical records. The four veterinary pharmacies sold a total of 2.8 tons of antimicrobials (active ingredients) during 2011. At the level of farms, 297 kg of antimicrobials (active ingredients) were used in the 50 layer poultry farms surveyed. Tetracycline, sulfonamides, quinolones, and β-lactams (aminopenicillins) were the most sold and used drugs in layer farms. As for treatment indication, metaphylactic (58.1%) and prophylactic (41.9%) treatments were the most observed practices, and nearly all (99%) treatments were administered per os as remedies to respiratory (33.4%) and digestive (24.7%) tract symptoms. Overall, 78.2% of antimicrobials sold in pharmacies and 67.3% used in the farms belonged to the class of critically important antimicrobials of the WHO categorization of antimicrobials according to their importance to human medicine. Doxycycline, sulfonamide, ampicillin, and streptomycin, which have been banned for layer poultry in the production of eggs for human consumption, were still used in Cameroon. The treatment incidences based on the used daily dose (TIUDD) and animal daily dose (TIADD) were 11.59 and 10.45, respectively. In regard to dosage correctness based on the UDD/ADD ratio, aminoglycosides (100%), macrolides (90.6%), and tetracyclines (74.5%) were the most underdosed, while trimethoprim sulfonamides (45.8%) and β-lactams (35.7%) were overdosed. This study highlights an irrational antimicrobial usage in layer poultry farms. Regulation of the use of antimicrobials and the education of farmers on adequate antimicrobial use are essential to preserve the effectiveness of drugs in both humans and animals.

Difference in clinical features of SARS-CoV-2 in pediatric patients before and after emergence of P.1

BackgroundThe P.1 variant is a Variant of Concern announced by the WHO. The present work aimed to characterize the clinical features of pediatric patients with SARS-CoV-2 before and after the emergence of P.1.MethodsThis is a cohort study. Data of symptomatic patients younger than 18 years diagnosed with COVID-19 by PCR tests registered in Painel COVID-19 Amazonas were analyzed.ResultsA total of 4080 symptomatic pediatric patients were identified in the database between March 2020 and July 2021, of which 1654 were categorized as pre-P.1 and 978 as P.1-dominant cases, based on the prevalence of P.1 of >90% in the North Region, Brazil. Lower case-fatality rate was observed in non-infants infected during the P.1-dominant period (0.9% vs. 2.2%). In general, patients infected during the P.1-dominant period had less fever (70.8% vs. 74.2%) and less lower respiratory tract symptoms (respiratory distress: 11.8% vs. 18.9%, dyspnea: 27.9% vs. 34.5%) yet higher prevalence of neurological symptoms, headache for example (42.8% vs. 5.9%).ConclusionsThe prevalence of symptoms of COVID-19 can differ across different periods of variant dominance. Lower prevalence of fever during the P.1-dominant period may reduce the effectiveness of symptom-based screening in public premises where laboratory diagnostic tests are not available.ImpactThe prevalence rate of symptoms of SARS-CoV-2 infection can differ among different variants.The present work documents the difference in the clinical features of SARS-CoV-2 in patients aged below 18 years before and after the emergence of P.1, the first study of its kind.Unlike previous studies that focus solely on hospitalized cases, the present work considers both mild and severe cases.While non-infants had a lower fatality rate, lower prevalence of fever associated with the emergence of P.1 may reduce the effectiveness of symptom-based screening in public premises where laboratory diagnostic tests are not available.

CUTANEOUS MANIFESTATIONS RELATED TO COVID-19 IN SOUTH ASIAN YOUNG ADULTS

COVID-19, a disease caused by SARS-CoV-2, which is mostly known to cause upper respiratory tract symptoms is recently found to cause cutaneous manifestations in a considerable number of patients.The purpose of the study was to study the features of dermatological manifestations of COVID-19 in young South Asian adults.After the initial survey obtaining the contact details, personal interviews of 53 participants were conducted personally asking them questions about gender, age, the presence of the disease on SARS-CoV-2 in the anamnesis and nature of the course, the presence of nosocomial infection, the use of medications during supervision and the presence of dermatological lesions. Analysis of obtained data was performed to identify the correlation between these factors/incidences of SARS-CoV-2 and different skin manifestation.The results displayed that the most frequent cutaneous manifestation among our 53 participants is maculopapular rash 27% (n=14). This is thought to develop because of high viral exanthem or due to possible drug related interactions through treatment. Others had skin manifestation such as generalized pruritus, petechiae on the feet and vesiculopapular rash. Majority of these rashes were generalized. Interestingly, a young female participant who had tested positive for COVID-19 in August 2020 has been experiencing dermographism since February 2021.Our research data show that coloured populations are less likely to present with cutaneous manifestations possibly because of the melanocyte content in the skin, and its relation to ACE receptor and that cutaneous manifestations can be detected in a specific age group, along with the respiratory problems that arise from infection with this strain and should be considered as a symptom.

Ocular events following the surge of cough and cold medications use during the Omicron outbreak in Hong Kong.

To the Editor Coronavirus disease 2019 (COVID-19) situation worsened since the Omicron spread in Hong Kong,1 numerous infected but mildly ill patients accumulated in our community.2,3 We report a surge in acute primary angle closure (APAC) since the local outbreak of Omicron. This letter highlights the potential ocular sequelae of antitussive and nasal decongestants usage and serves to alert practitioners to wear adequate personal protective equipment upon attending APAC cases. In second to third week of March, we encountered consecutive eight eyes (seven patients) of APAC (Table 1) in our hospital, which was more than triple of usual. Five (71.4%) were without past ocular history. The remaining two (28.6%) were known to be primary angle-closure suspect (PACS). All admitted prior cough mixture or cold medications uses for relief of upper respiratory tract symptoms, including promethazine compound linctus, diphenhydramine compound linctus, actified syrup (pseudoephedrine and triprolidine), chlorpheniramine and different over-the-counter anti-histamine and nasal decongestant. Four (57.1%) patients were known cases of COVID-19, when the first week of March was the peak of the Omicron surge. The remaining three (42.9%) were not yet tested upon attendance, yet symptomatic with cough, sputum and runny noses. All were SARS-CoV-2 RNA positive by polymerase chain reaction subsequently. Investigation gonioscopy of the contralateral eye revealed PACS in all cases.

Patterns of self-reported recovery from chemosensory dysfunction following SARS-CoV-2 infection: insights after 1 year of the pandemic

Background The coronavirus disease (COVID-19), due to the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), causes chemosensory dysfunction. Aims/objectives To determine the characteristics of chemosensory dysfunction and to identify factors associated with chemosensory complete recovery and time to recovery. Materials and methods This cross-sectional study included all patients presenting with chemosensory dysfunction and confirmed SARS-CoV-2 infection from May to August 2020 who underwent telemedicine follow-up after 1 year to assess their chemosensory recovery. Results A total of 372 patients were included, of which 53.8% were male. The mean age ± SD was 37.45 ± 13.44. The majority experienced combined (olfactory and gustatory) dysfunction (85.7%), and 315 patients (84.7%) had complete loss of chemosensory function. The independent predictors associated with a low likelihood of complete recovery were parosmia (aOR 0.16, p < .001), upper respiratory tract symptoms (aOR 0.28, p = .001), and dyspnoea (aOR 0.21, p < .001), whereas the factors associated with a long recovery period were parosmia (aOR 12.04, p = .002), headache (aOR 7.19, p = .007), and hypertension (aOR 7.76, p = .039). Conclusions A full recovery outcome was predominant. The presence of parosmia was linked to both an incomplete recovery and a long time to recovery. Significance Parosmia and respiratory symptoms are implicated in the incomplete recuperation of chemosensory function.