Signs Of Acute Respiratory Disease Research Articles

Improving diagnostics using extended point-of-care testing during in-home assessments of older adults with signs of emerging acute disease: a prospective observational non-randomised pilot and feasibility study

BackgroundDelayed recognition of acute disease among older adults hinders timely management and increases the risk of hospital admission. Point-of-Care testing, including Focused Lung Ultrasound (FLUS) and in-home analysis of biological material, may support clinical decision-making in suspected acute respiratory disease. The aim of this study was to pilot test the study design for a planned randomised trial, investigate whether in-home extended use of point-of-care testing is feasible, and explore its’ potential clinical impact.MethodsA non-randomised pilot and feasibility study was conducted during September–November 2021 in Kolding Municipality, Denmark. A FLUS-trained physician accompanied an acute community nurse on home-visits to citizens aged 65 + y with signs of acute respiratory disease. The acute community nurses did a clinical assessment (vital signs, capillary C-reactive protein and haemoglobin) and gave a presumptive diagnosis. Subsequently, the physician performed FLUS, venipuncture with bedside analysis (electrolytes, creatinine, white blood cell differential count), nasopharyngeal swab (PCR for upper respiratory pathogens), and urine samples (flow-cytometry). Primary outcomes were feasibility of study design and extended point-of-care testing; secondary outcome was the potential clinical impact of extended point-of-care testing.ResultsOne hundred consecutive individuals were included. Average age was 81.6 (SD ± 8.4). Feasibility of study design was acceptable, FLUS 100%, blood-analyses 81%, PCR for upper respiratory pathogens 79%, and urine flow-cytometry 4%. In addition to the acute community nurse’s presumptive diagnosis, extended point-of-care testing identified 34 individuals with a condition in need of further evaluation by a physician.ConclusionOverall, in-home assessments with extended point-of-care testing are feasible and may aid to identify and handle acute diseases in older adults.

T-cell immunity status of children with combined infection with SARS-CoV-2 and human herpesviruses

There is an opinion that COVID-19 may be the cause of the reactivation of herpesviruses. Purpose. To study the state of the cellular link of adaptive immunity in the combined course of herpesvirus infections and COVID-19, to describe the clinical and laboratory characteristics of such conditions. Material and methods. In 2022–2023 a cross-sectional study was conducted. 71 patients aged from 1 month to 16 years were selected. Inclusion criteria: presence of signs of acute respiratory disease associated with SARS-CoV-2 and/or mononucleosis-like syndrome associated with active herpesvirus infection. All patients underwent a standard laboratory examination, determined by nosology, and an additional assessment of the cellular link of adaptive immunity (CD3+, CD4+, CD8+, CD3+HLA-DR+, CD3- CD16+CD56+ and CD20+) on a flow cytometer using monoclonal antibodies. Results and conclusion. The clinical pattern of the combined course of herpesvirus infection and SARS-CoV-2 differs little from monoinfections. Only at the first encounter with the Epstein-Barr virus, lymphoproliferative syndrome and hepatomegaly were more often recorded (p<0.05). Comparing the nature of the cellular immune response in patients with COVID-19 and herpesvirus infection, we observed pronounced differences. In patients with primary herpesvirus infection, the T-cell immune response was an order of magnitude higher than in acute COVID-19, herpesvirus reactivation, and co-infection, and this was true for all studied lymphocyte subpopulations. With SARS-CoV-2, a decrease in the total number of T-lymphocytes, T-helpers, and cytotoxic lymphocytes was observed. This condition, of course, cannot be called immunosuppression, but some parallel is clearly traced. And even with the combined course of SARS-CoV-2 and herpesvirus infection, the absolute values of T-cell immunity indicators do not reach the same indicators in patients without COVID-19. It is likely that this reason underlies the phenomenon of reactivation of persistent herpesviruses in patients infected with SARS-CoV-2.

The study of platelet microparticles and P-selectin expression in patients with the peripheral arterial diseases

BACKGROUND: High platelet reactivity leads to the progression of atherosclerosis and its complications. Activated platelets adhere to the site of endothelium damage on the vessel wall and initiate the formation of an arterial thrombus, followed by acute ischemia of the organ. Biochemical and cellular marker such as platelet microvesicles and P-selectin can be analyzed using flow cytometry, which is based on a specific antigen-antibody interaction. Patients with peripheral arterial disease are at significantly greater risk of cardiovascular and cerebrovascular complications than individuals of the same age and sex. The use of antiplatelet agents is an important part of pathogenetic therapy and prevention of cardiovascular diseases and their complications.
 AIM: This study was to evaluate the level of platelet microparticles and P-selectin expression in patients with peripheral arterial disease receiving antiplatelet therapy.
 MATERIALS AND METHODS: The study included 49 people, which included three study groups: patients with obliterating disease of the arteries of the lower extremities (n = 14) on the background of long-term use (more than 14 days) of double (75 mg clopidogrel and 100 mg Acetylsalicylic acid) antiplatelet therapy, patients with COVID-19 (n = 15), who made up the positive control group in the determination of microparticles of platelet origin, and healthy volunteers (n = 20) without signs of acute respiratory disease, without a history of cardiovascular and thromboembolic episodes, not taking antiplatelet drugs. The functional activity of platelets was assessed by two methods: using light aggregometry and analysis of P-selectin expression on platelet surface by flow cytometry. The number of platelets microparticles in blood plasma was also determined using flow cytometry.
 RESULTS: A significant decrease in platelet aggregation was found in patients with peripheral arterial disease taking antiplatelet agents, compared with controls by used light aggregometry. Similar changes were obtained when analyzing the expression of P-selectin on platelets. A higher percentage of platelets microparticles with the CD9+CD41+ phenotype was found in patients with severe inflammation compared with peripheral arterial disease patients treated with antiplatelet agents and compared with the healthy controls.
 CONCLUSIONS: Thus, our study reflects the consistency of the results of three different laboratory tests in assessing the platelets reactivity in patients with the peripheral arterial diseases taking antiplatelet drugs.

Assessment of predictors of the development of heavy forms of SARS-CoV-2 during pregnancy

Aim: To evaluate the clinical significance of factors predisposing to the severe form of SARS-CoV-2 virus infection during pregnancy.Material and methods of study. 240 pregnant women with signs of acute respiratory disease were examined. All pregnant women were subjected to general clinical, obstetrical, and clinical-laboratory methods of examination (general analysis of blood, urine, biochemical blood tests, coagulogram, and PCR diagnostic test to verify SARS-CoV-2). To confirm the diagnosis of “community-acquired pneumonia” chest X-ray in two projections or computed tomography was performed.Results. Severe forms of coronavirus infection were most frequently diagnosed in the 20–29-year (34.3%) and 30–39-year (51.4%) age groups, in pregnant women who lived in an urban setting (82.9%), in pregnant women with a low level of education (85.7%), in pregnant women with a high index of extragenital pathology (100%), and women in the third trimester of pregnancy (67.7%).Conclusion. Risk factors for the severe form of SARS-CoV-2 include pregnant women in the age ranges 20-39 years; pregnant women who live in the urban setting; pregnant women with a low level of education; pregnant women with extragenital pathology; third-trimester pregnant women.

Risk factors for duration of equine rhinitis A virus respiratory disease.

Infectious respiratory disease is common in young horses and can impact athletic performance and long-term health. Significant variation in the duration of clinical disease has been observed, even in the absence of secondary complications. The determination of factors associated with disease chronicity may facilitate clinical decision-making and the development of improved biosecurity protocols. To investigate contact network characteristics, and demographic variables associated with time to clinical recovery from Equine Rhinitis A virus respiratory disease. Prospective cohort study. Yearling Standardbred racehorses (n=58) housed in a multi-barn training facility in Southern Ontario were included. Horses were monitored daily for clinical signs of acute respiratory disease over a 41-day period in Autumn 2017. Contact patterns between horses, including older racehorses, were determined through use of proximity loggers attached to halters during the initial 7-day of the study. Associations between duration of disease, demographic factors (birth month, gait, sex and yearling sale), serologic titres and network metrics (degree, betweenness and Eigenvector centrality) were investigated using a Cox proportional hazard model. Yearling attack rate for infectious respiratory disease was 87.9% (n=51). Median time to recovery was 6days (IQR=1-32) and 17 horses were censored due to early withdrawal or failure to recover during the study period. In those yearlings born February-May, birth month was significant in the Cox proportional hazard model (Hazard Ratio 0.7, 95% CI 0.49-1, P=0.05). Probability of censoring was not independent of outcome which necessitated use of sensitivity analysis. These findings suggest late born foals are less likely to recover quickly from infectious respiratory disease.

Fatal peste des petits ruminants disease in Chowsingha

This communication reports fatal Peste des petits ruminants (PPR) disease in Chowsingha (Tetracerus quadricornis), a member of the subfamily Bovinae and family Bovidae captured in a Zoological Park. The animals showed clinical signs of acute respiratory disease with frothy nasal discharge (1-2days) and mortality of twenty animals (80%) within 48hr. Necropsy of dead Chowsingha showed haemorrhagic patches in trachea and severe congestion of lungs and ocular mucosa. There was no characteristic lesion in the intestine. Swabs from trachea and nasal tract along with tissue samples of spleen and lung from dead animals were found positive for PPR virus based on reverse transcription-polymerase chain reaction using H gene and partial N gene-specific primers. Sequence analysis of complete H gene and partial N gene confirmed the aetiological agent as PPR virus lineage IV. The identity of the Chowsingha tissues used for PPRV isolation was confirmed by the 12S ribosomal RNA gene sequencing, and the amplified gene was analysed identically to the Chowsingha mitochondrial 12S ribosomal RNA gene. The present information of PPR in Chowsingha is the first report of PPRV lineage IV causing cross-species fatal disease in subfamily bovinae and family Bovidae. The acute manifestation of the disease indicates high susceptibility of this vulnerable wild bovid species to PPR lineage IV. This report extends host range and demands enhanced surveillance among subfamily bovinae to strengthen PPR eradication programme.

Diversity, microevolution and within-host niche adaptation of Streptococcus equi

The objectives of this workwere to evaluate seroprevalence of the disease in Algeria, knowing that vaccination against equine flu is not mandatory in this country and to characterize new viral isolates from nasal swabs collected during 2010 and 2011. 397 sera from distinct horses have been collected, 297 sera were collected in 2009/2010 and 100 were collected during 2011. Serological analysis of equine sera was conducted using haemagglutination inhibition assays (HI), using H7N7/Prague/1956 and H3N8 equine influenza viruses (H3N8/Miami/1963; H3N8/Russie/1983; H3N8/Grosbois/2009). Nasal swabs were taken from horses showing signs of acute respiratory disease. Genotyping was performed by amplification and sequencing of the haemagglutinin gene (HA1) using RNA extracted directly from nasal swabs. Around 59% from 297 sera collected during 2009/2010 showed antibodies anti-H3N8 subtypes, this percentage rises to 81% for sera collected in 2011. Moreover, antibodies anti-H7N7 were found in 6 sera, those horses were imported from Europe and have been certainly vaccinated against equine influenza viruses with a vaccine containing H7N7 antigens. In the meantime, nasal swabs were collected from 7 sick horses showing fever and nasal discharge. Nasal swabs were found positive using a quantitative RT-PCR assay. Phylogenetic analysis using these HA1 sequences and some reference strains and others from GenBank grouped the viruses in different clusters: the Predivergent and American lineages with the Florida sublineage clades 1 and 2. Viruses from Algeria are members of the Florida sublineage Clade 2. In conclusion, the seroepidemiology study performed shows that equine influenza viruses from H3N8 subtypes are circulating in horse population from Algeria. Moreover, the virus characterized in this paper, named A/equine/H3N8/Tiaret/2011, is the first one to be characterized in Algeria since 1972.

Poststreptococcal arthritis in teenagers

Система комплексной поддержки и сопровождения научного журнала Elpub позволяет запустить двуязычный сайт журнала со встроенной системой электронной редакции в соответствии с лучшими издательскими практиками, а так же предусматривает техническую и методическую поддержку со стороны специалистов НЭИКОН.

Development of nested PCR assays for detection of bovine respiratory syncytial virus in clinical samples.

Two nested PCR assays were developed for the detection of bovine respiratory syncytial virus (BRSV). Primers were selected from the gene encoding the F fusion protein (PCR-F) and the gene encoding the G attachment protein (PCR-G). Biotinylated oligonucleotide probes, termed F and G, were selected for the hybridization of the respective PCR products. The sensitivities of the PCR-F and PCR-G assays were similar, both detecting 0.1 tissue culture infective dose of the virus. The PCR-F assay amplified all bovine strains and one human strain (RS32) tested. No cross-reactions were observed with nine heterologous respiratory viruses. PCR-F products of bovine and human RSV strains were discriminated by using endonuclease restriction enzyme ScaI, which specifically cleaved, products of BRSV. Oligonucleotide probe F was also specific for products of BRSV. The PCR-G assay detected all bovine strains and none of the human strains tested. A faint electrophoretic band was also observed with products of Sendai virus. However, probe G did not hybridize with this product, only with products of BRSV. Nasal swabs collected from cattle with no symptoms and cattle in the acute stage of respiratory disease were analyzed for BRSV by the immunofluorescence (IF) method and by the PCR-F and PCR-G assays. The virus was detected by the PCR assays in 31 of 35 (89%) samples tested. Only 23 samples (66%) were positive by the IF method, and these samples were also positive by both the PCR-F and PCR-G assays. The 31 samples detected as positive by PCR originated from cattle presenting clinical signs of acute respiratory disease; the four PCR-negative samples originated from clinically asymptomatic neighboring cattle. All sampled animals subsequently seroconverted and became reactive to BRSV. Thus, the detection of BRSV by PCR correlated with clinical observations and was considerably more sensitive (66 versus 89%) than IF. These results indicate that both nested PCR assays provide rapid and sensitive means for the detection of BRSV infection in cattle. Considering its higher specificity, the PCR-F assay can be recommended as the method of choice in the analysis of clinical specimens of BRSV.

Experimental reproduction of acute lesions of porcine pleuropneumonia with a haemolysin-deficient mutant of Actinobacillus pleuropneumoniae

The role of the heat-labile haemolysin of Actinobacillus pleuropneumoniae in acute porcine pleuropneumonia was examined. A virulent strain was compared with an isogenic haemolysin-deficient mutant in experimental infections. The pigs which received the virulent strain showed clinical signs of acute respiratory disease whereas the animals infected with the mutant strain appeared to be less severely affected. At post mortem examination, both groups showed similar acute pulmonary lesions and pleurisy typical of A pleuropneumoniae infection. The bacterial antigen representing the haemolysin was detected in lung lesions infected with the parent strain but not in those infected with the mutant. These results demonstrate that the haemolysin of serotype 2 A pleuropneumoniae is not an essential factor for the production of the lesions of pleuropneumonia in pigs.

Immunorestoration in children with recurrent respiratory infections treated with isoprinosine

In 27 children, 4–8 years old, with recurrent respiratory infections of the upper and lower respiratory tracts Isoprinosine®(ISO) tablets were administered for 7 – 10 days at daily doses of 50–100 mg/ kg. Clinical signs of acute respiratory disease, including temperature abnormalities and subjective complaints, subsided in a short time and the children showed no symptoms for periods ranging from several weeks to several months following the theraphy. The children were selected for immunotherapy wit ISO on the basis of their low levels of E-rosette forming cells in peripheral blood. Several immune function parameters assessed immediately after treatment with ISO and compared with those obtained before illness and ISO administration. Low levels of T-lymphocytes returned to normal after ISO therapy, B-lymphocyte relative and absolute numbers, however, were not affected by the treatment. Nor were any changes due to ISO found in immunoglobulins, complements, beta 2-micrologbulin and C-reactive protein. Moreover, ISO had no stimulative effect on spotaneous tetrazolium reductase activity of granulocytes but it showed a slight inhibition of their phagocytosis-associated metabolic activity.

Isolation of an Etiologic Agent of Acute Respiratory Disease (Rhinotracheitis) of Turkey Poults

A small gram-negative motile bacillus was isolated from laboratory poults affected by acute respiratory disease (rhinotracheitis) of turkeys. The bacterium was inoculated intranasally into susceptible day-old poults; the poults developed typical clinical signs of acute respiratory disease, and the bacterium was reisolated. This same bacterium was isolated from commercial poults with typical signs of acute respiratory disease but not from poults of similar age which were clinically normal. The bacterium has not been identified taxonomically. We conclude that it is a primary etiologic agent for acute respiratory disease of turkey poults.

Transmission of Acute Respiratory Disease (Rhinotracheitis) of Turkeys

Clinical signs of acute respiratory disease of turkeys were transmitted to susceptible day-old poults by direct contact, litter contact, and drinking water. Attempts failed to transmit the disease by air (cage-to-cage) or by oral and nasal inoculation with feces, nasal exudates, or nasal turbinate extracts. The disease was not transmitted by inoculation with white blood cells. Chicks were not affected by the disease, but young quail developed signs of respiratory disease when exposed to contaminated drinking water. Thus, acute respiratory disease in turkeys appears to be of an infectious nature, and the infectious agent(s) probably exist in the heavily contaminated environment used to house young commercial turkey poults.