scholarly journals COVID-19 in children: an approach for multisystem inflammatory syndrome

2021 ◽  
Vol 69 (1) ◽  
Author(s):  
Haneen K. Morsy ◽  
Noha S. Tohamy ◽  
Hager M. Abd El Ghaffar ◽  
Rana Sayed ◽  
Nagwa A. Sabri
Keyword(s):  
Multiorgan Failure ◽  
Review Article ◽  
Main Body ◽  
Search Terms ◽  
Underlying Causes ◽  
Management Approaches ◽  
Evidence Based Guideline ◽  
Available Information ◽  
Inflammatory Syndrome ◽  
Current Guidelines

Abstract Background and objectives Children suffering from coronavirus disease (COVID-19) usually present with mild symptoms and show lower mortality rates than adults. However, there have been several recent reports of more severe hyperinflammatory presentation in pediatric COVID-19 patients. This review article aims to summarize the current literature available on the main clinical features and management approaches of multisystem inflammatory syndrome in children (MIS-C). Methods The authors searched different indexing databases for observational and interventional studies using search terms including “Coronavirus, COVID-19, pediatric, MIS-C, Kawasaki, and inflammation.” The retrieved publications were further assessed for relevance to the topic. Only relevant articles were included in writing this review article. Main body Multisystem inflammatory syndrome in children (MIS-C) is a hyperinflammatory syndrome temporally related to severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection in pediatrics. It is characterized by persistent fever, rash, elevated inflammatory markers, and multiorgan failure with increasing rates of cardiovascular and gastrointestinal involvement. The exact pathophysiologic mechanisms of MIS-C are still unknown, but it is postulated to be due to an exaggerated immune response to SARS-CoV-2 infection. Multisystem inflammatory syndrome in children is diagnosed by exclusion of other underlying causes of organ failure. There is a lack of clinical evidence on the management of MIS-C. The current guidelines depend mainly on expert opinion based on the management of other hyper-inflammatory syndromes in children. Patients suffering from MIS-C are treated with intravenous immunoglobulin (IVIg), corticosteroids, infliximab, tocilizumab, and anakinra. Conclusions Despite the growing reports on COVID-19 in children, there is still a lot to elucidate on the pathophysiology, diagnosis, and subsequent management of MIS-C. Further trials are needed to investigate new approaches to manage MIS-C. Specific evidence-based guideline for management of MIS-C should be tailored to the current available information on MIS-C.

scholarly journals Ethnopharmacological uses, phytochemistry, pharmacology, and toxicology of Olax subscorpioidea Oliv (Olacaceae): a review

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Mubarak Hussaini Ahmad ◽  
Abubakar Ibrahim Jatau ◽  
Omar Yahya Alshargi ◽  
Sa’adatu Muhammad Julde ◽  
Mustapha Mohammed ◽  
...  
Keyword(s):  
Bibliographic Databases ◽  
Main Body ◽  
Search Terms ◽  
Hepatic Diseases ◽  
Comprehensive Information ◽  
Pharmacological Studies ◽  
Available Information ◽  
Therapeutic Compounds ◽  
Phytochemical Studies ◽  
Ethnomedicinal Uses

Abstract Background The plant Olax subscorpioidea Oliv (Olacaceae) is a shrub that is widely available in Africa. It has been used in traditional medicine to treat various diseases including asthma, pain, inflammation, gastrointestinal and central nervous system (CNS) disorders, cough, diabetes mellitus, cancer, infectious diseases, hepatic diseases, and many other diseases. Several phytochemical and pharmacological investigations were conducted on this plant. However, comprehensive information on this medicinally important plant is not available in the literature. Therefore, in this review, we aimed to provide comprehensive and critical information on all the reported ethnomedicinal uses, phytochemistry, pharmacological activities, and potential toxicity of Olax subscorpioidea to highlight its therapeutic potentials based on traditional usage and identify research gaps as a basis for further investigations to develop novel therapeutic compounds. Main body The available information about the plant was retrieved from the online bibliographic databases (PubMed and Google Scholar) and published PhD dissertation using the search terms Olax subscorpioidea, traditional uses, ethnomedicinal uses, phytochemistry, pharmacology, toxicology, and safety. Phytochemical studies have shown that the plant contains several bioactive compounds such as rutin, morin, quercetin, caffeic acid, santalbic acid, n-hexadecanoic acid, squalene, nonacosane, hentriacontane, and many more compounds. Also, pharmacological investigations revealed that Olax subscorpioidea has antidepressant, antiepileptic, anti-Alzheimer’s, cytotoxic, antioxidant, antihyperlipidemic, analgesic, antiinflammatory, antiarthritic, antidiabetic, anticancer, antiulcer, antimicrobial, hepatoprotective, apoptotic, antiprotease, and other CNS effects. Conclusion Several pharmacological studies on Olax subscorpioidea have established its ethnopharmacological uses. However, there are limited phytochemical and pharmacological studies to validate other folkloric claims of the plant. Therefore, extensive phytochemical and further pre-clinical efficacy and safety evaluations to fully establish its therapeutic potentials and elucidate its mechanisms of pharmacological actions could be necessary. Graphical abstract

When to Consider Lynch Syndrome in Non-Colon and Non-Endometrial Malignancies

2021 ◽  
pp. 000313482110318
Author(s):  
Aaron J. Arroyave ◽  
Alan W. Good ◽  
Andrew J. Ward ◽  
Amila L. Orucevic ◽  
James M. McLoughlin
Keyword(s):  
Lynch Syndrome ◽  
Review Article ◽  
Genetic Syndrome ◽  
Clinical Criteria ◽  
Dna Mismatch ◽  
Dna Mismatch Repair Genes ◽  
Associated Malignancy ◽  
Revised Bethesda Guidelines ◽  
Current Guidelines ◽  
Repair Genes

Lynch syndrome (LS) is a common genetic syndrome characterized by pathogenic mutations of DNA mismatch repair genes resulting in a hereditary predisposition to cancer. While typically associated with colonic and endometrial cancer, LS additionally influences the development of many other malignancies. The Amsterdam II and Revised Bethesda Guidelines are the established clinical criteria for diagnosing LS. These guidelines are based on the most general characteristics of LS and do not address specific characteristics of the less commonly LS-associated malignancies. For individuals that present initially with a non-colon and non-endometrial malignancy, recommendations and guidelines on when to consider screening for LS are limited. Therefore, it is essential that clinicians are familiar with distinct LS-associated patient- and tumor-specific characteristics, especially of the less common LS-associated cancers, so that LS’s diagnosis is not missed. In this review article, we focus on extra-colonic and extra-endometrial LS-associated cancers, paying particular attention to any established or currently investigated cancer features that help raise suspicion for LS and potentially lead to its earlier diagnosis. This review will also discuss current guidelines specific to each LS-associated malignancy.

scholarly journals SARS-CoV-2: is there neuroinvasion?

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Conor McQuaid ◽  
Molly Brady ◽  
Rashid Deane
Keyword(s):  
Respiratory Distress ◽  
Vascular Dysfunction ◽  
Multiorgan Failure ◽  
Neurological Complications ◽  
Wide Distribution ◽  
The Body ◽  
Health Conditions ◽  
Main Body ◽  
Beneficial Effects ◽  
The Brain

Abstract Background SARS-CoV-2, a coronavirus (CoV), is known to cause acute respiratory distress syndrome, and a number of non-respiratory complications, particularly in older male patients with prior health conditions, such as obesity, diabetes and hypertension. These prior health conditions are associated with vascular dysfunction, and the CoV disease 2019 (COVID-19) complications include multiorgan failure and neurological problems. While the main route of entry into the body is inhalation, this virus has been found in many tissues, including the choroid plexus and meningeal vessels, and in neurons and CSF. Main body We reviewed SARS-CoV-2/COVID-19, ACE2 distribution and beneficial effects, the CNS vascular barriers, possible mechanisms by which the virus enters the brain, outlined prior health conditions (obesity, hypertension and diabetes), neurological COVID-19 manifestation and the aging cerebrovascualture. The overall aim is to provide the general reader with a breadth of information on this type of virus and the wide distribution of its main receptor so as to better understand the significance of neurological complications, uniqueness of the brain, and the pre-existing medical conditions that affect brain. The main issue is that there is no sound evidence for large flux of SARS-CoV-2 into brain, at present, compared to its invasion of the inhalation pathways. Conclusions While SARS-CoV-2 is detected in brains from severely infected patients, it is unclear on how it gets there. There is no sound evidence of SARS-CoV-2 flux into brain to significantly contribute to the overall outcomes once the respiratory system is invaded by the virus. The consensus, based on the normal route of infection and presence of SARS-CoV-2 in severely infected patients, is that the olfactory mucosa is a possible route into brain. Studies are needed to demonstrate flux of SARS-CoV-2 into brain, and its replication in the parenchyma to demonstrate neuroinvasion. It is possible that the neurological manifestations of COVID-19 are a consequence of mainly cardio-respiratory distress and multiorgan failure. Understanding potential SARS-CoV-2 neuroinvasion pathways could help to better define the non-respiratory neurological manifestation of COVID-19.

scholarly journals Evidence Based Care for Couples with Fertility Problems

2019 ◽  
Vol 3 (1) ◽  
pp. 22-28
Author(s):  
Filiz Degirmenci ◽  
Duygu Vefikuluçay Yılmaz ◽  
Asiye Uzel
Keyword(s):  
Review Article ◽  
Care Process ◽  
Evidence Based ◽  
Negative Experience ◽  
Counseling Needs ◽  
Fertility Problems ◽  
One Year ◽  
Evidence Based Care ◽  
Current Guidelines ◽  
Care Nursing

Fertility refers to the occurance and continuation of pregnancy in a period less than one year and the birth of a living baby. Couples may experience fertility problems in the period they want to have children. In this negative experience, nurses, who are the most co-existing health professionals with couples, have a significant role. Evidence-based practice is to show how to give the best care to the patient with the results of researches which conducted carefully and honestly, and yielded clear and accurate decisions. In this respect, nurses should work on the basis of evidence for meeting the education and counseling needs of couples with fertility problems. In this review article, evidence-based education, counseling and evaluation requirements of couples with fertility problems were reviewed in accordance with current guidelines. In addition, comments were made on how to inform nurses about evidence-based care in couples with fertility problems and how they should play a role in the care process. Keywords: Fertility problems; evidence based care; nursing.

scholarly journals Overview and Insights into Carbapenem Allergy

Pharmacy ◽  
2019 ◽  
Vol 7 (3) ◽  
pp. 110 ◽  
Author(s):  
Yuman Lee ◽  
Nicole Bradley
Keyword(s):  
Case Reports ◽  
Review Article ◽  
Limited Data ◽  
Substantial Impact ◽  
Cross Sensitivity ◽  
Search Terms ◽  
Incidence Risk ◽  
Pubmed Search ◽  
The Individual ◽  
Insight Into

Understanding antibiotic allergies and the risk of cross-sensitivity between and within antibiotic classes can have a substantial impact on patient care. The purpose of this review article is to provide insight into carbapenem allergies, describing the overall incidence, risk factors, and in-class cross-sensitivity. A PubMed search was conducted using the following search terms: carbapenem, allergy, cross-sensitivity, incidence, imipenem/cilastatin, meropenem, ertapenem, and doripenem. Article bibliographies and relevant drug monographs were also reviewed. The overall reported incidence of carbapenem allergy is 0.3%–3.7%. Risk of cross-sensitivity between penicillins and carbapenems is less than 1% in patients with a positive penicillin skin test. Data on cross-sensitivity between cephalosporins and carbapenems are limited; however, the risk appears to also be low. No clinical studies have described cross-sensitivity between the carbapenem agents thus far. The limited data available from case reports demonstrates a lack of cross-sensitivity between the individual carbapenems, suggesting that an alternative carbapenem may cautiously be used in patients with a reported carbapenem allergy.

Meta-analysis of the efficacy of moxifloxacin in treating Mycoplasma genitalium infection

2017 ◽  
Vol 28 (11) ◽  
pp. 1106-1114 ◽  
Author(s):  
Yang Li ◽  
Wen-Jing Le ◽  
Sai Li ◽  
Yu-Ping Cao ◽  
Xiao-Hong Su
Keyword(s):  
Treatment Efficacy ◽  
Meta Analysis ◽  
Elimination Rate ◽  
Mycoplasma Genitalium ◽  
Sample Collection ◽  
Cure Rate ◽  
Search Terms ◽  
Quinoline Carboxylic Acid ◽  
Current Guidelines

Mycoplasma genitalium is an important pathogen that is transmitted through sexual contact. For patients diagnosed with M. genitalium infection, the current guidelines recommend 1 g of azithromycin as the first-line treatment. Moxifloxacin is used as a second-line drug due to its remarkable efficacy; however, increased use of moxifloxacin to treat M. genitalium infections has caused the emergence of cases of moxifloxacin treatment failure. This meta-analysis aims to estimate the treatment efficacy of moxifloxacin for M. genitalium infection. Electronic databases were searched for articles published from 1983 to the end of May 2016 using the following search terms: ( Mycoplasma genitalium) AND (moxifloxacin OR 1-cyclopropyl–7-(2,8-diazabicyclo(4.3.0)non-8-yl)-6-fluoro-8-methoxy-1,4-dihydro-4-oxo-3-quinoline carboxylic acid OR Proflox OR moxifloxacin hydrochloride OR Octegra OR Avelox OR Avalox OR Izilox OR Actira OR [treatment efficacy]). All included studies were published in English; all participants were diagnosed with M. genitalium infection, and microbial cure times were measured within 12 months after treatment. Treatment efficacy was measured as microbial cure at the final follow-up after treatment. In total, 17 studies including 252 participants met the inclusion criteria. The majority of these studies were observational. The random-effects pooled microbial cure rate was 96% (95% confidence interval [CI], 90%–99%; I2 = 28.59%, P = 0.13). For studies with sample collection deadlines prior to 2010, the pooled microbial cure rate was 100% (95% CI, 99%–100%; I2 = 0.00%, P = 1.00). For studies with sample collection deadlines of 2010 and later, the pooled microbial cure rate was 89% (95% CI, 82%–94%; I2 = 0.00%, P = 0.59). The elimination rate of moxifloxacin for M. genitalium infection has decreased from 100% to 89% since 2010. This decline merits considerable attention. We suggest close follow-up to investigate the efficacy of moxifloxacin for treating M. genitalium infections. Additionally, sentinel points should be established to detect mutations in the gyrA/B and parC/E genes, which are associated with moxifloxacin resistance.

scholarly journals Patient after myocardial infarction: how to reduce the risk of recurrent ischemic events?

2015 ◽  
Vol 6 (2) ◽  
pp. 12-19
Author(s):  
O. L Barbarash ◽  
V. N Karetnikova ◽  
V. V Kashtalap
Keyword(s):  
Myocardial Infarction ◽  
Dual Antiplatelet Therapy ◽  
Patient Adherence ◽  
Review Article ◽  
Efficacy And Safety ◽  
Factors Affecting ◽  
Coronary Syndromes ◽  
Coronary Events ◽  
Current Guidelines ◽  
Ischemic Events

The review article highlights concerns related to a low survival rate in patients after myocardial infarction (MI) and factors affecting it. The pivotal role is given to the issue of patient adherence to therapy after acute coronary events. The options to improve it as well as mechanisms to optimize medical therapy for patients after myocardial infarction, particularly the need for prolonged dual antiplatelet therapy (DAPT), have been identified. The rationale for changing the current guidelines for the management of patients with acute coronary syndromes (ACS) is based on the findings of the recently completed international clinical trial PE- GASUS-TIMI 54 with ticagrelor (Brilinta®), utilized as part of a DAPT regimen, that have demonstrated the efficacy and safety of DAPT prolongation after 12-month period in post-MI patients.

scholarly journals Management of Psuedomonas Keratitis: a review article

10.3823/813 ◽  
2017 ◽  
Vol 7 (3) ◽  
Author(s):  
Mouna Mohamad Alsaad
Keyword(s):  
Vision Loss ◽  
Review Article ◽  
Topical Steroids ◽  
Drug Resistant ◽  
Corneal Scarring ◽  
Key Factor ◽  
Severe Vision Loss ◽  
Year 2000 ◽  
Current Guidelines

Bacterial keratitis can lead to severe vision loss and corneal scarring, and possibly perforation. Early and appropriate management is a key factor in decreasing and preventing complication. Pubmed and Medline were searched for articles related to Pseudomonas keratitis between year 2000 and  2017 to get current guidelines about the management of Pseudomonas keratitis. These articles are reviewed in this review article and information related to management is summarized.   The most used agents to treat Pseudomonas are either aminoglycosides (usually gentamicin) fortified with a cephalosporin or mono therapy with a fluoroquinolones usually ciprofloxacin. In most areas, most strains of Pseudomonasare sensitive to ciprofloxacin. The role of topical steroids is discussed, as well as, available options for treatment of multi drug resistant Pseudomonas.

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