scholarly journals Immunological and Neurological Manifestations of COVID-19: An Intimate Relationship

2020 ◽  
pp. 111-122
Author(s):  
Muaz Elsayed ◽  
R. Ahmed ◽  
A. Alkhedir ◽  
M. Saeed ◽  
S. El-Sadig
Keyword(s):  
Animal Studies ◽  
English Language ◽  
Literature Search ◽  
Clinical Manifestations ◽  
Severe Pneumonia ◽  
Organ Damage ◽  
Intimate Relationship ◽  
Upper Respiratory Tract ◽  
Neurological Manifestations ◽  
Pubmed Database

Background: COVID-19 has superseded all medical scientific challenges in 2020. It presented with a range of respiratory involvement from the mild upper respiratory tract to severe pneumonia with ARDS. A percentage of these patients manifested variable neurological presentations expanding the challenges of patients’ assessment, care, and management. Objective: To discuss the neurological manifestations and the possible immunopathology of COVID-19. Methods: A literature search was performed in the PubMed database for the relevant articles published in English language between April 9th , 2020 and June 1, 2020. Few papers were extracted from Google Scholar and pre-print material as well. The keywords used to perform search included “COVID-19,” “SARS Cov2,” “neurological manifestations,” and “immunology and pathology of COVID-19”. However, animal studies were excluded in the neurological manifestations, and the final number of literature search outcome was 27 articles. Results: The immunopathology involves angiotensin-converting enzyme (ACE) receptor 2 and spike protein S1. COVID-19 has a tremendous affinity to the ACE2 receptor. The status of secondary hemophagocytic lymphohistiocytosis (sHLH) and the cytokine storm lead to different organ damage and the corresponding clinical manifestations. The documented neurological manifestations mainly include acute ischemic stroke, hemorrhagic stroke, temporal lobe, thalamic encephalitis, and one case of Guillain-Barre Syndrome, in addition to agitation, headache, and seizures. Conclusion: Although the intimate relationship between the neurons and the immune activation is the basic concept of COVID-19 immunopathology, the definite routes of entry to the neuronal cells are yet to be disclosed. Acute stroke, myositis, headache, and meningoencephalitis are the most common types of complications of COVID-19 so far.

scholarly journals CHILDREN IN CORONAVIRUSES’ WONDERLAND: WHAT CLINICIANS NEED TO KNOW

2020 ◽  
Vol 12 (1) ◽  
pp. e2020042
Author(s):  
Giuseppe Lassandro ◽  
Valentina  Palladino ◽  
Anna Amoruso ◽  
Viviana Palmieri ◽  
Giovanna Russo ◽  
...  
Keyword(s):  
Respiratory Infections ◽  
Multiorgan Failure ◽  
Clinical Manifestations ◽  
Severe Pneumonia ◽  
Signs And Symptoms ◽  
Upper Respiratory Tract ◽  
Respiratory Tract Illnesses ◽  
Life Threatening ◽  
Human Coronaviruses ◽  
Coronavirus Infections

Human coronaviruses (HCoVs) commonly cause mild upper-respiratory tract illnesses but can lead to more severe and diffusive diseases. A variety of signs and symptoms may be present, and infections can range in severity from common cold and sore throat to more serious laryngeal or tracheal infections, bronchitis, and pneumonia. Among the seven coronaviruses that affect humans, (SARS)-CoV, the Middle East respiratory syndrome (MERS)-CoV and the most recent coronavirus disease 2019 (COVID-19) represent potential life-threatening diseases worldwide. In adults they may cause severe pneumonia that evolve in distress respiratory syndrome and multiorgan failure with a high mortality rate. Children appear to be less susceptible to develop severe clinical disease and present usually with mild and aspecific symptoms similar to other respiratory infections typical of childhood. However, some children such as infants, adolescents or those with underlying diseases may be more at-risk categories and require greater caution from clinicians. Available data on pediatric coronavirus infections are rare and scattered in the literature. The purpose of this review is to provide to clinicians a complete and updated panel useful to recognize and characterize the broad spectrum of clinical manifestations of coronavirus infections in the pediatric age.

scholarly journals Upper respiratory tract and otolaryngological manifestations of coronavirus disease 2019 (COVID-19): A systemic review

2021 ◽  
Vol 9 ◽  
pp. 205031212110169
Author(s):  
Jamil N Al-Swiahb ◽  
Mohammed A Motiwala
Keyword(s):  
Sore Throat ◽  
Clinical Presentation ◽  
Wide Spectrum ◽  
Research Question ◽  
Clinical Manifestations ◽  
Systemic Review ◽  
Cochrane Library ◽  
Lower Airway ◽  
Upper Respiratory Tract ◽  
Pubmed Database

To detect, analyze, and discuss the different ear nose throat manifestations, those were reported in coronavirus disease-positive patients in the published and reviewed literature. Coronavirus disease has been reported to present with several symptoms. Common symptoms include new onset of fever, cough, fatigue, and myalgia. Other symptoms like sputum production, dyspnea, rhinorrhea, anosmia, nasal stuffiness, headache, and sore throat are less frequently reported, but the clinical presentation is highly variable among individuals. We review the otolaryngologic manifestations of coronavirus disease reported in the published literature to assess its importance in the early diagnosis of coronavirus disease. We searched PubMed database, MEDLINE, Web of Science, LILACS, SciELO, and Cochrane Library to find out relevant articles, using the following keywords: COVID-19, clinical features, characteristics, symptoms, clinical, manifestations, throat, cough, rhinorrhea, COVID-19 anosmia, headache, nasal, coronavirus, and coronavirus otolaryngologic. Article selection was based on their relevance to the research question. Totally, 14 articles and 2971 patients were recruited for our study. A wide variety of upper and lower airway manifestations were reported. Fever (34%–96.5%), cough (17.9%–83%), myalgia or fatigue (10%–31%), expectoration (20%–32.7%), dyspnea (7.6%–7.5%), rhinorrhea (1%–6.8%), sore throat (4%–61%), nasal congestion (3%–4.8%), and headache (3%–16.2%) were the most common symptoms reported. Our findings confirm that coronavirus disease infection presents with a wide spectrum of clinical presentation. The ear nose throat manifestations for coronavirus disease are not uncommon, but more attention should also be paid to patients with otolaryngologic symptoms which can appear early, as this could encourage an earlier diagnosis and treatment, which limits spread of the disease.

Restlessness: The Anatomy of a Neuropsychiatric Symptom

1996 ◽  
Vol 30 (1) ◽  
pp. 38-53 ◽  
Author(s):  
Perminder Sachdev ◽  
Jane Kruk
Keyword(s):  
Key Words ◽  
Animal Studies ◽  
Literature Search ◽  
Clinical Manifestations ◽  
Neuropsychiatric Symptom ◽  
Neuronal Circuits ◽  
Complex Regulation ◽  
Underlying Mechanisms

Objective: The aim of the paper is to review the literature on restlessness and related syndromes in order to examine the different causes and clinical descriptions, and to present a pathogenetic model that would incorporate its diverse aetiology. Method: A literature search was undertaken with restlessness, agitation, akathisia, hyperactivity, fidgetiness and jitteriness as key words. Results: Causes of restlessness are diverse, and its distinction from other descriptions, such as agitation and hyperactivity, is poorly defined in the literature. Detailed descriptions of the syndromes are therefore lacking. The neuroanatomical basis of restlessness may consist of abnormalities in the corticc-subcortical neuronal circuits, the complex regulation of which may explain why different causes often lead to a common end result. Conclusions: The terms used to describe restlessness and related disorders should be standardised, and the clinical manifestations investigated pedanti- cally. Human and animal studies should investigate the pathophysiology so that intervention can be based on the underlying mechanisms.

scholarly journals Systematic review of prehospital haemostatic dressings

2019 ◽  
Vol 166 (3) ◽  
pp. 194-200 ◽  
Author(s):  
Matthew Welch ◽  
J Barratt ◽  
A Peters ◽  
C Wright
Keyword(s):  
Systematic Review ◽  
Animal Studies ◽  
English Language ◽  
Literature Search ◽  
Clinical Evidence ◽  
Grey Literature ◽  
High Quality ◽  
Exclusion Criteria ◽  
Military Forces ◽  
Language Studies

IntroductionHaemorrhage is one of the leading causes of battlefield and prehospital death. Haemostatic dressings are an effective method of limiting the extent of bleeding and are used by military forces extensively. A systematic review was conducted with the aim of collating the evidence on current haemostatic products and to assess whether one product was more effective than others.MethodsA systematic search and assessment of the literature was conducted using 13 health research databases including MEDLINE and CINAHL, and a grey literature search. Two assessors independently screened the studies for eligibility and quality. English language studies using current-generation haemostatic dressings were included. Surgical studies, studies that did not include survival, initial haemostasis or rebleeding and those investigating products without prehospital potential were excluded.Results232 studies were initially found and, after applying exclusion criteria, 42 were included in the review. These studies included 31 animal studies and 11 clinical studies. The outcomes assessed were subject survival, initial haemostasis and rebleeding. A number of products were shown to be effective in stopping haemorrhage, with Celox, QuikClot Combat Gauze and HemCon being the most commonly used, and with no demonstrable difference in effectiveness.ConclusionsThere was a lack of high-quality clinical evidence with the majority of studies being conducted using a swine haemorrhage model. Iterations of three haemostatic dressings, Celox, HemCon and QuikClot, dominated the studies, probably because of their use by international military forces and all were shown to be effective in the arrest of haemorrhage.

Novel Therapeutic Approaches and Targets for Treatment of Chronic Urticaria: New Insights and Promising Targets for a Challenging Disease

2020 ◽  
Vol 22 (1) ◽  
pp. 32-45
Author(s):  
Emanuela Martina ◽  
Federico Diotallevi ◽  
Tommaso Bianchelli ◽  
Matteo Paolinelli ◽  
Annamaria Offidani
Keyword(s):  
English Language ◽  
Life Experience ◽  
Case Reports ◽  
Immunosuppressive Agents ◽  
Real Life ◽  
Chronic Spontaneous Urticaria ◽  
New Targets ◽  
Current State ◽  
Pubmed Database ◽  
Novel Drugs

Background: Chronic Spontaneous Urticaria (CSU) is a disease characterized by the onset of wheals and/or angioedema over 6 weeks. The pathophysiology for CSU is very complex, involving mast cells and basophils with a multitude of inflammatory mediators. For many years the treatment of CSU has been based on the use of antihistamines, steroids and immunosuppressive agents with inconstant and frustrating results. The introduction of omalizumab, the only licensed biologic for antihistamine- refractory CSU, has changed the management of the disease. Objective: The aim of this article is to review the current state of the art of CSU, the real-life experience with omalizumab and the promising drugs that are under development. Methods:: An electronic search was performed to identify studies, case reports, guidelines and reviews focused on the new targets for the treatment of chronic spontaneous urticaria, both approved or under investigation. The search was limited to articles published in peer-reviewed journals in the English Language in the PubMed database and trials registered in Clinicaltrials.gov. Results:: Since the advent of omalizumab, the search for new therapies for chronic spontaneous urticaria has had a new impulse. Anti-IgE drugs will probably still be the cornerstone of therapy, but new targets may prove effective in syndromic urticaria or refractory cases. Conclusion:: Although omalizumab has been a breakthrough in the treatment of CSU, many patients do not completely get benefit and even require more effective treatments. Novel drugs are under investigation with promising results.

Covid-19 and Autoimmune Diseases: A Systematic Review of Reported Cases

2020 ◽  
Vol 16 ◽  
Author(s):  
Mariam Ahmed Saad ◽  
Mostafa Alfishawy ◽  
Mahmoud Nassar ◽  
Mahmoud Mohamed ◽  
Ignatius N Esene ◽  
...  
Keyword(s):  
Systematic Review ◽  
Autoimmune Disease ◽  
Kawasaki Disease ◽  
Autoimmune Diseases ◽  
English Language ◽  
Clinical Evidence ◽  
Eligibility Criteria ◽  
Thrombocytopenic Purpura ◽  
Pubmed Database ◽  
Viral Illness

Introduction: Over 4.9 million cases of Coronavirus disease 2019 (COVID-19) have been confirmed since the worldwide pandemic began. Since the emergence of COVID-19, a number of confirmed cases reported autoimmune manifestations. Herein, we reviewed the reported COVID-19 cases with associated autoimmune manifestations. Methods: We searched PubMed database using all available keyword for COVID-19. All related studies between January 1st, 2020 to May 22nd, 2020 were reviewed. Only studies published in English language were considered. Articles were screened based on titles and abstract. All reports of confirmed COVID-19 patients who have associated clinical evidence of autoimmune disease were selected. Results: Among 10006 articles, searches yielded, Thirty-two relevant articles for full-text assessment. Twenty studies meet the eligibility criteria. The twenty eligible articles reported 33 cases of confirmed COVID-19 diagnosis who developed an autoimmune disease after the onset of covid-19 symptoms. Ages of patients varied from a 6 months old infant to 89 years old female (Mean=53.9 years of 28 cases); five cases had no information regarding their age. The time between symptoms of viral illness and onset of autoimmune symptoms ranged from 2 days to 33 days (Mean of the 33 cases=9.8 days). Autoimmune diseases were one case of subacute thyroiditis (3%), two cases of Kawasaki Disease (6.1%), three cases of coagulopathy and antiphospholipid syndrome (9.1%), three cases of immune thrombocytopenic purpura (9.1%), eight cases of autoimmune hemolytic anemia (24.2%), and sixteen cases of Guillain–Barré syndrome (48.5%). Conclusions: COVID-19 has been implicated in the development in a range of autoimmune diseases which may shed a light on the association between autoimmune diseases and infections.

Malignant Pleural Effusion: Still a Long Way to Go

2019 ◽  
Vol 14 (1) ◽  
pp. 24-30 ◽  
Author(s):  
Fausto Meriggi
Keyword(s):  
Pleural Effusion ◽  
Malignant Pleural Effusion ◽  
English Language ◽  
Metastatic Cancer ◽  
Primary Tumour ◽  
Clinical Problem ◽  
Therapeutic Options ◽  
High Morbidity ◽  
Sclerosing Agents ◽  
Pubmed Database

Background:Malignant pleural effusion, which is a common clinical problem in patients with cancer, may be due to both primary thoracic tumours or to a metastatic spread in the chest and constitutes the first sign of disease in approximately 10% of patients. Almost all cancers can potentially produce a pleural effusion. The presence of malignant tumour cells in the pleural fluid is generally indicative of advanced disease and is associated with high morbidity and mortality with reduced therapeutic options. Dyspnoea during mild physical activity or at rest is generally the typical sign of restrictive respiratory failure. </P><P> Methods: This is a systematic review of all the main articles in the English language on the topic of malignant pleural effusion and reported by the Pubmed database from 1959 to 2018. I reviewed the literature and guidelines with the aims to focus on what is known and on future pathways to follow the diagnosis and treatment of malignant pleural effusions.Results:The main goal of palliation of a malignant pleural effusion is a quick improvement in dyspnoea, while thoracentesis under ultrasound guidance is the treatment of choice for patients with a limited life expectancy or who are not candidates for more invasive procedures such as drainage using an indwelling small pleural catheter, chemical pleurodesis with sclerosing agents, pleurectomy or pleuro-peritoneal shunt.Conclusion:Despite progress in therapeutic options, the prognosis remains severe, and the average survival is 4-9 months from the diagnosis of malignant pleural effusion. Moreover, mortality is higher for patients with malignant pleural effusion compared with those with metastatic cancer but no malignant pleural effusion. Therefore, the prognosis of these patients primarily depends on the underlying disease and the extension of a primary tumour. This review focuses on the most relevant updates in the management of malignant pleural effusion.

Scabies: A Neglected Global Disease

2020 ◽  
Vol 16 (1) ◽  
pp. 33-42 ◽  
Author(s):  
Alexander K.C. Leung ◽  
Joseph M. Lam ◽  
Kin F. Leong
Keyword(s):  
English Language ◽  
Clinical Manifestations ◽  
Skin Lesions ◽  
Sarcoptes Scabiei ◽  
Clinical Findings ◽  
Effective Control ◽  
Search Term ◽  
Skin Contact ◽  
Intense Pruritus ◽  
Meta Analyses

Background: Scabies is a skin disease caused by an obligate human parasite mite Sarcoptes scabiei var. hominis. Children under the age of two and elderly individuals are at the greatest risk. Knowledge of this condition is important for an early diagnosis to be made and treatment to be initiated. Objective: The review aimed to familiarize physicians with the clinical manifestations, diagnosis, evaluation, and management of scabies. Methods: A search was conducted using Pubmed with the built-in "Clinical Queries" tool. The search term "Scabies" was used. The categories of "epidemiology", "diagnosis", "therapy", "prevention" and "prognosis" had a limited scope for primary clinical studies. Meta-analyses, randomized controlled trials, clinical trials, observational studies, and reviews were included. Only papers published in the English language were included. A descriptive, narrative synthesis was provided of the retrieved articles. Results: Worldwide, scabies affects 200 to 300 million individuals annually. The average prevalence is estimated to be 5 to 10% in children of developing countries. Transmission usually occurs after close prolonged skin-to-skin contact. Classic scabies is characterized by an erythematous papular eruption, serpiginous burrows, and intense pruritus. Sites of predilection include the webs of the fingers, volar wrists, lateral aspects of fingers, extensor surfaces of elbows and knees, waist, navel, abdomen, buttocks, groins, and, genitals. A clinical diagnosis of classic scabies can be made on the basis of the history and clinical findings. Other clinical variants include crusted scabies, nodular scabies, and bullous scabies. Finding the mite, ova, or fecal pellets on microscopic examination of scrapings taken from skin lesions confirms the diagnosis of scabies infestation. For eradication of scabies mites, the drugs of choice are topical permethrin and oral ivermectin. Conclusion: Scabies is a highly contagious parasitic cutaneous disease that is stigmatising and debilitating. Increased awareness, accurate diagnosis, and prompt treatment are essential for the effective control of scabies and for the prevention of the spread of the disease.

scholarly journals A systematic review of historical and current trends in Chagas disease

2021 ◽  
Vol 8 ◽  
pp. 204993612110337
Author(s):  
Diego-Abelardo Álvarez-Hernández ◽  
Rodolfo García-Rodríguez-Arana ◽  
Alejandro Ortiz-Hernández ◽  
Mariana Álvarez-Sánchez ◽  
Meng Wu ◽  
...  
Keyword(s):  
Systematic Review ◽  
Chagas Disease ◽  
Case Reports ◽  
Clinical Manifestations ◽  
Human Case ◽  
Acute Stage ◽  
Diagnostic Tools ◽  
Chronic Stage ◽  
Pubmed Database ◽  
Trypanocidal Drugs

Introduction: Chagas disease (CD) is caused by Trypanosoma cruzi. When acquired, the disease develops in stages. For diagnosis, laboratory confirmation is required, and an extensive assessment of the patient’s health should be performed. Treatment consists of the administration of trypanocidal drugs, which may cause severe adverse effects. The objective of our systematic review was to analyze data contained in the CD published case reports to understand the challenges that patients and clinicians face worldwide. Materials and methods: We performed a systematic review following the PRISMA guidance. PubMed database was explored using the terms ‘American trypanosomiasis’ or ‘Chagas disease’. Results were limited to human case reports written in English or Spanish. A total of 258 reports (322 patients) were included in the analysis. Metadata was obtained from each article. Following this, it was analyzed to obtain descriptive measures. Results: From the sample, 56.2% were males and 43.8% were females. Most cases were from endemic countries (85.4%). The most common clinical manifestations were fever during the acute stage (70.0%), dyspnea during the chronic stage in its cardiac form (53.7%), and constipation during the chronic stage in its digestive form (73.7%). Most patients were diagnosed in the chronic stage (72.0%). Treatment was administered in 56.2% of cases. The mortality rate for the acute stage cases was 24.4%, while for the chronic stage this was 28.4%. Discussion: CD is a parasitic disease endemic to Latin America, with increasing importance due to human and vector migration. In this review, we report reasons for delays in diagnosis and treatment, and trends in medical practices. Community awareness must be increased to improve CD’s diagnoses; health professionals should be appropriately trained to detect and treat infected individuals. Furthermore, public health policies are needed to increase the availability of screening and diagnostic tools, trypanocidal drugs, and, eventually, vaccines.

scholarly journals The hospital telemedicine TELEMED database: Providing information on evidence-based telemedicine services to hospital managers and healthcare professionals

2021 ◽  
pp. 1357633X2110155
Author(s):  
Kristian Kidholm ◽  
Ida W Svendsen ◽  
Knud Yderstræde ◽  
Anne M Ølholm ◽  
Kathrine Rayce ◽  
...  
Keyword(s):  
Literature Search ◽  
Healthcare Professionals ◽  
Economic Effects ◽  
Control Group ◽  
Evidence Based ◽  
Implementation Challenges ◽  
Hospital Managers ◽  
Pubmed Database ◽  
Significant Difference ◽  
Hospital Patients

Background Increased use of telemedicine in the healthcare system is a political goal in Denmark. Although the number of hospital patients using interventions such as the video consultation has increased in recent years only a small proportion of the outpatient and inpatient visits involve telemedicine. The TELEMED database ( https://telemedicine.cimt.dk/ ) has been launched at the Center for Innovative Medical Technologies in Denmark to ensure that hospital managers and healthcare professionals have access to information about telemedicine services and their effectiveness. This article describes the development and the content of the TELEMED database. Methods A structured literature search was made in the PubMed Database for randomised controlled trials or observational studies with a control group that investigated the effect of telemedicine interventions for hospital patients. Data were extracted from each article on the clinical effectiveness, patient perceptions, economic effects and implementation challenges. As the database should only provide inspiration to healthcare professionals regarding possibilities for use of telemedicine, the risk of bias in the studies was not assessed. Results The literature search resulted in 2825 hits. Based on full text assessment, 331 articles were included for data extraction and assessment. These articles present telemedicine services used in 22 different medical specialities. Forty-eight percent of the studies found a positive, statistically significant clinical effect, while 47% showed no statistically significant difference. In 48% of the studies, patients’ experiences were examined and of these 68% found positive patient experiences. Fifty-four percent of the articles included information on the economic effects and, of these, 51% found reduction in healthcare utilization. In the majority of studies between two and four types of implementation challenges were found. Conclusions and recommendations: The TELEMED database provides an easily accessible overview of existing evidence-based telemedicine services for use by hospital managers and health professionals, who whish to to implement telemedicine. The database is freely available and expected to be continuously improved and broadened over time.

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