New Doctrine and Principles of Treatment of Acute Inflammation of the Lung Tissue

Modern ideas about the nature of acute inflammatory processes in the lungs are focused on the leading significance of the etiology of the disease. The predominance of this concept defines etiotropic therapy as the basis for providing medical care to this category of patients. In fact, the causative agent of acute pneumonia in most patients remains unknown or the accuracy of its diagnosis is questionable. At the same time, the targeted use of etiotropic drugs is always delayed due to the delay in the results of microbiological diagnostics. Recently, these difficulties of etiotropic therapy have been compounded by an increase in the number of patients with viral lung inflammation and the lack of effective antiviral drugs.

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What the History of Medical Care for Acute Lung Inflammation Teaches Us

Archives of Health Science ◽

10.31829/2641-7456/ahs2021-5(1)-008 ◽

2021 ◽

pp. 1-5

Keyword(s):

Medical Care ◽

Lung Inflammation ◽

The State ◽

Acute Lung Inflammation ◽

Historical Experience ◽

The Past ◽

Number Of Patients ◽

Acute Pneumonia ◽

History Of ◽

Usual Scheme

Historical experience in any discipline is invaluable for its future, as the study of the results of previous practice allows you to use and develop on a new level previous successes and achievements, but at the same time avoid the mistakes of the past. Looking from these positions at the state of the problem of acute pneumonia (AP), it seems that this disease, which has more than two and a half thousand years of fame, does not have any worthy results of centuries of experience. This is not just a statement, it is a statement of fact. Today, when a large number of patients with coronavirus pneumonia appeared, it turned out that there is no reasonable treatment for this situation, and its search is conducted in a "combat situation" and actually from a "clean slate". There is no doubt that many experts, after reading such an assessment, immediately parry it, saying that we are talking about a new pathogen, against which there are no specific means yet. But this is only a small part of the circumstances. The fact is that the usual scheme of fighting the pathogen, created over the past decades, has long turned into a leading didactic and practical dogma, replacing a logical scientific and clinically based program of medical care for a specific disease.

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Look at the COVID-19 Pandemic with an Open Mind

Archives of Health Science ◽

10.31829/2641-7456/ahs2021-5(1)-004 ◽

2021 ◽

pp. 1-6

Keyword(s):

Lung Tissue ◽

Causative Agent ◽

Clinical Picture ◽

Modern Concept ◽

Open Mind ◽

Usual Treatment ◽

Acute Pneumonia ◽

Current Events ◽

Coronavirus Infection ◽

Definition Of

Our assessment of various events and phenomena depends, first of all, on our baggage of acquired knowledge, established stereotypes and worldviews. It is this kind of bias that affects the definition of our goals, decisions and specific actions, which often go against the observed facts and lose sight of important features of the object being studied. The way experts perceive the current COVID-19 pandemic is one typical example of such a biased interpretation. The basis of the clinical picture of coronavirus infection is a lesion of the lung tissue, which, according to clinical and radiological and pathoanatomical data, is defined as viral inflammation and corresponds to the nosology "acute pneumonia" (AP)(1-4). According to the modern concept of AP, the only and main cause of this disease is considered to be its causative agent. This view of the nature of the AP is generally consistent with current events. Indeed, coronavirus infection causes inflammation of the lung tissue. At the same time, the usual treatment of AP with etiotropic drugs is unattainable in coronavirus infection due to the lack of such drugs.

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A Multi-Objective Optimization Method for Hospital Admission Problem—A Case Study on Covid-19 Patients

Algorithms ◽

10.3390/a14020038 ◽

2021 ◽

Vol 14 (2) ◽

pp. 38

Author(s):

Amr Mohamed AbdelAziz ◽

Louai Alarabi ◽

Saleh Basalamah ◽

Abdeltawab Hendawi

Keyword(s):

Medical Care ◽

Real Life ◽

Optimization Method ◽

Multi Objective Optimization ◽

Admission Process ◽

Multi Objective ◽

Admission Time ◽

King Faisal Specialist Hospital ◽

Number Of Patients ◽

Massive Number

The wide spread of Covid-19 has led to infecting a huge number of patients, simultaneously. This resulted in a massive number of requests for medical care, at the same time. During the first wave of Covid-19, many people were not able to get admitted to appropriate hospitals because of the immense number of patients. Admitting patients to suitable hospitals can decrease the in-bed time of patients, which can lead to saving many lives. Also, optimizing the admission process can minimize the waiting time for medical care, which can save the lives of severe cases. The admission process needs to consider two main criteria: the admission time and the readiness of the hospital that will accept the patients. These two objectives convert the admission problem into a Multi-Objective Problem (MOP). Pareto Optimization (PO) is a common multi-objective optimization method that has been applied to different MOPs and showed its ability to solve them. In this paper, a PO-based algorithm is proposed to deal with admitting Covid-19 patients to hospitals. The method uses PO to vary among hospitals to choose the most suitable hospital for the patient with the least admission time. The method also considers patients with severe cases by admitting them to hospitals with the least admission time regardless of their readiness. The method has been tested over a real-life dataset that consisted of 254 patients obtained from King Faisal specialist hospital in Saudi Arabia. The method was compared with the lexicographic multi-objective optimization method regarding admission time and accuracy. The proposed method showed its superiority over the lexicographic method regarding the two criteria, which makes it a good candidate for real-life admission systems.

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Methods of early diagnostics of severe pneumonia in children

NATURE AND SCIENCE ◽

10.36719/2707-1146/04/43-46 ◽

2020 ◽

Vol 03 (04) ◽

pp. 43-46

Author(s):

Sabir Nurgalam Amiraliev ◽

Keyword(s):

Young Children ◽

Key Words ◽

Lung Tissue ◽

Tissue Damage ◽

Severe Pneumonia ◽

Early Diagnostics ◽

Key Words Pneumonia ◽

Pneumonia Severity ◽

Acute Pneumonia ◽

Lung Tissue Damage

Studies have shown that the severity and outcome of acute pneumonia largely depends on the prevalence of the focus of inflammation in the lung tissue, which is determined radiologically. We analyzed and determined a statistically significant effect of the degree of lung tissue damage on the severity and prognosis of pneumonia in young children, taking into account the conditions of infection. In pneumonia, χ² = 47.13 (p <0.001), indicates that the greater the degree of damage, the greater the likelihood of a severe course and unfavorable outcome of pneumonia. Key words: pneumonia, severity of the course, outcome, young children

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Enhanced Infiltration of Central Memory T Cells to the Lung Tissue during Allergic Lung Inflammation

International Archives of Allergy and Immunology ◽

10.1159/000518835 ◽

2021 ◽

pp. 1-15

Author(s):

Mashael Alabed ◽

Asma Sultana Shaik ◽

Narjes Saheb Sharif-Askari ◽

Fatemeh Saheb Sharif-Askari ◽

Shirin Hafezi ◽

...

Keyword(s):

T Cells ◽

T Cell ◽

Lung Tissue ◽

Lung Inflammation ◽

Inflammatory Responses ◽

Memory T Cells ◽

Central Memory ◽

Effector Memory ◽

Differential Distribution ◽

Allergic Lung Inflammation

Memory T cells play a central role in regulating inflammatory responses during asthma. However, tissue distribution of effector memory (TEM) and central memory (TCM) T-cell subtypes, their differentiation, and their contribution to the persistence of lung tissue inflammation during asthma are not well understood. Interestingly, an increase in survival and persistence of memory T cells was reported in asthmatic lungs, which may suggest a shift toward the more persistent TCM phenotype. In this report, we investigated the differential distribution of memory T-cell subtypes during allergic lung inflammation and the mechanism regulating that. Using an OVA-sensitized asthma mouse model, we observed a significant increase in the frequency of TCM cells in inflamed lungs compared to healthy controls. Interestingly, adoptive transfer techniques confirmed substantial infiltration of TCM cells to lung tissues during allergic airway inflammation. Expression levels of TCM homing receptors, CD34 and GlyCAM-1, were also significantly upregulated in the lung tissues of OVA-sensitized mice, which may facilitate the increased TCM infiltration into inflamed lungs. Moreover, a substantial increase in the relative expression of TCM profile-associated genes (EOMES, BCL-6, ID3, TCF-7, BCL-2, BIM, and BMI-1) was noted for TEM cells during lung inflammation, suggesting a shift for TEM into the TCM state. To our knowledge, this is the first study to report an increased infiltration of TCM cells into inflamed lung tissues and to suggest differentiation of TEM to TCM cells in these tissues. Therapeutic interference at TCM infiltration or differentiations could constitute an alternative treatment approach for lung inflammation.

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Longitudinal characterization of a model of chronic allergic lung inflammation in mice using imaging, functional and immunological methods

Clinical Science ◽

10.1042/cs20130086 ◽

2013 ◽

Vol 125 (12) ◽

pp. 555-564 ◽

Cited By ~ 5

Author(s):

Kumar Changani ◽

Catherine Pereira ◽

Simon Young ◽

Robert Shaw ◽

Simon P. Campbell ◽

...

Keyword(s):

Lung Tissue ◽

Lung Inflammation ◽

Allergic Inflammation ◽

Treated Group ◽

Similar Rate ◽

Immunological Methods ◽

Tissue Density ◽

Cell Counts ◽

Rate Of Increase ◽

Tissue Changes

The present study investigated the role that imaging could have for assessing lung inflammation in a mouse model of HDM (house dust mite)-provoked allergic inflammation. Inflammation is usually assessed using terminal procedures such as BAL (bronchoalveolar lavage) and histopathology; however, MRI (magnetic resonance imaging) and CT (computed tomography) methods have the potential to allow longitudinal, repeated study of individual animals. Female BALB/c mice were administered daily either saline, or a solution of mixed HDM proteins sufficient to deliver a dose of 12 or 25 μg total HDM protein±budesonide (1 mg/kg of body weight, during weeks 5–7) for 7 weeks. AHR (airway hyper-responsiveness) and IgE measurements were taken on weeks 3, 5 and 7. Following imaging sessions at weeks 3, 5 and 7 lungs were prepared for histology. BAL samples were taken at week 7 and lungs prepared for histology. MRI showed a gradual weekly increase in LTI (lung tissue intensity) in animals treated with HDM compared with control. The 25 μg HDM group showed a continual significant increase in LTI between weeks 3 and 7, the 12 μg HDM-treated group showed a similar rate of increase, and plateaued by week 5. A corresponding increase in AHR, cell counts and IgE were observed. CT showed significant increases in lung tissue density from week 1 of HDM exposure and this was maintained throughout the 7 weeks. Budesonide treatment reversed the increase in tissue density. MRI and CT therefore provide non-invasive sensitive methods for longitudinally assessing lung inflammation. Lung tissue changes could be compared directly with the classical functional and inflammatory readouts, allowing more accurate assessments to be made within each animal and providing a clinically translatable approach.

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Epidemiology of Visceral Mycoses: Analysis of Data in Annual of the Pathological Autopsy Cases in Japan

Journal of Clinical Microbiology ◽

10.1128/jcm.37.6.1732-1738.1999 ◽

1999 ◽

Vol 37 (6) ◽

pp. 1732-1738 ◽

Cited By ~ 84

Author(s):

Toshikazu Yamazaki ◽

Hikaru Kume ◽

Setsuko Murase ◽

Eriko Yamashita ◽

Mikio Arisawa

Keyword(s):

Medical Care ◽

Japanese Society ◽

Antifungal Drugs ◽

Pulmonary Aspergillosis ◽

Hematopoietic System ◽

Mycotic Infection ◽

Number Of Patients ◽

Severe Infections ◽

Annual Total ◽

Immunocompromised State

The data on visceral mycoses that had been reported in theAnnual of the Pathological Autopsy Cases in Japan from 1969 to 1994 by the Japanese Society of Pathology were analyzed epidemiologically. The frequency of visceral mycoses among the annual total number of pathological autopsy cases increased noticeably from 1.60% in 1969 to a peak of 4.66% in 1990. Among them, the incidences of candidiasis and aspergillosis increased the most. After 1990, however, the frequency of visceral mycoses decreased gradually. Until 1989, the predominant causative agent was Candida, followed in order by Aspergillus and Cryptococcus. Although the rate of candidiasis decreased by degrees from 1990, the rate of aspergillosis increased up to and then surpassed that of candidiasis in 1991. Leukemia was the major disease underlying the visceral mycoses, followed by solid cancers and other blood and hematopoietic system diseases. Severe mycotic infection has increased over the reported 25-year period, from 6.6% of the total visceral mycosis cases in 1969 to 71% in 1994. The reasons for this decrease of candidiasis combined with an increase of aspergillosis or of severe mycotic infection might be that (i) nonsevere (not disseminated) infections were excluded from the case totals, since they have become controllable by antifungal drugs such as fluconazole, but (ii) the available antifungal drugs were not efficacious against severe infections such as pulmonary aspergillosis, and (iii) the number of patients living longer in an immunocompromised state had increased because of developments in chemotherapy and progress in medical care.

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Enhanced clearance of surfactant protein D during LPS-induced acute inflammation in rat lung

AJP Lung Cellular and Molecular Physiology ◽

10.1152/ajplung.2001.281.1.l268 ◽

2001 ◽

Vol 281 (1) ◽

pp. L268-L277 ◽

Cited By ~ 28

Author(s):

Joel F. Herbein ◽

Jo Rae Wright

Keyword(s):

Host Defense ◽

Lung Tissue ◽

Pulmonary Surfactant ◽

Acute Inflammation ◽

Surfactant Protein ◽

Enzymatic Digestion ◽

Time Dependent ◽

Surfactant Protein D ◽

Rat Lung ◽

Secretion Clearance

Pulmonary surfactant participates in the regulation of alveolar compliance and lung host defense. Surfactant homeostasis is regulated through a combination of synthesis, secretion, clearance, recycling, and degradation of surfactant components. The extracellular pool size of surfactant protein (SP) D fluctuates significantly during acute inflammation. We hypothesized that changes in SP-D levels are due, in part, to altered clearance of SP-D. Clearance pathways in rats were assessed with fluorescently labeled SP-D that was instilled into control lungs or lungs that had been treated with lipopolysaccharide (LPS) 16 h earlier. SP-D clearance from lavage into lung tissue was time dependent from 5 min to 1 h and 1.7-fold greater in LPS-treated lungs than in control lungs. Analysis of cells isolated by enzymatic digestion of lung tissue revealed differences in the SP-D-positive cell population between groups. LPS-treated lungs had 28.1-fold more SP-D-positive tissue-associated neutrophils and 193.6-fold greater SP-D association with those neutrophils compared with control lungs. These data suggest that clearance of SP-D into lung tissue is increased during inflammation and that tissue-associated neutrophils significantly contribute to this process.

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CD4+ cells are required for chronic eosinophilic lung inflammation but not airway remodeling

AJP Lung Cellular and Molecular Physiology ◽

10.1152/ajplung.90543.2008 ◽

2009 ◽

Vol 296 (2) ◽

pp. L229-L235 ◽

Cited By ~ 38

Author(s):

Taylor A. Doherty ◽

Pejman Soroosh ◽

David H. Broide ◽

Michael Croft

Keyword(s):

T Cells ◽

Cd4 T Cells ◽

Lung Inflammation ◽

Chronic Exposure ◽

Acute Inflammation ◽

Airway Remodeling ◽

Allergen Challenge ◽

Cd4 Cells ◽

Inkt Cells ◽

Subepithelial Fibrosis

The contribution of CD4 T cells and other CD4+ cells to lung inflammation and airway remodeling remains unclear during bouts of chronic exposure to airborne allergen. Previously, murine models have shown that CD4 T cells are required for initiation of acute inflammation and the remodeling process. However, it is unknown whether CD4 T cells or other CD4+ cells continue to be required for remodeling during ongoing allergen challenges after the development of acute eosinophilic lung inflammation. To test this, mice were sensitized and challenged with ovalbumin (OVA). After acute airway inflammation was established, a CD4 depleting antibody was administered for 4 wk during a period of chronic exposure to intranasal OVA, resulting in effective depletion of CD4+ cells from all organs, including the lung, lung-draining lymph nodes, and spleen. In these mice, levels of peribronchial inflammation, bronchoalveolar (BAL) eosinophils, and lung CD11c+, CD8+, and Siglec-F+CD11c- cells were significantly reduced. However, mucus metaplasia, peribronchial subepithelial fibrosis, and smooth muscle mass were not affected. Additionally, depletion of CD4+ cells before the last week of chronic allergen challenges also led to significant reductions in BAL eosinophils, peribronchial inflammation, and lung CD11c+, CD8+, and Siglec-F+CD11c- cells. These results show that CD4 T cells, and other CD4+ cells including subsets of dendritic cells, iNKT cells, and LTi cells, play a role in ongoing eosinophilic lung inflammation during periods of chronic allergen challenge, but are not required for progressive airway remodeling that develops after initial acute inflammation.

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Health Care Services in Shopping Centers: A Routine Mass-Gathering Event

Prehospital and Disaster Medicine ◽

10.1017/s1049023x2000120x ◽

2020 ◽

Vol 35 (6) ◽

pp. 669-675

Author(s):

Mehmet Ali Ceyhan ◽

Gültekin Günhan Demir

Keyword(s):

Health Care ◽

Medical Care ◽

Health Care Providers ◽

Health Care Services ◽

Shopping Centers ◽

Medical Conditions ◽

Care Providers ◽

Care Services ◽

Number Of Patients ◽

Number Of Customers

AbstractBackground:Shopping centers (SCs) are social areas with a group of commercial establishments which attract customers of numerous people every day. However, analysis of urgent health conditions and provided health care in SCs has not been performed so far.Objective:The aim of the study was to perform a comparative analysis of clients visiting SCs and demographics, complaints, and health care of patients admitted to Emergency Medical Intervention Units (EMIU) located in grand SCs in Ankara, Turkey.Methods:Customer and health care records of nine grand SCs in Ankara from January 1, 2018 through December 31, 2018 were evaluated retrospectively. Health care services in EMIUs of SCs were provided by employed medical staff. Data including demographic characteristics, complaints, treatment protocols, discharge, and referral to hospital of the patients were retrospectively analyzed from medical registration forms.Results:Medical records of nine grand SCs were analyzed. Number of customers could not be obtained in three SCs due to privacy issues and were not included in patient presentation rate (PPR) and transport-to-hospital rate (TTHR) calculation. Total number of customers in the remaining six SCs were 53,277,239. The total number of patients seeking medical care was 6,749. The number of patients seeking health care in six SCs with known number of customers was 4,498 and PPR ranged from 0.018 to 0.381 patients per 1,000 attendants. The median age of the recorded 4,065 patients (60.2%) was 28 (interquartile range [IQR]: 38-21), and 3,611 (53.5%) of the patients admitted to EMIUs were female. The number of patients treated in the SC was 4,634 (68.6%) and 189 patients (2.8%) were transferred-to-hospital by ambulance for further evaluation and treatment. Transportation to hospital was required in 125 patients who sought medical care in six SCs which provided total number of customers, and TTHR ranged from 0.000 to 0.005 patients per 1,000 attendants. No sudden cardiac death was seen. Medical conditions were the primary reasons for seeking health care. The most frequent causes of presentation were laceration and abrasions (639 patients, 9.4%).Conclusion:The PPR and TTHR in SCs are low. The most common causes of presentation are minor conditions and injuries. Majority of urgent medical conditions in SCs can be managed by health care providers in EMIUs.

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