scholarly journals The Risk of COVID-19 Pandemic in Patients with Moderate to Severe Plaque Psoriasis Receiving Systemic Treatments

Vaccines ◽  
2020 ◽  
Vol 8 (4) ◽  
pp. 728
Author(s):  
Paolo Gisondi ◽  
Francesco Bellinato ◽  
Andrea Chiricozzi ◽  
Giampiero Girolomoni
Keyword(s):  
General Population ◽  
Plaque Psoriasis ◽  
Case Reports ◽  
Upper Respiratory Tract ◽  
Disease Modifying Antirheumatic Drugs ◽  
Obesity And Diabetes ◽  
Systemic Treatments ◽  
Increased Risk ◽  
Upper Respiratory ◽  
Metabolic Comorbidities

Chronic plaque psoriasis is an inflammatory skin disease affecting 2–3% of the general population. Approximately one-third of patients are candidates for systemic immunosuppressive treatments, such as synthetic or biological disease-modifying antirheumatic drugs, because of disease extensions, localization in sensitive or visible areas and/or resistance to topical treatments. These therapies have been associated with increased risk of infection, including upper respiratory tract viral infection. Psoriasis is frequently associated with cardio-metabolic comorbidities, such as obesity and diabetes, that are risk factors for poor prognosis in the case of coronavirus disease (COVID-19) pneumonia. A narrative review of the literature based on an electronic search of the PubMed® database was undertaken with the objective of investigating whether there is an increased risk of COVID-19 infection in psoriasis patients on systemic treatment. Original articles, such as case reports, published up to 1 November 2020 were included. There is no evidence that patients with moderate-to-severe psoriasis receiving systemic treatments, including biologics, have higher risk of SARS-CoV-2 infection and/or increased hospitalization and death related to COVID-19 compared to the general population. Several case reports described full recovery from COVID-19 with favorable outcomes in psoriasis patients who were being treated with synthetics or biologicals. Nonetheless, caution should be maintained in this setting, and more data are needed to draw definitive conclusions.

Do Children Who Experience Laryngospasm Have an Increased Risk of Upper Respiratory Tract Infection?

1996 ◽  
Vol 85 (3) ◽  
pp. 475-480. ◽  
Author(s):  
Mark S. Schreiner ◽  
Irene O'Hara ◽  
Dorothea A. Markakis ◽  
George D. Politis
Keyword(s):  
Confidence Interval ◽  
Respiratory Infection ◽  
Odds Ratio ◽  
Signs And Symptoms ◽  
Control Group ◽  
Upper Respiratory Tract ◽  
Upper Respiratory Infection ◽  
Airway Surgery ◽  
Increased Risk ◽  
Upper Respiratory

Background Laryngospasm is the most frequently reported respiratory complication associated with upper respiratory infection and general anesthesia in retrospective studies, but prospective studies have failed to demonstrate any increase in risk. Methods A case-control study was performed to examine whether children with laryngospasm were more likely to have an upper respiratory infection on the day of surgery. The parents of all patients (N = 15,183) who were admitted through the day surgery unit were asked if their child had an active or recent (within 2 weeks of surgery) upper respiratory infection and were questioned about specific signs and symptoms to determine if the child met Tait and Knight's definition of an upper respiratory infection. Control subjects were randomly selected from patients whose surgery had occurred within 1 day of the laryngospasm event. Results Patients who developed laryngospasm (N = 123) were 2.05 times (95% confidence interval 1.21-3.45) more likely to have an active upper respiratory infection as defined by their parents than the 492 patients in the control group (P < or = 0.01). The development of laryngospasm was not related to Tait and Knight's definition for an upper respiratory infection or to recent upper respiratory infection. Children with laryngospasm were more likely to be younger (odds ratio = 0.92, 95% confidence interval 0.87-0.99), to be scheduled for airway surgery (odds ratio = 2.08, 95% confidence interval 1.21-3.59), and to have their anesthesia supervised by a less experienced anesthesiologist (odds ratio = 1.69, 95% confidence interval 1.04-2.7) than children in the control group. Conclusion Laryngospasm was more likely to occur in children with an active upper respiratory infection, children who were younger, children who were undergoing airway surgery, and children whose anesthesia were supervised by less experienced anesthesiologists. Understanding the risk factors and the magnitude of the likely risk should help clinicians make the decision as to whether to anesthetize children with upper respiratory infection.

Treatment of attention deficit/hyperactivity disorder in children with CHD

2021 ◽  
pp. 1-4
Author(s):  
Alyson R. Pierick ◽  
Melodie Lynn ◽  
Courtney M. McCracken ◽  
Matthew E. Oster ◽  
Glen J. Iannucci
Keyword(s):  
Attention Deficit Hyperactivity Disorder ◽  
General Population ◽  
Adverse Events ◽  
Supraventricular Tachycardia ◽  
Medical Therapy ◽  
Attention Deficit ◽  
Case Reports ◽  
Single Centre ◽  
Hyperactivity Disorder ◽  
Increased Risk

Abstract Introduction: The prevalence of attention deficit/hyperactivity disorder in the general population is common and is now diagnosed in 4%–12% of children. Children with CHD have been shown to be at increased risk for attention deficit/hyperactivity disorder. Case reports have led to concern regarding the use of attention deficit/hyperactivity disorder medications in children with underlying CHD. We hypothesised that medical therapy for patients with CHD and attention deficit/hyperactivity disorder is safe. Methods: A single-centre, retrospective chart review was performed evaluating for adverse events in patients aged 4–21 years with CHD who received attention deficit/hyperactivity disorder therapy over a 5-year span. Inclusion criteria were a diagnosis of CHD and concomitant medical therapy with amphetamines, methylphenidate, or atomoxetine. Patients with trivial or spontaneously resolved CHD were excluded from analysis. Results: In 831 patients with CHD who received stimulants with a mean age of 12.9 years, there was only one adverse cardiovascular event identified. Using sensitivity analysis, our median follow-up time was 686 days and a prevalence rate of 0.21% of adverse events. This episode consisted of increased frequency of supraventricular tachycardia in a patient who had this condition prior to initiation of medical therapy; the condition improved with discontinuation of attention deficit/hyperactivity disorder therapy. Conclusion: The incidence of significant adverse cardiovascular events in our population was similar to the prevalence of supraventricular tachycardia in the general population. Our single-centre experience demonstrated no increased risk in adverse events related to medical therapy for children with attention deficit/hyperactivity disorder and underlying CHD. Further population-based studies are indicated to validate these findings.

scholarly journals Left ventricular mechanical dispersion in a general population: Data from the Akershus Cardiac Examination 1950 study

2019 ◽  
Author(s):  
Erika N Aagaard ◽  
Brede Kvisvik ◽  
Mohammad O Pervez ◽  
Magnus N Lyngbakken ◽  
Trygve Berge ◽  
...  
Keyword(s):  
General Population ◽  
Global Longitudinal Strain ◽  
Population Data ◽  
Left Ventricular ◽  
Linear Regression Models ◽  
Cross Sectional ◽  
Clinical Model ◽  
Mechanical Dispersion ◽  
Obesity And Diabetes ◽  
Increased Risk

Abstract Aims Increased left ventricular mechanical dispersion by 2D speckle tracking echocardiography predicts ventricular arrhythmias in ischaemic heart disease and heart failure. However, little is known about mechanical dispersion in the general population. We aimed to study mechanical dispersion in the general population and in diseases associated with increased risk of cardiovascular disease. Methods and results The present cross-sectional study consists of 2529 subjects born in 1950 included in the Akershus Cardiac Examination (ACE) 1950 study. Global longitudinal strain (GLS) was assessed from 17 strain segments, and mechanical dispersion calculated as the standard deviation of contraction duration of all segments. The cohort was divided according to the median value of mechanical dispersion, and multivariable linear regression models were performed with mechanical dispersion as the dependent variable. The prevalence of coronary artery disease (CAD), hypertension, obesity, and diabetes (P < 0.01 for all) was significantly higher in subjects with supra-median mechanical dispersion. In a multivariable clinical model, CAD (B = 7.05), hypertension (B = 4.15; both P < 0.001), diabetes (B = 3.39), and obesity (B = 1.89; both P < 0.05) were independently associated with increasing mechanical dispersion. When echocardiographic indices were added to the multivariable model, CAD (B = 4.38; P < 0.01) and hypertension (B = 2.86; P < 0.001) remained significant in addition to peak early diastolic tissue velocity e’ (B = −2.00), GLS (B = 1.68), and ejection fraction (B = 0.22; P < 0.001 for all). Conclusion In a general middle-aged population, prevalent CAD and hypertension were associated with increasing mechanical dispersion, possibly indicating elevated risk of fatal arrhythmias and sudden cardiac death. Albeit weaker, systolic and diastolic dysfunction, were also associated with increasing mechanical dispersion.

scholarly journals The association between training load indices and upper respiratory tract infections (URTIs) in elite soccer players

2021 ◽  
pp. 174795412110204
Author(s):  
Caoimhe Tiernan ◽  
Thomas Comyns ◽  
Mark Lyons ◽  
Alan M Nevill ◽  
Giles Warrington
Keyword(s):  
Respiratory Tract ◽  
Signs And Symptoms ◽  
Training Load ◽  
Soccer Players ◽  
Upper Respiratory Tract ◽  
Increased Risk ◽  
Upper Respiratory ◽  
Tract Infections ◽  
Load Indices ◽  
And Training

This study aimed to investigate the association between training load indices and Upper Respiratory Tract Infection (URTI) across different lag periods in elite soccer players. Internal training load was collected from 15 elite soccer players over one full season (40 weeks). Acute, chronic, Acute:Chronic Workload Ratio (ACWR), Exponentially Weighted Moving Averages (EWMA) ACWR, 2, 3 and 4-week cumulative load, training strain and training monotony were calculated on a rolling weekly basis. Players completed a daily illness log, documenting any signs and symptoms, to help determine an URTI. Multilevel logistic regression was used to analyze the associations between training load indices and URTIs across different lag periods (1 to 7-days). The results found a significant association between 2-week cumulative load and an increased likelihood of a player contracting an URTI 3 days later (Odds Ratio, 95% Confidence Interval: OR = 2.07, 95% CI = 0.026-1.431). Additionally, a significant association was found between 3-week cumulative load and a players’ increased risk of contracting an URTI 4 days later (OR = 1.66, 95% CI = 0.013–1.006). These results indicate that accumulated periods of high training load (2- and 3-week) associated with an increased risk of a player contracting an URTI, which may lead to performance decrements, missed training sessions or even competitions.

Is There an Increased Risk of Haemophilus influenzae Septicemia in Children with Sickle Cell Anemia?

PEDIATRICS ◽  
1983 ◽  
Vol 71 (6) ◽  
pp. 927-931
Author(s):  
Darleen Powars ◽  
Gary Overturf ◽  
Ernest Turner
Keyword(s):  
Haemophilus Influenzae ◽  
Sickle Cell ◽  
Sickle Cell Anemia ◽  
Clinical Course ◽  
Febrile Child ◽  
Low Grade ◽  
Upper Respiratory Tract ◽  
Pneumococcal Infections ◽  
Increased Risk ◽  
Upper Respiratory

The risk of Haemophilus influenzae septicemia/meningitis to children who have sickle cell anemia (SS) has been determined to be greater than that seen among normal infants. Of ten bacteriologically proven cases, eight episodes of infection were observed among 234 children with sickle cell anemia (645 person-years), who were less than 5 years of age. There was one case per 69 infants with sickle cell anemia who were less than 18 months old and one case per 36 children with sickle cell anemia between 19 and 59 months of age. Unexpectedly, two infections occurred among 224 children (824 person-years), aged 5 to 9 years; both died. Contrary to the rapid clinical course of pneumococcal infections in children with sickle cell anemia H influenzae septicemia was regularly heralded by a greater than 24-hour prodrome of upper respiratory tract infection, low-grade fever, and otitis media. Three (30%) preventable deaths occurred. Antibiotic therapy for the febrile child with sickle cell anemia must be predicated on the known 400-fold increased risk of pneumococcal septicemia in those less than 5 years old and the fourfold risk of H influenzae septicemia in those less than 9 years of age.

Exercise and resistance to infection

1998 ◽  
Vol 76 (5) ◽  
pp. 573-580 ◽  
Author(s):  
David C Nieman
Keyword(s):  
Immune Response ◽  
Tract Infection ◽  
Respiratory Tract ◽  
Respiratory Tract Infection ◽  
Killer Cell ◽  
Cell Activity ◽  
Upper Respiratory Tract Infection ◽  
Upper Respiratory Tract ◽  
Increased Risk ◽  
Upper Respiratory

Epidemiological data suggest that endurance athletes are at increased risk for upper respiratory tract infection (URTI) during periods of heavy training and the 1- to 2-week period following race events. Moderate exercise training has been associated with a reduction in incidence of URTI. There is growing evidence that for several hours subsequent to heavy exertion, several components of both the innate (e.g., natural killer cell activity and neutrophil oxidative burst activity) and adaptive (e.g., T and B cell function) immune system exhibit suppressed function. The immune response to heavy exertion is transient, and further research on the mechanisms underlying the immune response to prolonged and intensive endurance exercise is necessary before meaningful clinical applications can be drawn. Some attempts have been made through chemical or nutritional means (e.g., indomethacin, glutamine, vitamin C, and carbohydrate supplementation) to attenuate immune changes following intensive exercise to lower the risk of infection.Key words: upper respiratory tract infection, immunity, running, lymphocyte, neutrophil.

Consumption of gold kiwifruit reduces severity and duration of selected upper respiratory tract infection symptoms and increases plasma vitamin C concentration in healthy older adults

2011 ◽  
Vol 108 (7) ◽  
pp. 1235-1245 ◽  
Author(s):  
Denise C. Hunter ◽  
Margot A. Skinner ◽  
Frances M. Wolber ◽  
Chris L. Booth ◽  
Jacelyn M. S. Loh ◽  
...  
Keyword(s):  
Vitamin C ◽  
Respiratory Tract ◽  
Immune Function ◽  
Washout Period ◽  
Community Dwelling ◽  
Plasma Vitamin ◽  
Upper Respiratory Tract ◽  
Increased Risk ◽  
Upper Respiratory ◽  
Tract Infections

In the elderly, immunosenescence and malnourishment can contribute to increased risk and severity of upper respiratory tract infections (URTI). Gold kiwifruit (Actinidia chinensis ‘Hort16A’) contains nutrients important for immune function and mitigation of symptoms of infection, including vitamins C and E, folate, polyphenols and carotenoids. The objective of the present study was to evaluate whether regular consumption of gold kiwifruit reduces symptoms of URTI in older people, and determine the effect it has on plasma antioxidants, and markers of oxidative stress, inflammation and immune function. A total of thirty-two community-dwelling people ( ≥ 65 years) participated in a randomised crossover study, consuming the equivalent of four kiwifruit or two bananas daily for 4 weeks, with treatments separated by a 4-week washout period. Participants completed the Wisconsin Upper Respiratory Symptom Survey-21 daily, and blood samples were collected at baseline and at the end of each treatment and washout period. Gold kiwifruit did not significantly reduce the overall incidence of URTI compared with banana, but significantly reduced the severity and duration of head congestion, and the duration of sore throat. Gold kiwifruit significantly increased plasma vitamin C, α-tocopherol and lutein/zeaxanthin concentrations, and erythrocyte folate concentrations, and significantly reduced plasma lipid peroxidation. No changes to innate immune function (natural killer cell activity, phagocytosis) or inflammation markers (high-sensitivity C-reactive protein, homocysteine) were detected. Consumption of gold kiwifruit enhanced the concentrations of several dietary plasma analytes, which may contribute to reduced duration and severity of selected URTI symptoms, offering a novel tool for reducing the burden of URTI in older individuals.

scholarly journals The Safety of Delayed Versus Immediate Antibiotic Prescribing for Upper Respiratory Tract Infections

2020 ◽  
Author(s):  
Tjeerd Pieter van Staa ◽  
Victoria Palin ◽  
Benjamin Brown ◽  
William Welfare ◽  
Yan Li ◽  
...  
Keyword(s):  
Respiratory Tract ◽  
Hospital Admission ◽  
Respiratory Tract Infections ◽  
Population Based ◽  
Upper Respiratory Tract Infections ◽  
Antibiotic Prescribing ◽  
Upper Respiratory Tract ◽  
Increased Risk ◽  
Upper Respiratory ◽  
Tract Infections

Abstract Background This study aimed to evaluate the clinical safety of delayed antibiotic prescribing for upper respiratory tract infections (URTIs), which is recommended in treatment guidelines for less severe cases. Methods Two population-based cohort studies used the English Clinical Practice Research Databank and Welsh Secure Anonymized Information Linkage, containing electronic health records from primary care linked to hospital admission records. Patients with URTI and prescriptions of amoxicillin, clarithromycin, doxycycline, erythromycin, or phenoxymethylpenicillin were identified. Patients were stratified according to delayed and immediate prescribing relative to URTI diagnosis. Outcome of interest was infection-related hospital admission after 30 days. Results The population included 1.82 million patients with an URTI and antibiotic prescription; 91.7% had an antibiotic at URTI diagnosis date (immediate) and 8.3% had URTI diagnosis in 1–30 days before (delayed). Delayed antibiotic prescribing was associated with a 52% increased risk of infection-related hospital admissions (adjusted hazard ratio, 1.52; 95% confidence interval, 1.43–1.62). The probability of delayed antibiotic prescribing was unrelated to predicted risks of hospital admission. Analyses of the number needed to harm showed considerable variability across different patient groups (median with delayed antibiotic prescribing, 1357; 2.5% percentile, 295; 97.5% percentile, 3366). Conclusions This is the first large population-based study examining the safety of delayed antibiotic prescribing. Waiting to treat URTI was associated with increased risk of hospital admission, although delayed antibiotic prescribing was used similarly between high- and low-risk patients. There is a need to better target delayed antibiotic prescribing to URTI patients with lower risks of complications.

scholarly journals Whole Cell Euglena Gracilis Supplementation Reduces Upper Respiratory Tract Infection Symptoms in Healthy Adults (P19-009-19)

2019 ◽  
Vol 3 (Supplement_1) ◽  
Author(s):  
Janaki Iyer ◽  
Paul Falcone ◽  
Kelli Herrlinger ◽  
Joanne Lasrado ◽  
Emily Pankow Fritz ◽  
...  
Keyword(s):  
Immune System ◽  
Respiratory Tract ◽  
Euglena Gracilis ◽  
Illness Severity ◽  
Healthy Adults ◽  
Upper Respiratory Tract ◽  
Whole Cell ◽  
Increased Risk ◽  
Upper Respiratory ◽  
Tract Infections

Abstract Objectives Upper respiratory tract infections (URTI) cause cold and flu-like symptoms, with roughly 70% of the general population experiencing at least one episode annually. The resultant lost productivity has a drastic impact with an estimated 40 M work or school days missed each year, translating to over $40B USD in lost potential. Certain populations, such as athletes and stressed workers are at an increased risk of URTIs. While diet, sleep, low stress and exercise are all important for a healthy functioning immune system, supplementation with natural ingredients could provide additional support. Euglena gracilis is a nutrient-rich natural microalgae (commonly consumed in Japan), containing immunomodulating beta 1,3-glucans, protein, some essential vitamins, and minerals. This double-blind, placebo-controlled, parallel study aimed at investigating the immunomodulating effects of a patented whole cell algae fermentate (WCF) in healthy active adults. Methods Thirty-four, healthy, active (1.5–3 hours/day of an aerobic sport, 5–6 days/week) participants were randomized to either WCF or placebo for 90 days. URTI symptoms were assessed Day (D) 1 to 90 using the Wisconsin Upper Respiratory Symptom Survey. Data are shown for the a priori defined per protocol population (n = 27). Results Participants supplemented with WCF reported a lower number of URTI symptoms from D1 to 30 (P = 0.042) and from D1 to 90 (P = 0.029), lower mean number of sick days between D1 and 30 (P = 0.047) and D1 and 90 (P = 0.041), lower mean number of URTI episodes per person (P = 0.032), and lower mean number of days with at least 1 reported URTI symptom per person (P = 0.019) between D1 and 90 compared to taking placebo. Evaluation of global illness severity found that the mean total AUC for daily symptoms was significantly lower in the WCF group compared to placebo at D1 to D30 (P = 0.043) and D1 to D90 (P = 0.049). Conclusions Supplementation with WCF positively influences the immune system by reducing URTI incidence, duration, and severity in healthy adults. It is noteworthy that in the absence of the intervention, active young adults reported more URTI episodes, sick days, and global illness severity, respectively. These data suggest the ability of WCF supplementation to strengthen the immune response as evidenced by reduced cold and flu symptoms. Funding Sources Kemin Foods L.C.

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