Research hotspots and theme analysis of infection management in operating room based on Nvivo software.

Objective To analyze the research hotspots and theme in the field of infection prevention and control（infection control) management in operating room in recent six years in China, so as to provide reference for further research on infection control management in operating room. Methods The articles related to infection control management in operating room published in China National Knowledge Infrastructure（CNKI), Wanfang and VIP databases from 2015 to 2021 were selected as the research objects, and Nvivo software query, coding and cluster analysis were adopted as the main methods to visually present the research hotspots and theme groups in the field of infection management in operating rooms. Results A total of 128 literatures with 30 high-frequency keywords were included. After free coding, 8 parent nodes, 28 child nodes, 60 secondary nodes and 1 736 coding reference points were formed. Six theme groups had been formed, which were the guidelines for infection control of COVID-19 infection, construction and management of clean operating rooms, management of relevant personnel in operating rooms, management of surgical supplies, operating room environment control, theoretical support and occupational exposure control. Conclusion The research content related to infection control management in operating rooms is becoming increasingly mature, and is constantly improving in line with the development of the times. The research direction and theory are also showing a trend of diversification. In response to the huge challenge of COVID-19 situation, it is supposed to preparing for surgery protection in general hospitals actively, ensure the safety of patients and medical staff, and prevent hospital infection events. (English) [ FROM AUTHOR] 目的 分析国内近6年手术室感染预防和控制(感控)管理领域的研究热点和主题内容, 为手 术室感控管理的进一步研究提供借鉴。方法 选取2015-2021年中国知网、万方和维普等数据库刊出的手术 室感控管理相关内容的期刊论文作为研究对象, 主要采用 Nvivo软件查询、编码、聚类分析等研究方法, 以可视 化方式呈现手术室感控管理领域的研究热点和主题类团。结果 共纳入128篇文献, 30个高频关键词;经自由 编码形成8个树状节点、28个子节点、60个次节点、1736个编码参考点;形成6个主题类团, 分别为新型冠状 病毒(新冠病毒)感染疫情感染防控指引、洁净手术室建设与管理、手术室相关人员管理、手术用品管理、手术室 环境管控、理论支持与职业暴露管控。结论 手术室感控管理相关研究内容日渐成熟, 且紧扣时代发展不断完 善, 研究方向和理论也呈多元化趋势。在应对新冠病毒感染疫情的巨大挑战下积极做好综合医院的手术防护 准备工作, 保障患者和医务人员安全, 防止医院内感染事件的发生。 (Chinese) [ FROM AUTHOR] Copyright of Journal of Modern Medicine & Health is the property of Journal of Modern Medicine & Health and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)

New Approaches to the Economic Security of Russian Regions in Terms of the COVID-19 Pandemic

The study aims to identify the problems of economic security of the Russian regions under the influence of force majeure caused by the pandemic COVID-19 and their assessment, as well as to determine ways to stabilize the socio-economic situation. The authors conducted a grouping of the economic security indicators of the federal districts and proposed a methodology for its assessment in terms of the coronavirus pandemic. The authors identified the problem areas of socio-economic development of the Russian regions and also proved the decline in their economic security during the pandemic. The authors evaluated the effectiveness of the internal state administration of the federal districts according to the anti-crisis measures adopted in 2020 (maintaining turnover in the main regional segments of the economy, avoiding tax debt on regional fees, increasing the profitability of the real business, raising the level of digital development), as well as measures to preserve employment and solvency of the population of each region. The authors justified the directions of normalization of the socio-economic development of the federal districts of Russia by eliminating the economic security problems. © The Editor(s) (if applicable) and The Author(s), under exclusive license to Springer Nature Switzerland AG 2022.

Repurposing of poly-gamma-glutamic acid, immunotherapeutic drug for cervical intraepithelial neoplasia 1, as covid-19 treatment

Covid-19 virus variants identified so far are due to viral genetic diversity, genetic evolution, and variable infectivity, suggesting that high infection rates and high mortality rates may be contributed by these mutations. And it has been reported that the targeting strategies for innate immunity should be less vulnerable to viral evolution, variant emergence and resistance. Therefore, the most effective solution to Covid-19 infection has been proposed to prevent and treat severe exacerbation of patients with moderate disease by enhancing human immune responses such as NK cell and T cell. In previous studies, we demonstrated for the first time that gamma-PGA induced significant antitumor activity and antiviral activity by modulating NK cell-mediated cytotoxicity. Especially intranasal administration of gamma-PGA was found to effectively induce protective innate and CTL immune responses against viruses and we found out that gamma-PGA can be an effective treatment for cervical intraepithelial neoplasia 1 through phase 2b clinical trial. In this study, the possibility of gamma-PGA as a Covid-19 immune modulating agent was confirmed by animal experiments infected with Covid-19 viruses. After oral administration of gamma-PGA 300mug/mouse once a day for 5 days in a K18-hACE2 TG mouse model infected with SARS-CoV-2 (NCCP 43326;original strain) and SARS-CoV-2 (NCCP 43390;Delta variant), virus titer and clinical symptom improvement were confirmed. In the RjHan:AURA Syrian hamster model infected with SARS-CoV-2 (NCCP 49930;Delta variant), 350 or 550 mug/head of gamma-PGA was administered orally for 10 days once a day. The virus for infection was administered at 5 x 104 TCID50, and the titer of virus and the improvement of pneumonia lesions were measured to confirm the effectiveness in terms of prevention or treatment. In the mouse model infected with original Covid-19 virus stain, the weight loss was significantly reduced and the survival rate was also improved by the administration of gamma-PGA. And gamma-PGA alleviated the pneumonic lesions and reduced the virus titer of lung tissue in mice infected with delta variant. In the deltavariant virus infected hamster model, gamma-PGA showed statistically significant improvement of weight loss and lung inflammation during administration after infection. This is a promising result for possibility of Covid-19 therapeutics along with the efficacy results of mouse model, suggesting gammaPGA can be therapeutic candidate to modulate an innate immune response for Covid-19.

Certolizumab

Certolizumab is a Fab fragment of a humanized monoclonal antibody against tumor necrosis factor-alpha (TNF-alpha). Differing from the other TNF-alpha inhibitors due to the absence of Fc fragment and pegylation, it binds to both the soluble and transmembrane forms of TNF-alpha, creating a strong TNF-alpha blockage. Previously approved for psoriatic arthritis, certolizumab received another approval from FDA in 2018 for the treatment of moderate to severe chronic plaque psoriasis that does not respond to conventional systemic treatments or for which these treatments are contraindicated. Administered via subcutaneous injections, certolizumab also has a low-dose option for patients weighing less than 90 kg. Certolizumab is considered a safe biological drug that can be preferred during pregnancy and lactation.Copyright © 2022 by Turkish Society of Dermatology and Venereology.

Acute or chronic? Failing left ventricle in a 34 year old

Submission content Introduction: An unusual case of a very young patient without previously known cardiac disease presenting with severe left ventricular failure, detected by a point of care echocardiogram. Main Body: A 34 year old previously well man was brought to hospital after seeing his general practitioner with one month of progressive shortness of breath on exertion. This began around the time the patient received his second covid-19 vaccination. He was sleeping in a chair as he was unable to lie flat. Abnormal observations led the GP to call an ambulance. In the emergency department, the patient required oxygen 5L/min to maintain SpO2 >94%, but he was not in respiratory distress at rest. Blood pressure was 92/53mmHg, mean 67mmHg. Point of care testing for COVID-19 was negative. He was alert, with warm peripheries. Lactate was 1.0mmol/L and he was producing more than 0.5ml/kg/hr of urine. There was no ankle swelling. ECG showed sinus tachycardia. He underwent CT pulmonary angiography which demonstrated no pulmonary embolus, but there was bilateral pulmonary edema. Troponin was 17ng/l, BNP was 2700pg/ml. Furosemide 40mg was given intravenously by the general medical team. Critical care outreach asked for an urgent intensivist review given the highly unusual diagnosis of pulmonary edema in a man of this age. An immediate FUSIC Heart scan identified a dilated left ventricle with end diastolic diameter 7cm and severe global systolic impairment. The right ventricle was not severely impaired, with TAPSE 18mm. There was no significant pericardial effusion. Multiple B lines and trace pulmonary effusions were identified at the lung bases. The patient was urgently discussed with the regional cardiac unit in case of further deterioration, basic images were shared via a cloud system. A potential diagnosis of vaccination-associated myocarditis was considered,1 but in view of the low troponin, the presentation was felt most likely to represent decompensated chronic dilated cardiomyopathy. The patient disclosed a family history of early cardiac death in males. Aggressive diuresis was commenced. The patient was admitted to a monitored bed given the potential risk of arrhythmia or further haemodynamic deterioration. Advice was given that in the event of worsening hypotension, fluids should not be administered but the cardiac centre should be contacted immediately. Formal echocardiography confirmed the POCUS findings, with ejection fraction <35%. He was initiated on ACE inhibitors and beta adrenergic blockade. His symptoms improved and he was able to return home and to work, and is currently undergoing further investigations to establish the etiology of his condition. Conclusion(s): Early echocardiography provided early evidence of a cardiac cause for the patient's presentation and highlighted the severity of the underlying pathology. This directed early aggressive diuresis and safety-netting by virtue of discussion with a tertiary cardiac centre whilst it was established whether this was an acute or decompensated chronic pathology. Ultrasound findings: PLAX, PSAX and A4Ch views demonstrating a severely dilated (7cm end diastolic diameter) left ventricle with global severe systolic impairment.

Supporting practice nurses in diabetes, revalidation and appraisal programme: A practical course for new practice nurses (PN) undertaken diabetes care

Aims: To upskilling PN to undertake diabetes clinics and ensure high quality healthcare for our patients by maintain the nursing workforce in primary care. Method(s): The programme was delivered over two days, one month apart with follow up day's at six months and 1 year. During Covid-19 we had adapted the session to 4 half days over a 2 month period and are waiting to do our follow up day face to face. The programme included a broad range of topics and skills required to undertake diabetes clinics. Result(s): 13 PN attended from different geographical areas in our healthboard;having a various amount of experience as a PN from 16 yrs to 1 month but limited diabetes experience. Through anonymous questionnaire responses we showed an improvement in confidence across a broad range of core skills and management. Asked if they felt individually confident pre and post course -new diabetes diagnosis (38% to 92%), hypoglycaemia (53% to 92%), pens and meters (8% to 76%), sick day rules (30% to 84%), foot screening (61% to 92%) and advising on oral medication (30% no confidence improving to 84%). Increasing PN knowledge will ultimately improve patient's care thus reducing the risk of complications. preceptorship throught the course was offered by experience Diabetes Specialist Nurses. Conclusion(s): Even in these challenging times we have to maintain a skilled workforce by delivering education and preceptorship to PN. The Supporting prActice Nurses in Diabetes, Revalidation and Appraisal programme provides PN the tools to undertake diabetes clinics with confidence and ensure excellent patient care.

Biodegradable Polyester Nanoparticle Vaccines Deliver Self-Amplifying mRNA in Mice at Low Doses

Delivery of self-amplifying mRNA (SAM) has high potential for infectious disease vaccination due to its self-adjuvanting and dose-sparing properties. Yet a challenge is the susceptibility of SAM to degradation and the need for SAM to reach the cytosol fully intact to enable self-amplification. Lipid nanoparticles are successfully deployed at incredible speed for mRNA vaccination, but aspects such as cold storage, manufacturing, efficiency of delivery, and the therapeutic window can benefit from further improvement. To investigate alternatives to lipid nanoparticles, a class of >200 biodegradable end-capped lipophilic poly(beta-amino ester)s (PBAEs) that enable efficient delivery of SAM in vitro and in vivo as assessed by measuring expression of SAM encoding reporter proteins is developed. The ability of these polymers to deliver SAM intramuscularly in mice is evaluated, and a polymer-based formulation that yields up to 37-fold higher intramuscular (IM) expression of SAM compared to injected naked SAM is identified. Using the same nanoparticle formulation to deliver a SAM encoding rabies virus glycoprotein, the vaccine elicits superior immunogenicity compared to naked SAM delivery, leading to seroconversion in mice at low RNA injection doses. These biodegradable nanomaterials may be useful in the development of next-generation RNA vaccines for infectious diseases.Copyright © 2023 The Authors. Advanced Therapeutics published by Wiley-VCH GmbH.

New development: A ‘journey of personal and professional emotions'—emergency ambulance professionals during Covid-19

IMPACTThis article explores the consequences of emotional labour on UK NHS ambulance staff and their response to the Covid-19 pandemic. It highlights the challenges faced by ambulance crews while dealing with their emotional labour within the context of organizational settings. Research findings also explain the importance of emergency responders' psychosocial wellbeing. The article has clear relevance as to how frontline staff manage their emotional labour in other emergency service settings, such as the police and fire and rescue services.Alternate :Managing emotions are essential aspect of many jobs, and frontline healthcare workers have to manage and control their emotions while caring for critically ill patients and working in an emotionally-charged dynamic environment;this was particularly the case during Covid-19. Ambulance workers are an important group in this respect but they are currently under-researched. Evidence behind this article comes from data collected from an NHS ambulance trust in England. One of the key contributions of this article is to highlight how frontline ambulance professionals manage their emotional labour while working within the stipulations of organizational constraints.

Workplace violence and associations with health outcomes in public health administration agencies in Taiwan: a survey during the COVID-19 pandemic

Objectives: To investigate the prevalence of workplace violence in public health administration agencies and its effects on health outcomes. Methods: A survey was conducted in March 2022. Staff who had been working for at least one year in the Ministry of Health and Welfare or its subordinate agencies, the Department of Health, or in public health centers were recruited. Data were collected anonymously with a structured, online questionnaire. A total of 492 valid questionnaires were collected. Results: A total of 48.17% participants reported having experienced workplace violence (physical, psychological, verbal, or sexual). The most common type of violence was verbal (43.50%), followed by psychological (31.71%). Supervisors were the primary perpetrators of verbal and psychological violence, followed by clients and colleagues. Staff reported long working hours and high levels of psychological and physical stress. Furthermore, 22.97% of workers reported poor self-rated health, 60.57% had personal burnout levels higher than 50, and 63.41% reported poor mental health. Regression analyses showed that low workplace justice was most strongly associated with internal verbal and psychological violence, whereas routine work requiring interaction with the public was most strongly associated with external verbal violence. Staff who had experienced workplace violence in the past year had significantly higher risks of poor self-rated health, mental health, and personal burnout, and poor health was more strongly associated with workplace violence that originated inside the organization than with workplace violence that originated from outside the organization. Conclusions: This survey was conducted on-line anonymously, so the representativeness of our findings might be limited. However, heavy workloads and workplace violence in public health administration agencies during the COVID-19 pandemic are important issues deserving urgent attention. (Taiwan J Public Health. 2023;42(1) :42-61)

SARS-COV-2 Infection in Children and Young People in Bulgaria - A Prospective, Single-Center, Cohort Study

Compared to other respiratory viruses, the proportion of hospitalizations due to SARS-CoV-2 among children is relatively low. While severe illness is not common among children and young individuals, a particular type of severe condition called multisystem inflammatory syndrome in children (MIS-C) has been reported. The aim of this prospective cohort study, which followed a group of individuals under the age of 19, was to examine the characteristics of patients who had contracted SARS-CoV-2, including their coexisting medical conditions, clinical symptoms, laboratory findings, and outcomes. The study also aimed to investigate the features of children who met the WHO case definition of MIS-C, as well as those who required intensive care. A total of 270 patients were included between March 2020 and December 2021. The eligible criteria were individuals between 0-18 with a confirmed SARS-CoV-2 infection at the Infectious Disease Hospital "Prof. Ivan Kirov"in Sofia, Bulgaria. Nearly 76% of the patients were <= 12 years old. In our study, at least one comorbidity was reported in 28.1% of the cases, with obesity being the most common one (8.9%). Less than 5% of children were transferred to an intensive care unit. We observed a statistically significant difference in the age groups, with children between 5 and 12 years old having a higher likelihood of requiring intensive care compared to other age groups. The median values of PaO2 and SatO2 were higher among patients admitted to the standard ward, while the values of granulocytes and C-reactive protein were higher among those transferred to the intensive care unit. Additionally, we identified 26 children who met the WHO case definition for MIS-C. Our study data supports the evidence of milder COVID-19 in children and young individuals as compared to adults. Older age groups were associated with higher incidence of both MIS-C and ICU admissions.Copyright © 2023 P. Velikov et al., published by Sciendo.

The burnout warning

This chapter covers three distinct themes that encompass the concept of burnout warning: inherent adversities in the modality shift, fear and ambiguity in higher education, and attempting to work in suboptimal conditions. While thriving represents a concept that denotes success and achievement, burnout represents exhaustion and fatigue. The behavior exhibited by staff and its correlation to burnout is best explained by the works of Maslach and Leiter using the areas of worklife (AW) model entailing organizational risk factors. The AW model explains how burnout is expedited when there is a disruption to balance in the following areas: workload, control, reward, community, fairness, and values. The findings indicate that staff members at the University of Utah displayed early signs of burnout warning. The factors that contribute to early signals of burnout include resource shortages, an increase in overall workload-including persistent emotional labor-and a lack of acknowledgement. The chapter illustrates how stressors, aggravated by COVID fatigue, fostered an environment that mobilized the onset of burnout. (PsycInfo Database Record (c) 2023 APA, all rights reserved)

Changes in Kawasaki disease incidence and phenotype during the COVID-19 pandemic

INTRODUCTION. The aetiology of Kawasaki disease (KD) remains unknown. Changes in infectious exposure during the COVID-19 pandemic owing to infection prevention measures may have affected the incidence of KD, supporting the pathogenic role of an infectious trigger. The purpose of this study was to evaluate the incidence, phenotype and outcome of KD before and during the COVID-19 pandemic in Denmark. METHODS. This was a retrospective cohort study based on patients diagnosed with KD at a Danish paediatric tertiary referral centre from 1 January 2008 to 1 September 2021. RESULTS. A total of 74 patients met the KD criteria of whom ten were observed during the COVID-19 pandemic in Denmark. Alof these patients were negative for SARS-CoV-2 DNA and antibodies. A high KD incidence was observed during the first six months of the pandemic, but no patients were diagnosed during the following 12 months. Clinical KD criteria were equally met in both groups. The fraction of intravenous immunoglobulin (IVIG) non-responders was higher in the pandemic group (60%) than in the in the pre-pandemic group (28.3%), although the rate of timely administered IVIG treatment was the same in both groups (>= 80%). Coronary artery dilation was observed in 21.9% in the pre-pandemic group compared with 0% in KD patients diagnosed during the pandemic. CONCLUSION. Changes in KD incidence and phenotype were seen during the COVID-19 pandemic. Patients diagnosed with KD during the pandemic had complete KD, higher liver transaminases and significant IVIG resistance but no coronary artery involvement.Copyright © 2023, Almindelige Danske Laegeforening. All rights reserved.

Cutaneous Adverse Drug Reactions of COVID-19 Vaccines: A Cross-Sectional Study of the Largest Healthcare System in Taiwan

Objectives: Potential cutaneous adverse drug reactions (cADRs) associated with COVID-19 vaccinations are well-known. However, comprehensive evaluation including detailed patient characteristics, vaccine types, signs and symptoms, treatments and outcomes from such cADRs are still lacking in Taiwan. Method(s): A cross-sectional study was conducted from December 2019 to October 2022 to analyze spontaneous ADR reporting data from Taiwan's largest multi-institutional healthcare system. Physicians and pharmacists initially ensured the data quality and completeness of the reported ADR records. Subsequently, we applied descriptive statistics to analyze the patient cohort based on demographic characteristics, administered COVID-19 vaccines, clinical manifestations, and patient management. Result(s): We identified 242 cADRs from 759 reported COVID-19 vaccine-related ADRs, 88.3% of which were judged as "possible" using the Naranjo Scale. The mean age of patients with cADRs was 48.1+/-17.5 years, with the majority (44.2%) of cADRs reported in the 40-64yr old age group. cADRs were more common in women (68.2%) and most of the patients had no history of allergy to vaccines (99.6%). Oxford/AstraZeneca (58.6%) accounted for the most reported brand of COVID-19 vaccines. Patients developed cADRs within 1 to 198 days (median = 5.5 days), and mostly after first-dose vaccination (77.8%). The most frequently reported cADR was rash/eruption (18.7%), followed by itchiness/pruritus (11.7%) and urticaria (9.2%), mainly affecting the lower limbs (23.8%) and upper limbs (22.6%). Medications were prescribed for 65.1% of the cADRs, and signs and symptoms were resolved within 1 to 167 days (median = 7 days) after treatment with oral antihistamines (23.0%), topical corticosteroids (14.6%) or oral corticosteroids (14.4%). Conclusion(s): Our findings provide comprehensive details regarding COVID-19 vaccine-related cADRs in Taiwan. Certain groups, especially women and the middle-aged, who reported a relatively higher rate of cADRs, may benefit from pre-vaccination counseling about the risks of cADRs and the use of appropriate medications.Copyright © 2023

Loss of organic community and decentralized communications

This chapter explores the barriers and disruption to community and communication resulting from remote working during the COVID-19 pandemic. The University of Utah's decision to abruptly transition to a fully online model resulted in several communication impacts for staff. First, staff participants received little and inconsistent communication from the University. This caused uncertainty within departments, which trickled down to the students staff serve. Second, this led to staff participants feeling disconnected from the institution and increased their concerns around misinforming students. At the same time, the move to online learning and work decreased efficient communication between colleagues. Casual interactions in the office became email threads and extended feedback processes. Third, staff reported that online communications with students became less personal, which created difficulty for building and maintaining rapport. Finally, staff members' overall sense of community consistently dropped as the COVID-19 pandemic raged on and they were forced to continue to work remotely. The discontent and apprehension felt by staff members around the communication provided from University leadership was compounded by the impact of working from home. (PsycInfo Database Record (c) 2023 APA, all rights reserved)

Nanosponges: As a Dynamic Drug Delivery Approach for Targeted Delivery

Recent advancements in nanotechnology have resulted in improved medicine delivery to the target site. Nanosponges are three-dimensional drug delivery systems that are nanoscale in size and created by cross-linking polymers. The introduction of Nanosponges has been a significant step toward overcoming issues such as drug toxicity, low bioavailability, and predictable medication release. Using a new way of nanotechnology, nanosponges, which are porous with small sponges (below one microm) flowing throughout the body, have demonstrated excellent results in delivering drugs. As a result, they reach the target place, attach to the skin's surface, and slowly release the medicine. Nanosponges can be used to encapsulate a wide range of medicines, including both hydrophilic and lipophilic pharmaceuticals. The medication delivery method using nanosponges is one of the most promising fields in pharmacy. It can be used as a biocatalyst carrier for vaccines, antibodies, enzymes, and proteins to be released. The existing study enlightens on the preparation method, evaluation, and prospective application in a medication delivery system and also focuses on patents filed in the field of nanosponges.Copyright © 2023 The Authors.

Pilot Study Evaluating the Trends in Utilization of Compounded Products Pre- and Post- COVID-19 Pandemic

Objectives: To assess utilization differences in compounded products before and after the COVID-19 pandemic. Secondary objectives were to understand if there were changes in patient cost sharing and types of products compounded pre- and post- pandemic. Method(s): A cross-sectional study was completed using a large national claims database for patients who received at least one COVID-related vaccine, test, or treatment from October 2015 to July 2022. Claims included in the analysis are those identified as paid, listed as compounded, and were filled in 2019, 2020, or 2021. Chi-Square and T-Tests were used to determine if there are differences between each year. Result(s): The prevalence of paid claims for compounded products was 0.00055% (14,101) in 2019, 0.00042% (11,551) in 2020, and 0.00048% (14,005) in 2021. In each year, most claims for compounded products were through commercial insurance 70% in 2019, 62% in 2020, and 65% in 2021. On average there were approximately 2 claims per patient. The most frequently compounded product was lidocaine hydrochloride 20mg/ML topical solution. In 2020 there was an increase in utilization of naltrexone hydrochloride, a treatment for opioid use disorder (OUD). Between 2019 and 2020 the number of compounded claims decreased 17.6% while the number of total claims increased by 9.01%. From 2020 to 2021 the number of claims for compounded products returned to pre-pandemic levels with a 21.24% increase. In the same period, the total number of claims increased 5.86%. The average patient cost sharing for compounded products was $42.57 (SD: $60.02) in 2019, $40.07 ($80.36) in 2020, and $42.61 ($60.02) in 2021. Conclusion(s): We found that there were fewer patients receiving compounded products following the COVID-19 pandemic. We found no change in the number of compounded claims for hydroxychloroquine and ivermectin, though in 2020, there was a notable increase in the number of claims for naltrexone hydrochloride.Copyright © 2023

Bilateral Spontaneous Pneumothorax in a Child with Multisystem Inflammatory Syndrome Associated with COVID-19

Introduction: Spontaneous pneumothorax is a rare complication of coronavirus disease 2019 (COVID-19), primarily reported in adults. Pediatric cases with bilateral pneumothorax are much less reported. Case Presentation: We presented the case of a five-year-old previously healthy boy who developed persistent fever, abdominal pain, generalized maculopapular rash, and dyspnea before admission. His chest computed tomography (CT) showed a viral involvement pattern of pneumonia suggestive of COVID-19. Subsequently, he was confirmed with multisystem inflammatory syndrome in children (MIS-C). While he responded well to the therapies, on the fifth day of admission, he developed respiratory distress again. A chest roentgenogram showed bilateral spontaneous pneumothorax. Bilateral chest tubes were inserted, and his condition improved sig-nificantly after five days of admission to the intensive care unit. Two weeks later, he was discharged in good condition. Conclusion(s): Children with MIS-C associated with COVID-19 may develop primary spontaneous pneumothorax. Owing to the clinical picture overlapping with MIS-C associated with COVID-19, the timely diagnosis of pneumothorax may be challenging in such patients.Copyright © 2022, Author(s).

Drugs that aggravate the course of COVID-19: really?.

The safety of NSAIDs, corticosteroids and renin-angiotensin inhibitors in COVID-19 is challenged. NSAIDs may interfere with the defense process against viral infection and are best avoided. Systemic corticosteroids have not shown benefit in viral infection, including other coronavirus;thus they should be avoided, unless prescribed for another indication. The benefit-risk ratio is however clearly in favor of continuing inhaled corticosteroids in patients with asthma or COPD. ACE inhibitors and sartans upregulate the expression of angiotensin-converting enzyme 2 (ACE2), the pulmonary receptor for SARS-CoV-2. Any possible clinical impact of these treatments on COVID-19 infection remains to be clarified;in the meantime, they should be continued.Copyright © 2020 Editions Medecine et Hygiene. All rights reserved.