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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.
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The review is dedicated the interconnection between neurodegenerative diseases, chronic pain and gut microbiota's structure and function. The gut microbiota's role in gut-brain axis, neuroimmune interaction is considered. The modern data about gut dysbiosis in Alzheimer disease, Parkinson disease, osteoarthrosis, neuropathic pain in COVID infection, muscular-skeletal pain in fibromyalgia, irritable bowel syndrome et cetera are provided. The gut microbiota's modification by means of pre and probiotics in combination with medicines and diet modification can be used for the treatment of chronic pain and dementia.Copyright © T.M. MANEVICH.
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OBJECTIVE: To determine the probability of hospitalization for chronic degenerative disease in patients with COVID-19. MATERIALS AND METHODS: A retrospective cohort in patients with COVID-19, confirmed by RT-PCR. Two study groups were integrated, the exposed group made up of 3 subgroups, exclusively diabetes mellitus, exclusively arterial hypertension and exclusively obesity;the unexposed group was the one in which any chronic comorbidity was ruled out. Relative risk, multiple logistic regression and probability calculation of the event (hospitalization) were used. RESULT(S): The relative risk for hospitalization in diabetes was of 3.59 (95%CI;2.44-5.29), 3.20 (95%CI;2.10-4.87) in hypertension and 2.56 (95%CI;1.72-3.81) in obesity. The multiple regression equation was y = -1358 + 2388 (diabetes mellitus) + 2005 (systemic arterial hypertension) + 1458 (obesity). The probability of hospitalization when there was no chronic disease was of 20.6%, when there was a chronic disease the probability fluctuated between 52.5% and 73.5%, when there were two chronic diseases it varied from 89.1% to 95.4%, and when there were three diseases the probability of hospitalization was of 98.9%. CONCLUSION(S): In the context of the probability of hospitalization when there is a chronic degenerative disease or it is absent, the research shows the difference in these two scenarios, as revealed by the more than 70 percentage points identified in the extreme scenarios, a condition that, led to the clinical field, reaffirms the presence of chronic degenerative disease as a risk factor for hospitalization.Copyright © 2023 Comunicaciones Cientificas Mexicanas S.A. de C.V.. All rights reserved.
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Obesity is associated with several diseases, including mental health. Adipose tissue is distributed around the internal organs, acting in the regulation of metabolism by storing and releasing fatty acids and adipokine in the tissues. Excessive nutritional intake results in hypertrophy and proliferation of adipocytes, leading to local hypoxia in adipose tissue and changes in these adipokine releases. This leads to the recruitment of immune cells to adipose tissue and the release of pro-inflammatory cytokines. The presence of high levels of free fatty acids and inflammatory molecules interfere with intracellular insulin signaling, which can generate a neuroinflammatory process. In this review, we provide an up-to-date discussion of how excessive obesity can lead to possible cognitive dysfunction. We also address the idea that obesity-associated systemic inflammation leads to neuroinflammation in the brain, particularly the hypothalamus and hippocampus, and that this is partially responsible for these negative cognitive outcomes. In addition, we discuss some clinical models and animal studies for obesity and clarify the mechanism of action of anti-obesity drugs in the central nervous system.Copyright © 2023 Wolters Kluwer Medknow Publications. All rights reserved.
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Silymarin, is a phytoactive constituent isolated from the fruits and seeds of Silybum maria-num L Gaetn.), also called milk thistle belonging to the family of Asteracease. The phytoactive has been used to treat several physiological disorders. The objective of this manuscript was to review the therapeutic prospective of silymarin due to its ability to treat several physiological disorders. The da-tabases such as Pubmed, Elsevier, and Google Scholar were reviewed for the investigations or reviews published related to the title. The discussion is focused on the immunomodulatory, chemopreventive, and anti-inflammatory mechanisms of silymarin in various metabolic and dermatological disorders. In addition, the review discusses the different therapeutic potentials of silymarin such as the management of the liver disorder, skin carcinogenesis, cardiovascular disorders, diabetes mellitus, neurodegenera-tive disorders, and several dermatological disorders such as melasma, anti-aging, acne, rosacea, atopic dermatitis, and psoriasis. Silymarin is safe even with a dose higher than the therapeutic dose. Si-lymarin had good potential for the safe and effective treatment of numerous metabolic and dermatological disorders. © 2023 Bentham Science Publishers.
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Objective: To elucidate the relationship between COVID-19 and neurodegenerative diseases. Background(s): Recently, the impact of the COVID-19 pandemic on patients with neurodegenerative disease, as well as the specific neurological manifestations of COVID-19 have aroused great interests. However, there are still many issues of concern to us that need to be clarified. Method(s): We reviewed the current literature on the complex relationship between neurodegenerative diseases [including Parkinson's disease (PD) and Alzheimer's disease (AD)] and COVID-19. We summarized the impact of COVID-19 infection on symptom severity, disease progression and mortality of neurodegenerative disease, and discussed whether COVID-19 infection could trigger neurodegenerative disease. The vulnerability to COVID-19 infection and prognosis of COVID-19 positive individuals in patients with neurodegenerative disease were also included. Modification of care strategy, specific drug therapies and vaccines during the pandemic were also listed. At last, mechanisms underlying the link between COVID-19 and neurodegenerative disease were reviewed. Result(s): There is an interaction between COVID-19 infection and neurodegenerative diseases, including worsening symptomatic severity and accelerating neurodegeneration by COVID-19 infection in PD and AD patients, and vice versa, neurodegenerative diseases increasing the vulnerability to COVID-19 infection and enhancing the risks of hospitalization and death after virus infection. Many potential molecular and cellular pathways were hypothesized to be the link between COVID-19 infection and neurodegenerative diseases, but further studies are still needed to verify the mechanisms. COVID-19 pandemic has profoundly changed the way of medical care, telemedicine, vaccines and specific drug therapies are promising for the better management of PD and AD patients [Table 1] [Table2]. Conclusion(s): COVID-19 and neurodegenerative diseases have reciprocal impact on each other.
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Stunted growth is a condition in which toddlers are less than their age or height. As a result, non-optimal nutritional needs were satisfied in the first 1000 days of life. A child suffering from stunting has a slower cognitive and physical development than he should. Stunting also decreases productivity and health. This disease has a risk of degenerative diseases such as diabetes. Stunting in children under five requires special attention because it inhibits physical, mental, and cognitive development effects. Stunting at an early age can increase the risk of death, morbidity, and non-optimal posture in adulthood. Stunting prevention requires behavior change in all intervention targets, especially the primary targets, mothers and toddlers. The number of blockages and malnutrition in Indonesia is expected to increase significantly due to the COVID-19 pandemic. The pandemic has made it more challenging to meet children's nutrition during their growth and development. This pandemic has also prevented monitoring activities for the growth and development of children early in life. The monitoring activities are usually implemented at Integrated Healthcare Centers in villages or in Posyandu. If approximately undetectable through weight measures, body length, and head circumference, children can suffer from chronic malnutrition and become inhibited. Therefore, our $SiCenting+Team$ created a Website about Stunting education for the community in Pandeglang Regency. $SiCenting+is$ an application developed for Mothers, Policymakers, and Posyandu. Extensive data was processed to assist stunting screening for use by cadres with family profiles related to specific nutritional factors and sensitive nutrition. Furthermore, villages can use this data to plan the budget for stunting reduction programs at the village level through village deliberations. The $SiCenting+website$ can be opened via a web browser with the following URL address: https://sicenting.id/ © 2022 IEEE.
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Nigella sativa is an annual herb of the buttercup family, native to Western Asia and North Africa. Its seeds are used as a spice, especially in india and the Middle east, but also for medicinal purposes. Nigella sativa seeds contain a large number of bioactive substances, which have a number of pharmacological effects. It is a forgotten medicine and has been used in various systems of traditional medicine for thousands of years, but studies of modern medicine in recent years show that its therapeutic use can be much wider. it is likely that it could also find use in the treatment of mental disorders such as anxiety, depression and some neurodegenerative diseases. Its potential use in COVID-19 therapy is not without interest.Copyright © 2022 TIGIS Spol. s.r.o.. All rights reserved.
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Introduction: SARS-CoV-2 infection frequently causes neurological symptoms. Cognitive alterations are among the most frequent symptoms, and may persist beyond the acute phase of infection. Method(s): We conducted a narrative review of the literature. Result(s): Hospitalised patients, and especially critically ill patients, are at greater risk of developing cognitive symptoms. Post-COVID-19 cognitive symptoms, unlike those associated with other viral illnesses, have been observed in patients with mild infection, and present some atypical features. Cognitive symptoms may last longer in COVID-19 than in other infectious processes, and more frequently affect young people. Post-COVID-19 cognitive symptoms share common features with those described in chronic fatigue syndrome, including a similar profile with affective symptoms. Brief screening tests for cognitive impairment present suboptimal diagnostic performance, and standardised criteria are needed to ensure correct diagnosis. Post-COVID-19 cognitive impairment can have a significant impact on the patient's quality of life and functional independence, regardless of other post-COVID-19 symptoms. Currently, no specific treatments have been approved for post-COVID-19 cognitive impairment, although cognitive stimulation may be useful in some patients. Conclusion(s): Post-COVID-19 cognitive symptoms are common and are often associated with other systemic symptoms. Neuropsychological evaluation may be useful for diagnosis and to quantify their severity and long-term prognosis. Detailed, and individualised assessment of cognitive impairment may enable the design of treatment plans.Copyright © 2021 Sociedad Espanola de Neurologia
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In December 2019, the novel coronavirus strain SARS-CoV-2 caused an outbreak that quickly spread worldwide and led to the COVID-19 pandemic. COVID-19, the severe infectious disease caused by SARS-CoV-2, often presents with symptoms including fever, cough, and mental confusion and can cause the acute respiratory inflammatory disorder. Additionally, viral infection with SARS-CoV-2 is associated with mental health, neuronal degeneration, and psychiatric complications. With infection by the virus, cytokines are released by immune cells, causing acute systemic inflammation affecting the lungs. Lung damage can occur, resulting in hypoxia, brain damage, and mental health dysfunction. In addition, a cascade of inflammatory cytokines, including IL-1, IL-6, and TNF, are released, a phenomenon termed the "cytokine storm" that causes serious pathological damage to tissues and organs and mental health. This exaggerated production of cytokines leads to lymphopenia and disrupts the balance of Treg and Th17 cells, weakening the immune system. The elderly population is particularly at risk for damage associated with the "cytokine storm", which can affect neurological functions or result in death. Copyright © by BIOLIFE.
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Pineapple (Ananas comosus) is a tropical fruit that is numerous in Indonesia. This fruit can be processed into various processed food products. This author writes this article to find out the potential of pineapple as a food product that can be anti-noncommunicable diseases (NCDs) such as diabetes, obesity, oxidative stress, and cancer. This article is written using the narrative review method where data are collected from literature studies, namely articles in journals, books, and other literature-based online on database portals and leading search engines such as PUBMED and NCBI, the official website of the USDA (United States Department of Agriculture) and the European Phenols Explorer. The collected data are then analyzed, synthesized, discussed in the discussion, and general conclusions are drawn. The findings uncovered that pineapple contains polyphenols and antioxidant components, which are pretty high in concentration and could be useful as anti-NCDs. This fruit also has a proteolytic enzyme, bromelains, which is an immunomodulator against viral infections and diseases. This review concluded that pineapple fruit can be processed into various functional food products through several methods to maintain the content of polyphenols and antioxidants that have anti-NCDs potentials. It is necessary to process or execute this idea to identify and feel its benefits according to the research objectives, and in vivo, clinical trials are needed. Copyright © 2022 The Authors. Published by Rynnye Lyan Resources.
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Aim/Introduction: In SARS-CoV2 outbreak scenario, many considerations about possible long-term effects of this infection can be made. Early evidences reported in literature about the relation between long-COVID disease and brain involvement in patients with persistent neurological symptoms, found brain hypometabolism on 18F-FDG PET/CT. Our study aims to evaluate the impact of SARSCoV2 infection on brain metabolism in a long-term setting, also in asymptomatic patients. Material(s) and Method(s): Brain PET scans of 48 patients with documented previous SARS-CoV2 infection (COVID-group), performed from January to December 2021, were analysed and compared with brain PET scans of 48 patients, controlled for age and sex, who didn't experience the infection (control-group) using a quantitative software-aided approach. Patients with documented brain metastases or neurodegenerative diseases were excluded. No patient had neurological symptoms at the time of PET. CortexID Suite software (GE Healthcare) was applied for a segmentation analysis reporting Z score (ZS) values for each brain area in both groups. Basing on hypometabolism severity, the sample was divided as follows: normal (>=-1 ZS), mild (between -1 and -2 ZS), severe (<=-2 ZS). For COVID-group, time intercurred from infection to PET was recorded. Differences between ZS per areas between the two groups were evaluated using Mann-Withney-U test. Considering hypometabolism severity, Chi-Square test was applied to evaluate differences between groups. Finally, Pearson's test was used to correlate COVID-group ZS and time intercurred from infection. Result(s): Mean age of patients was 63.2 and 63.6 years old in the COVID-and control-group respectively. In both groups, 22/48 were male. In COVID-group 27/48 patients have had symptoms (cough, fever, dyspnoea) during SARS-CoV2 infection. The majority of brain areas showed a statistically significant difference in ZS values between groups. According to hypometabolism severity, left pre-frontal medial (p=0.032), right sensory-motor (p=0.014), right inferior parietal (p=0.001) and right lateral temporal (p=0.002) areas showed a statistically significant difference between COVIDand control-group with a prevalence in COVID-group of mild and severe brain hypometabolism. Lower ZS values were observed in patients with a longer time intercurred from infection to PET/CT scan. Conclusion(s): Our preliminary results confirm the impact of SARS-CoV2 infection on brain metabolism, consisting mostly in a mild hypometabolism. The presence of this metabolic pattern in patients without neurological symptoms suggests a devious action of the infection. Further studies, also using serial PET, are necessary to explore whether these metabolic alterations are transient or predictive of a future clinical manifestation.
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As population ages, the prevalence of neurodegenerative diseases, including Alzheimer's and Parkinson's disease, will continue to rise. Disruption of daily functioning often contributes to increased difficulties in accessibility to ap-propriate healthcare services. Patients in remote areas are affected to a higher degree, due to the understaffing of the region from specialized healthcare professionals. The COVID-19 pandemic has highlighted the growing need for remote medical services through telemedicine. The purpose of this literature review is to investigate the role of tele-medicine in neurodegenerative disorders, in terms of efficacy, benefits, limitations and reliability of the examination, focusing on recent studies on Alzheimer's and Parkinson's disease. As relevant studies show, the examination of patients with neurodegenerative diseases through telemedicine is feasible, quite reliable, effective and acceptable. At the same time, it is related with high satisfaction rates from patients, caregivers and health professionals, and also can improve accessibility, offering comfort, reducing unnecessary travel and financial costs, and providing the pos-sibility of early diagnosis, regular monitoring and treatment of diseases. Limitations concern the limited availability of the required technological equipment, the lack of a specific legal framework in our country, the absence of official guidelines and the lack of training of healthcare professionals in the provision of telemedicine services. Finally, the need for studies that will investigate the reliability of the telemedicine examination regarding the differential diagnosis of neurodegenerative diseases is emphasized, as well as prospective studies on the long-term results of the monitoring of these patients through telemedicine. Copyright © Athens Medical Society.
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COVID-19 is a multisystem disease with considerable heterogeneity of manifestations, including neurological. Neurological manifestations occur in up to 2/3 of patients in the acute phase and include non-specific, central nervous system and peripheral nervous system disorders. This is potentially explained because the SARS-CoV-2 virus has neuroinvasive properties, either directly by retrograde transport via nerve terminations or hematogenous dissemination, and induces neuroinflammation. The persistence of the SARS-CoV-2 in the nervous tissue for an extended period combined with secondary changes determined by neuroinflammation and hypoxia could be potential explanatory mechanisms for the longCOVID neurological manifestations, which occur even more often than those in the acute phase of COVID-19. Since available specialized therapies against neurological manifestations are still lacking, existing treatment options directed against viral invasiveness, the effects of immune dysregulation and hypercoagulable state, along with supportive measures to combat hypoxia, could serve as an efficient treatment for patients with COVID-19 and neurological manifestations. By preventing the SARS-CoV-2 from affecting the nervous tissue in the acute phase, it could also be possible to avoid longCOVID neurological impairment and probably the potential development of neurodegenerative diseases. Copyright © 2022, Romanian Society for Pharmaceutical Sciences. All rights reserved.
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INTRODUCTION: Specific to COVID-19, patients are placed in isolation rooms, visitors are restricted, and clinicians are reducing in-person interactions with patients, significantly limiting the patient's communication with the medical providers and families. Communication limitations result in an increased risk of post-traumatic stress disorder and psychological distress post discharge from the ICU. Our study aimed to assess the impact of speech and swallow treatment frequency in COVID-19 patients post-extubation from mechanical ventilation in ICU. METHOD(S): In this case-control study based on a data pull and review of electronic medical records, we obtained and analyzed data from ARDS patients who were COVID-19 positive and COVID-19 negative and required intubation in the ICU to describe communication and swallowing characteristics and SLP interventions. Patients were eligible for inclusion if they were 18 years or older, seen by SLP during inpatient admission, and were intubated or had a tracheostomy during their admission. Exclusion criteria included: 1) gastrostomy tube at baseline, 2) documented baseline dysphagia, 3) laryngectomy, 4) open chest surgery (e.g., sternotomy) <=1 year, 5) known or suspected anatomical abnormalities or trauma of the oral cavity, pharynx, larynx, or esophagus, 6) head and/or neck disease (e.g., laryngeal cancer), 7) head and/or neck surgery (other than tonsillectomy) or head and/or neck radiation, and 8) progressive neurodegenerative disorders/diseases. RESULT(S): A total of 244 patients met the criteria for inclusion. There was an approximately even distribution, with 50% of patients diagnosed with COVID positive. The average age of the participants was 64+/-12, with 40% females. The mortality rate across all groups was 18%. We are still analyzing the remaining data and are confident that the data will be ready for presentation by January 2023. CONCLUSION(S): Given data extraction is in its early stages, we are unable to make confirmatory conclusions, but we think that being aware of the challenges with speech and swallowing post-extubation after suffering COVID-19. Nurses and Speech-Language Pathologists can be proactive in performing bedside swallow evaluation and using appropriate tools/devices for communication to improve the quality of life.
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Background: The COVID-19 pandemic has largely affected spine care worldwide. At the beginning of the pandemic in Germany, surgical volume dropped markedly. Currently, it is unclear how surgical volume changed afterwards and especially during later pandemic waves. For this Registry study it was hypothesized that the COVID-19 pandemic in Germany is associated with a reduction of executed surgical spinal interventions, which was more prominent for specific spinal pathologies. Method(s): Surgical cases were selected from the German Spine Registry (DWG Register) during a 4-year period. Two groups were composed and compared. Patients enrolled prior to the start of the COVID-19 pandemic (before 01.01.2020) were included in group 'PRE-pandemic'. Patients admitted between 01.01.2020 and 31.12.2021 were selected for the group 'PANdemic'. We compared surgical volume over time and between groups. Subanalysis of specific pandemic waves and the impact on surgery foe specific spinal pathologies was studied as well. In order to optimize comparability, institutions that provided information during the entire study period were studied separately as well (adjusted analysis) Results: A total of 206841 patients have been identified. The prepandemic group included 89405 cases, whereas the PANDemic group had 117436 cases. A total of 142 institutions managed to include patients for this study (Fig.1a/b). As anticipated, monthly surgical volume did not differ between 2018 and 2019. However, an altered annual distribution pattern was seen in the pandemic years 2020 and 2021 Fig.2a/b). The additional adjusted analysis included 96 identical clinics. In parallel to pandemic waves, a drop in executed interventions was seen in the PANdemic group. Following the 1st pandemic wave, restoration of normal surgical volume took 3 months, whereas after later waves, normalization of surgical spine care occurred faster. Furthermore, following waves in 2021, a compensatory upsurge of surgical volume was seen. The most prominent reduction of surgical volume was seen in patients with degenerative diseases. In addition, a striking drop of performed interventions for critical categories such as infection and tumours occurred as well. Conclusion(s): The current study demonstrates that the COVID-19 pandemic is associated with decreased surgical load. However, restoration after pandemic waves occurs faster and more profound. Not only elective surgery rates dropped but also interventions for critical indications. During periods of peak COVID-19 incidences not only a decrease in performed elective surgeries was seen, but also the number of interventions for critical conditions dropped markedly. More protocols are required to optimize restoration of surgical volume after pandemic waves for different spine pathologies.
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Case Diagnosis: A 65-year-old woman who developed multiple system atrophy as a sequelae of COVID-19 infection Case Description or Program Description: The patient developed progressive dizziness, blurriness, and unsteady gait immediately following hospitalization for COVID-19 infection. Formal evaluation noted rightward nystagmus, mild resting tremor of the right hand, slowed finger tapping test bilaterally, overshooting on right finger to nose, and shuffling gait. MRI of the brain revealed moderate cerebellar and pontine volume loss with crossed hyperintensity of the pons, or "hot cross bun sign", raising suspicion for degenerative disease. Lumbar puncture analysis was normal. The patient was diagnosed with multiple system atrophy with parkinsonism features and started on a trial of amantadine and carbidopa/levodopa. Videonystagmography confirmed cerebellar etiology of her symptoms. Vestibular rehabilitation and meclizine was initiated with subsequent improvement in dizziness and functionality. Setting(s): Acute inpatient rehabilitation facility. Assessment/Results: After 20 days of acute inpatient rehabilitation including vestibular therapy, amantadine, carbidopa/levodopa, and meclizine, there was improvement of dizziness, dysarthria, tremor, weakness, and gait. The therapy team noted good progress since admission regarding performance of self-care tasks as well as transfers and mobility. The patient was discharged home with outpatient vestibular therapy. Discussion (relevance): This is a case of newly diagnosed multiple system atrophy associated with "hot cross buns sign" on MRI with COVID19 infection as the implicated etiology. To our knowledge, this is the first case of central cerebellopontine degeneration associated with COVID19. Conclusion(s): New onset multiple system atrophy may be a sequelae of COVID19 infection.