Deducing the Interplay Between Gut Flora and Respiratory Diseases: A New Therapeutic Strategy?

The gastrointestinal system, also referred to as the gut, is a universe that colonizes trillions of microbes. In addition to its digestive functions, the gut represents a biosystem that determines all the health vectors. It is now recognized as one of the body's defense systems, and good gut health regulates the body's immune responses. Disturbance of this barrier can trigger many diseases, including respiratory tract infections, as there is a close correlation between the gut microbiome and the chances of triggering illness. This review investigates the various factors affecting the gut microbiome, the diseases that can result from the dysregulation of the same, and their molecular mechanisms. The most basic solution to tackle this problem is to maintain the gut microbiome at the desired level. Timely diagnosis and interventions are needed for the proper management of the ensuing conditions. It is important to address the effects of factors on the gut microbiome and thereby regulate this level. The study also found that dysregulation in the system can lead to various diseases such as asthma, COPD, lung cancer following their respective pathways. In short, this paper reinforces the importance of the gut microbiome, the need to maintain its average level, and the need for proper interventions to treat the consequences. The manuscript posit that medications, diet as well and good physiological conditions of the human body can alter the microbiome and can ward off respiratory infections.

A systematic review and meta-analysis of the relationship between T-lymphocytes and respiratory tract infection in children.

The objective of this paper was to investigate the relationship between T-lymphocytes and respiratory tract infection in children. A meta-analysis was performed of studies related to virus-infected respiratory illnesses in children, and the change in the ratio of their T-lymphocyte subsets CD4+/CD8+. A systematic literature review was performed using MEDLINE (through PubMed), CINAHL (via Ebsco), Scopus, and Web of Science, for studies describing change in T-lymphocyte levels in children suffering from acute respiratory illnesses. Studies were included as per the Population, Intervention, Comparison, Outcomes and Study (PICOS) criteria, and relevant event data were extracted. A risk of publication bias and a risk of bias assessment were performed, and a funnel plot was designed using RevMan software. A column histogram was designed to compare the adverse effects. A total of 12 studies from the years 2000-2022 were included in the meta-analysis, containing information about 1111 patients. The current meta-analysis has a low risk of publication bias with the Egger's test p-value being 0.583 (p > 0.05) and the Begg's test p-value being 0.772 (p > 0.05). The odds ratio (OR) value was 3.66 (95% confidence interval (95% CI): 1.08-12.43), the risk ratio (RR) value was 1.91 (95% CI: 1.07-3.40) and the significance level was p < 0.05, which indicates that an alteration in T-lymphocyte levels occurs in respiratory infections. T-lymphocyte levels are altered during infection, and the association between T-lymphocytes and respiratory diseases in children was investigated in this study. Based on statistically significant data (p < 0.05), we concluded that T-lymphocyte levels are adjusted in the event of viral respiratory sickness in children to alleviate the infection.

A systematic review and meta-analysis of the relationship between T-lymphocytes and respiratory tract infection in children

The objective of this paper was to investigate the relationship between T-lymphocytes and respiratory tract infection in children. A meta-analysis was performed of studies related to virus-infected respiratory illnesses in children, and the change in the ratio of their T-lymphocyte subsets CD4+/CD8+. A systematic literature review was performed using MEDLINE (through PubMed), CINAHL (via Ebsco), Scopus, and Web of Science, for studies describing change in T-lymphocyte levels in children suffering from acute respiratory illnesses. Studies were included as per the Population, Intervention, Comparison, Outcomes and Study (PICOS) criteria, and relevant event data were extracted. A risk of publication bias and a risk of bias assessment were performed, and a funnel plot was designed using RevMan software. A column histogram was designed to compare the adverse effects. A total of 12 studies from the years 2000-2022 were included in the meta-analysis, containing information about 1111 patients. The current meta-analysis has a low risk of publication bias with the Egger's test p-value being 0.583 (p > 0.05) and the Begg's test p-value being 0.772 (p > 0.05). The odds ratio (OR) value was 3.66 (95% confidence interval (95% CI): 1.08-12.43), the risk ratio (RR) value was 1.91 (95% CI: 1.07-3.40) and the significance level was p < 0.05, which indicates that an alteration in T-lymphocyte levels occurs in respiratory infections. T-lymphocyte levels are altered during infection, and the association between T-lymphocytes and respiratory diseases in children was investigated in this study. Based on statistically significant data (p < 0.05), we concluded that T-lymphocyte levels are adjusted in the event of viral respiratory sickness in children to alleviate the infection.

Using Smartwatches to Detect Face Touching.

Frequent spontaneous facial self-touches, predominantly during outbreaks, have the theoretical potential to be a mechanism of contracting and transmitting diseases. Despite the recent advent of vaccines, behavioral approaches remain an integral part of reducing the spread of COVID-19 and other respiratory illnesses. The aim of this study was to utilize the functionality and the spread of smartwatches to develop a smartwatch application to identify motion signatures that are mapped accurately to face touching. Participants (n = 10, five women, aged 20-83) performed 10 physical activities classified into face touching (FT) and non-face touching (NFT) categories in a standardized laboratory setting. We developed a smartwatch application on Samsung Galaxy Watch to collect raw accelerometer data from participants. Data features were extracted from consecutive non-overlapping windows varying from 2 to 16 s. We examined the performance of state-of-the-art machine learning methods on face-touching movement recognition (FT vs. NFT) and individual activity recognition (IAR): logistic regression, support vector machine, decision trees, and random forest. While all machine learning models were accurate in recognizing FT categories, logistic regression achieved the best performance across all metrics (accuracy: 0.93 ± 0.08, recall: 0.89 ± 0.16, precision: 0.93 ± 0.08, F1-score: 0.90 ± 0.11, AUC: 0.95 ± 0.07) at the window size of 5 s. IAR models resulted in lower performance, where the random forest classifier achieved the best performance across all metrics (accuracy: 0.70 ± 0.14, recall: 0.70 ± 0.14, precision: 0.70 ± 0.16, F1-score: 0.67 ± 0.15) at the window size of 9 s. In conclusion, wearable devices, powered by machine learning, are effective in detecting facial touches. This is highly significant during respiratory infection outbreaks as it has the potential to limit face touching as a transmission vector.

Adapting the modified barium swallow: modifications to improve safety in the setting of airborne respiratory illnesses like COVID-19.

No guidance exists on how to safely perform modified barium swallows (MBS) in the midst of the COVID-19 pandemic or other communicable airborne respiratory infections (C-ARI). MBS has the potential to become an aerosol generating procedure (AGP) as it may trigger a cough or necessitate suctioning which may result in transmission of C-ARI putting patients and health care workers at risk. Regulations and best practices from international and US governmental and commercial agencies were reviewed. This review led to the multidisciplinary development of best practices of the safety measures and structural requirements to avoid transmission of SARS-CoV-2 or other C-ARIs when performing MBS. Implementation of these best practices resulted in structural changes to the fluoroscopy suite and protocol workflows. This enabled patients with COVID-19 to undergo MBS while maintaining patient and staff safety including mitigation of potential risk of onward transmission of SARS-CoV-2 to other patients. With proper modifications, MBS can be safely performed on patients with C-ARI such as COVID-19 while maintaining patient and health care worker (HCW) safety.

A Bottom-Up Approach Addressing Patient Care and Differential Diagnosis Amidst the Covid-19 Response.

Patient care often refers to the broad spectrum of care, prevention, and treatment that a provider delivers, while the point of a differential diagnosis is to make a distinction between 2 or more conditions that share similar signs or symptoms. A broad differential should be considered for every single patient who is currently ill (eg, all patients with respiratory illnesses); without it, there will likely be an increase of misdiagnosis, unnecessary patient suffering, and an influx of patients to the emergency department. The COVID-19 response has forced many of these basic medical values aside, like providing differential diagnosis or practicing bedside manner through social interaction, while physicians struggle to continue care for patients. As a result, newly formed hospital and clinical policies may have dangerously traded everyday diagnosis and treatment of patients for the pandemic and quarantine recommendations. This type of assumptive medicine is based on a singular differential that can be detrimental to patients, who are more likely affected with more common illnesses, like bronchitis or pneumonia-or perhaps, even more threatening illnesses, like a pulmonary embolism, COPD exacerbation, congestive heart failure and even lung cancer. Although these new policies and reactions to COVID-19 are proactive, these actions could be at the cost of providing quality patient care for people who have not contracted COVID-19.