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Treatment should be initiated early in the illness as the greatest effect on outcome is achieved if given within 48 hours of the onset of symptoms.1 In one randomized controlled trial, baloxavir marboxil had greater efficacy than oseltamivir in adolescents and adults with influenza B virus infection.3 (You can see the recommended list of antiviral medications for this season on the online Table at contemporarypediatrics.com/ influenza-and-RSV-during-COVID). Health care providers are already seeing a less severe influenza and RSV season due to the COVID-19 precautions, with individuals wearing masks and continued physical distancing. What HCPs can do in the meantime is test as many patients as they can to determine the infecting organism and the most appropriate treatment. Because HCPs know that the 2018-2019 influenza vaccine reducedpediatric influenza A-associ-ated hospitalizations and emergency department visits by 40% to 60%,5 this season's approach has been to immunize as many children with the influenza vaccine and test as many as possible for influenza and COVID-19. There are many single testing options available and a few multiplex assays using RT-PCR, mostly in hospital labs. But as the flu season marches on, I anticipate more assays to be available for use in the office as well. ¦ COMMENTS?
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The final act of Philip Roth's achingly poignant novel, Nemesis, based on the 1944 polio epidemic condenses the trajectories of each of the main protagonists' lives as a result of events that sultry summer, Bucky Cantor, swapping life stories with a former pupil at his school. [...]the implications for long term (psychological and physical) health are arguably worse: late presentation for other febrile illness (EDs have never been so empty—something is wrong);fear of infection by dint of ‘exposure' to a health facility;interruption of standard health surveillance particularly vaccination;mental health;child abuse as a result of prolonged internment and loss of, at least the social side of, education. The reasons for less aggressive disease are still not completely understood, though there are a number of candidate explanators: host-response factors;lower infective dose (as most often from an adult household member);age related ACE receptor differences and more recent exposure to antigenically similar coronaviruses conferring relative immunity.
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PurposeThis study aims to identify the dietary patterns of two groups of subjects (with and without COVID-19), and to assess the relationship of findings with the prognosis of COVID-19 and metabolic risk parameters.Design/methodology/approachThis study included 100 individuals in the age range of 19–65 years. The medical history, and data on biochemical, hematological and inflammatory indicators were retrieved from the files. A questionnaire for the 24-h food record and the food intake frequency was administered in face-to-face interviews, and dietary patterns of subjects were assessed.FindingsIn individuals with COVID-19, the hip circumference, the waist-hip ratio and the body fat percentage were significantly higher (p < 0.05), and the muscle mass percentage was significantly lower (p < 0.05). Mediterranean diet adherence screener (MEDAS), dietary approaches to stop hypertension (DASH) and healthy eating ındex-2015 (HEI-2015) scores were low in the two groups. A linear correlation of DASH scores was found with the muscle mass percentage (p = 0.046) and a significant inverse correlation of with the body fat percentage (p = 0.006). HEI-2015 scores were significantly and negatively correlated with body weight, body mass index, waist circumference, hip circumference and neck circumference (p < 0.05). Every one-unit increase in MEDAS, DASH and HEI-2015 scores caused reductions in C-reactive protein levels at different magnitudes. Troponin-I was significantly and negatively correlated with fruit intake (p = 0.044), a component of a Mediterranean diet and with HEI-2015 total scores (p = 0.032).Research limitations/implicationsThe limitation of this study includes the small sample size and the lack of dietary interventions. Another limitation is the use of the food recall method for the assessment of dietary patterns. This way assessments were performed based on participants' memory and statements.Practical implicationsFollowing a healthy diet pattern can help reduce the metabolic risks of COVÍD-19 disease.Originality/valueDespite these limitations, this study is valuable because, to the best of the authors' knowledge, it is the first study demonstrating the association of dietary patterns with disease prognosis and metabolic risks concerning COVID-19. This study suggests that dietary patterns during the COVID-19 process may be associated with several metabolic risks and inflammatory biomarkers.
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BackgroundA widely held belief is that "Medical student syndrome” is frequently experienced by young medical students, that is, they experience the symptoms of the diseases they are studying or fear of having such illness. A hypothesis is that because medical students constantly learn about life-threatening conditions and diseases, they experience persistent fear and stress regarding having a severe medical condition, an anxiety-related illness called nosophobia.ResultsAlthough medical students scored an average of 14.14 on a scale measuring potential nosophobia a, the difference between their scores and those of non-medical students, who scored an average of 0.11, is significantly higher (p 0.001). According to the presented analysis, non-medical and medical students exhibit distinct levels of nosophobia. The analysis of responses to hypochondriacal behaviors revealed that students from non-medical faculties scored an average of 1.43 points. By contrast, the average score for medical students was 7.87, which is significantly higher than that of the non-medical students (p 0.001).ConclusionsMedical students are at higher risk for health anxiety and hypochondrial attitudes than non-medical students are.
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BackgroundThe emergence of COVID-19 has spurred a wide range of psychological morbidities. However, its influence on a vulnerable population with chronic conditions is less addressed. Therefore, this study aimed to investigate the psychological health among patients with chronic diseases during the elevated psychiatric distress associated with the outbreak and examine the efficacy and feasibility of mindfulness-based stress reduction intervention (MBSR). The study involved 149 participants recruited from university hospital outpatient clinics. Patients were allocated into two groups: MBSR training program and control group. Standardized questionnaires were administered to assess depression, anxiety and stress prior to the MBSR program and at completion of the training after 8 weeks.ResultsThe results showed that MBSR intervention improved psychological distress and decreased the mean scores of depression, anxiety and stress.ConclusionsMindfulness training program based on audio and smartphone was feasible and effective when it was applied to patients with chronic diseases and showed positive impact on negative psychological stress domains. These findings pave the way for the integration of psychological support for patients with chronic illnesses in clinical settings.
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BackgroundThe medium-long impact of coronavirus disease 2019 (COVID-19) on active populations is yet to be fully understood, with potential individual and operational impact on military service personnel (SP). The M-COVID study was established to investigate cardiopulmonary, functional, cognitive, and mental health post-COVID-19 SP outcomes, across the spectrum of acute COVID-19 severity.MethodObservational four-cohort study;hospitalised, community-based illness with on-going symptoms (communitysymptomatic), community-based illness now recovered (community-recovered) and age, sex, job-role matched control. Participants underwent extensive clinical assessment involving cardiopulmonary imaging, submaximal and maximal exercise testing, pulmonary function, cognitive assessment, blood tests, electrocardiogram and questionnaires on mental health and physical function.Results113 participants (aged 39±9, 86% male) were recruited;Hospitalised (n=35), community-symptomatic (n=34), community-recovered (n=18) and control (n=26), 159±72 days following acute illness. Hospitalised and community-symptomatic groups were older (p=0.003), with a higher body mass index (p<0.001), and worse mental health (anxiety,p=0.011;depression,p<0.001;post-traumatic stress, p<0.001), fatigue (p<0.001), and quality of life scores (p=0.001), with a mean of 2±2 and 2±1 symptoms, respectively. Hospitalised and community-symptomatic participants also performed less well on sub-maximal (p<0.001) and maximal exercise testing, with hospitalised individuals displaying impaired ventilatory efficiency (p<0.001), less work at the anaerobic threshold and at peak (both p<0.001), and significantly reduced forced vital capacity (p=0.004). Clinically significant abnormal cardiopulmonary imaging findings were present in 6% of hospitalised participants, lower than those seen in other studies. Those who recovered from communitybased, mild-moderate COVID-19 had no significant differences from controls on any parameter.ConclusionsRecovered SP who suffered mild-moderate COVID-19 do not differ from an age, sex and job-role matched controls. This is reassuring for the vast majority of individuals who have had acute COVID-19 not requiring hospital management. Individuals who were hospitalised or continue to suffer symptoms may require a specific, comprehensive clinical and occupational assessment prior to a full return to duty.
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[...]many elementary and secondary schools were closed in 2020;when they reopened in 2021, masks and social distancing were in place. [...]these factors may have significantly reduced children and unvaccinated families from contracting and spreading the measles virus. Pediatric tuberculosis A diagnosis of pediatric tuberculosis (TB), for either latent TB (referred to as tuberculosis infection [TBI]7) or TB disease (active TB), is made for patients aged less than 15 years who have either a positive tuberculin skin test or a positive interferongamma release assay.7,8 Both tests have a high positive predictive value when used for children who have had a direct contact exposure to an adult with TB disease.7 Infants and young children are at increased risk of developing life-threatening forms of the disease, including TB meningitis and disseminated TB, compared with older children and adults.8 The greatest numbers of TB cases occur in children under 5 years old, with 38% of pediatric cases occurring within this age range.7 In addition, in 2020, 28% of the 10- to 14-year-old population had a diagnosis of pediatric TB.8 Data from TB cases in children aged less than 18 years living in the United States from 2010 to 2017 revealed that 32% of children with TB disease were born in other countries.9 Adults who have the TB bacterium, Mycobacterium tuberculosis, spread the organism via airborne transmission by coughing, speaking, or singing. [...]children with pediatric TB do not spread the organism as readily as adults, because pediatric TB is less infectious than the adult form.8 Children may present with a cough, weakness, weight loss, fever, change in playtime behaviors, and/or night sweats.8 Children younger than 4 years are at the highest riskof progressing from TBI to TB disease, with data showing a risk of 40% to 50% for infants less than 1 year old and 25% for 1- to 2-year-olds.8 However, children with a diagnosis of TBI who receive drug therapy and whose parents adhere to the regimen have a 90% reduced risk of developing TB disease.8 Adolescents older than 12 years have a risk of progression to adult-type TB disease. Providers need to be aware that the Centers for Disease Control and Prevention does not recommend the 4-month rifapentine-moxifloxacin TB regimen for children younger than 12 years.8 Best practices for pediatric providers include consulting a TB expert prior to beginning the treatment course, based on the available data showing that young children have a high risk of developing life-threatening TB disease.8 Conclusions Pediatric health care providers are on the frontlines for identifying infectious diseases and, to prevent poor outcomes, must react quickly to diagnose and treat cases in children and adolescents.
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Background: The utilization of herbal medicine (HM) as a component of complementary and alternative medicine (CAM) is increasing worldwide. Little is known about justifications for its use and the factors associated with it. This study gains insights into the use of herbal medicines in Northern Cyprus, concentrating on targets for its use, the role played by disease type, reasons for its use, and sources of information. Methods: A questionnaire was utilized to achieve the aim of the study. The questionnaire was distributed to a random sample comprised of people in two different regions in Northern Cyprus over a 12-week period from August to November 2020. A self-administered questionnaire was used for data collection. Moreover, qualitative research explored individuals' decision making regarding CAM, which aimed to examine 20 patients as a context for beliefs, decision making, and dialogue about CAM. After audio-taping and verbatim transcription, the data were analyzed with qualitative content analysis. Results: The findings show that the majority of respondents learned about herbal products (HPs) and CAM from other patients, the Internet, friends, and family. The results indicate that almost half of the respondents were aware of how CAMs, especially herbal preparations, are used to treat common illnesses. Fennel, ginger, and echinacea were the most commonly used HMs, mainly for the treatment of the common cold. Furthermore, nearly 50% of the participants expressed the belief that HMs are safe, have fewer side effects than conventional medicines, and are also effective for treating minor health conditions. The prevalence was strongly associated with education level based on a Pearson Chi-square analysis. Conclusions: Although herbal medicines were mostly used to treat mild to moderate ailments and the participants were aware of their limitations, the combination of self-medication, inexperienced counseling, and lack of awareness of the risks of herbal medicines is potentially harmful. This is particularly important for elderly users, because although they seemed to be more aware of health-related issues, they generally used more medication than younger people. Given our finding that dissatisfaction with modern medicine is the most important reason for the preferred use of herbal medicines, government agencies, physicians, and pharmaceutical companies should be aware of this issue and should aim to create some level of awareness among users.
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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.