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1.
J Clin Med ; 10(1)2020 Dec 30.
Article in English | MEDLINE | ID: covidwho-1753519

ABSTRACT

Candida species are common global opportunistic pathogens that could repeatedly and chronically cause oral mucosa infection and create an inflammatory environment, leading to organ dysfunction. Oral Candida infections may cause temporary or permanent damage to salivary glands, resulting in the destruction of acinar cells and the formation of scar tissue. Restricted function of the salivary glands leads to discomfort and diseases of the oral mucosa, such as dry mouth and associated infection. This narrative review attempts to summarize the anatomy and function of salivary glands, the associations between Candida and saliva, the effects of Candida infection on salivary glands, and the treatment strategies. Overall, clinicians should proactively manage Candida infections by educating patients on oral hygiene management for vulnerable populations, conducting frequent checks for a timely diagnosis, and providing an effective treatment plan.

2.
Zhonghua Nei Ke Za Zhi ; 59(8): 610-617, 2020 Aug 01.
Article in Chinese | MEDLINE | ID: covidwho-1555470

ABSTRACT

Objective: To explore the feasibility of direct renin inhibitor aliskiren for the treatment of severe or critical coronavirus disease 2019 (COVID-19) patients with hypertension. Methods: The antihypertensive effects and safety of aliskiren was retrospectively analyzed in three severe and one critical COVID-19 patients with hypertension. Results: Four patients, two males and two females, with an average age of 78 years (66-87 years), were referred to hospital mainly because of respiratory symptoms. Three were diagnosed by positive novel coronavirus 2019 (2019-nCoV) nucleic acid or antibody, and the critical patient with cardiac insufficiency was clinically determined. Two patients were treated with calcium channel antagonist (CCB), one with angiotensin converting enzyme inhibitor (ACEI), and one with angiotensin Ⅱ receptor antagonist (ARB). After admission, ACEI and ARB were discontinued, one patient with heart failure was treated by aliskiren combined with diuretic.Three patients were treated with aliskiren combined with CCB among whom two withdrew CCB due to low blood pressure after 1 to 2 weeks. Based on comprehensive treatment including antiviral and oxygenation treatment, blood pressure was satisfactorily controlled by aliskiren after three to four weeks without serious adverse events. All patients were finally discharged. Conclusion: Our preliminary clinical data shows that antihypertensive effect of aliskiren is satisfactory and safe for severe COVID-19 patients complicated with hypertension.


Subject(s)
Antihypertensive Agents , COVID-19 , Hypertension , Renin/antagonists & inhibitors , Aged , Aged, 80 and over , Amides/therapeutic use , Angiotensin Receptor Antagonists , Angiotensin-Converting Enzyme Inhibitors , Antihypertensive Agents/therapeutic use , COVID-19/complications , Female , Fumarates/therapeutic use , Humans , Hypertension/drug therapy , Male , Retrospective Studies
3.
Int J Environ Res Public Health ; 18(8)2021 04 08.
Article in English | MEDLINE | ID: covidwho-1178247

ABSTRACT

Since December 2019, coronavirus disease (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has rapidly spread, becoming the first pandemic of the 21st century by number of deaths (over 2,000,000 worldwide). Many aspects of SARS-CoV-2 infection in children and adolescents remain unclear, and optimal treatment has not yet been defined. Therefore, our goal was to develop a consensus document, practically synthesizing the accumulated data and clinical experience of our expert group. Literature research was carried out using the keywords "COVID-19" or "SARS-CoV-2" and "children" or "pediatrics" and "prevention" or "diagnosis" or "MIS-C" or "treatment" in electronic databases (MEDLINE, PUBMED), existing guidelines and gray literature. The fact that the majority of the problems posed by SARS-CoV-2 infection in pediatric age do not need hospital care and that, therefore, infected children and adolescents can be managed at home highlights the need for a strengthening of territorial pediatric structures. The sharing of hospitalization and therapeutic management criteria for severe cases between professionals is essential to ensure a fair approach based on the best available knowledge. Moreover, the activity of social and health professionals must also include the description, management and limitation of psychophysical-relational damage resulting from the SARS-CoV-2 pandemic on the health of children and adolescents, whether or not affected by COVID-19. Due to the characteristics of COVID-19 pathology in pediatric age, the importance of strengthening the network between hospital and territorial pediatrics, school, educational, social and family personnel both for strictly clinical management and for the reduction in discomfort, with priority in children of more frail families, represents a priority.


Subject(s)
COVID-19 , Pediatrics , Adolescent , Child , Consensus , Humans , Italy/epidemiology , SARS-CoV-2
4.
PLoS One ; 16(4): e0249095, 2021.
Article in English | MEDLINE | ID: covidwho-1167104

ABSTRACT

BACKGROUND: Neurodegenerative diseases are sporadic hereditary conditions characterized by progressive dysfunction of the nervous system. Among the symptoms, vestibulopathy is one of the causes of discomfort and a decrease in quality of life. Hereditary spastic paraplegia is a heterogeneous group of hereditary degenerative diseases involving the disorder of a single gene and is characterized by the progressive retrograde degeneration of fibers in the spinal cord. OBJECTIVE: To determine the benefits of vestibular rehabilitation involving virtual reality by comparing pre intervention and post intervention assessments in individuals with hereditary spastic paraplegia. METHODS: In this randomized controlled clinical trial from the Rebec platform RBR-3jmx67 in which allocation concealment was performed and the evaluators be blinded will be included. The participants will include 40 patients diagnosed with hereditary spastic paraplegia. The interventions will include vestibular rehabilitation with virtual reality using the Wii® console, Wii-Remote and Wii Balance Board (Nintendo), and the studies will include pre- and post intervention assessments. Group I will include twenty volunteers who performed balance games. Group II will include twenty volunteers who performed balance games and muscle strength games. The games lasted from 30 minutes to an hour, and the sessions were performed twice a week for 10 weeks (total: 20 sessions). RESULTS: This study provides a definitive assessment of the effectiveness of a virtual reality vestibular rehabilitation program in halting the progression of hereditary spastic paraplegia, and this treatment can be personalized and affordable. CONCLUSION: The study will determine whether a vestibular rehabilitation program with the Nintendo Wii® involving virtual reality can reduce the progressive effect of hereditary spastic paraplegia and serve as an alternative treatment option that is accessible and inexpensive. Rebec platform trial: RBR-3JMX67.


Subject(s)
Exercise Therapy , Postural Balance/genetics , Spastic Paraplegia, Hereditary/rehabilitation , Spinal Cord/pathology , Adolescent , Adult , Brazil , Cognitive Dysfunction/physiopathology , Cognitive Dysfunction/rehabilitation , Female , Games, Recreational , Humans , Male , Middle Aged , Muscle Strength/physiology , Pain/physiopathology , Pain/prevention & control , Quality of Life , Spastic Paraplegia, Hereditary/genetics , Spastic Paraplegia, Hereditary/physiopathology , Treatment Outcome , Virtual Reality , Young Adult
5.
Adv Respir Med ; 88(6): 638-639, 2020.
Article in English | MEDLINE | ID: covidwho-1058966

ABSTRACT

Performing medical procedures with the use of personal protective equipment may reduce the efficiency of medical procedures performed, for example, as with the current use of respiratory protection devices, including N95 or surgical masks. Healthcare workers (HCWs) using N95 respirators or medical masks may experience discomfort associated with wearing a mask when performing medical procedures, in particular those associated with increased physical activity, causing increased respiratory effort.


Subject(s)
COVID-19/prevention & control , Infection Control/methods , N95 Respirators/standards , Occupational Exposure/prevention & control , Emergency Medical Services , Humans , Masks/standards
6.
Vopr Kurortol Fizioter Lech Fiz Kult ; 97(6): 11-16, 2020.
Article in Russian | MEDLINE | ID: covidwho-976632

ABSTRACT

The number of patients who have had pneumonia caused by COVID-19 is increasing every month. However, despite the ongoing treatment, the consequences of this disease are possible, which may appear in the short term or after a while. Pneumonia caused by the new coronavirus infection COVID-19 is characterized by the presence of such complications as cough, shortness of breath, fatigue, sleep disturbances, appetite disorders, etc. Often, pneumonia leads to dysfunctions of the respiratory system, higher mental functions, functions of the cardiovascular system and, unfortunately, possible disability. The search and implementation of new methods of physical rehabilitation is an urgent task of modern medicine. Low-frequency magnetotherapy is one of the safest and most commonly recommended treatments for pneumonia. OBJECTIVE: To assess the effectiveness of the use of low-frequency magnetotherapy in the complex medical rehabilitation of patients who have had pneumonia in the phase of convalescence. MATERIAL AND METHODS: The study included 52 patients who had suffered from pneumonia caused by COVID-19 and whose average age was 56.2±5.7 years. Group I (main) group (n=30), against the background of standard therapy on the 16th day after discharge from the hospital, received low-frequency magnetotherapy on the ALMAG-02 apparatus (Elamed, Russia) daily for 20 minutes, a course of 10-12 procedures. In the second (control) group (n=22), therapy was carried out in accordance with the Temporary Clinical Recommendations of the Ministry of Health of the Russian Federation for the prevention, diagnosis and treatment of new coronavirus infection COVID-19 (version 8.1 of 01/10/2020), as well as the Temporary Clinical recommendations for medical rehabilitation for a new coronavirus infection (version 8.1 of 01/10/2020). Evaluation method: spirometry using a spirographMIR (Italy), chest excursion, rehabilitation routing scale (RRM), quality of life questionnaire (EQ-5D), Borg scale for patient assessment of exercise tolerance, ECG, oxygen saturation in the blood. RESULTS AND DISCUSSION: The patients of the 1st group showed an increase in the vital capacity of the lungs by 16.4% in comparison with the 2nd (control) group; an increase in chest excursion by 45.6%, a decrease in the level of shortness of breath from moderate to mild by 64.1%, a decrease in disabilities by 62.7%, compared with the second (control) group. According to the data of the quality of life questionnaire (EQ-5D), the patients of the main group showed improvements in general mobility (mobility) by 44.5%, everyday activity by 26.1%, a decrease in pain/discomfort by 47.9%, anxiety and depression by 42.2%, compared with the control group (p=0.001). CONCLUSION: The inclusion of low-frequency magnetic therapy in complex rehabilitation contributes to the regression of respiratory disorders, reduces the level of anxiety and depression, reduces pain and discomfort, thereby improving the patient's quality of life.


Subject(s)
COVID-19 , Magnetic Field Therapy , Pneumonia, Viral , COVID-19/therapy , Humans , Middle Aged , Pandemics , Pneumonia, Viral/therapy , Quality of Life , Russia , SARS-CoV-2
7.
Andrology ; 9(1): 99-106, 2021 01.
Article in English | MEDLINE | ID: covidwho-910378

ABSTRACT

BACKGROUND: The coronavirus disease 2019 (COVID-19) has been spreading all over the world since December 2019. However, medical information regarding the urogenital involvement in recovered COVID-19 patients is limited or unknown. OBJECTIVES: To comprehensively evaluate urogenital involvement in recovered COVID-19 patients. MATERIALS AND METHODS: Men aged between 20 years and 50 years who were diagnosed with SARS-CoV-2 infection and recovered when the study was conducted were enrolled in our study. Demographic and clinical characteristics, and history of hospitalization were collected and analyzed. Urine, expressed prostatic secretions (EPSs), and semen samples were collected for SARS-CoV-2 RNA detection. Semen quality and hormonal profiles were analyzed. RESULTS: Among 74 male recovered COVID-19 patients, 11 (14.9%) were asymptomatic, classified into mild type, and 31 (41.9%) were classified into moderate type. The remaining patients (32/74, 43.2%) had severe pneumonia. No critically ill recovered COVID-19 patient was recruited in our cohort. The median interval between last positive pharyngeal swab RT-PCR test and semen samples collection was 80 days (IQR, 64-93). The median age was 31 years (IQR, 27-36; range, 21-49), and the median body mass index (BMI) was 24.40 (IQR, 22.55-27.30). Forty-five (61.6%) men were married, and 28 (38.4%) were unmarried. Fifty-three (72.6%) patients denied cigarette smoking, 18 (24.7%) were active smokers, and 2 of them were past smokers. The majority of our participants (53/74, 72.6%) did not consume alcohol. Fever occurred in most of the patients (75.3%), and 63 of them had abnormal chest CT images. Only one patient complained of scrotal discomfort during the course of COVID-19, which was ruled out orchitis by MRI (data not shown). A total of 205 samples were collected for SARS-CoV-2 detection (74 urine samples, 70 semen samples, and 61 EPS samples). However, viral nucleic acid was not detected in body fluids from the urogenital system. In terms of hormonal profiles, the levels of FSH, LH, testosterone, and estradiol were 5.20 [4.23] mIU/mL, 3.95 [1.63] mIU/mL, 3.65 [1.19] ng/mL, and 39.48 [12.51] pg/mL, respectively. And these values were within the normal limits. The overall semen quality of recovered COVID-19 patients was above the lower reference limit released by the WHO. While compared with healthy control, sperm concentration, total sperm count, and total motility were significantly declined. In addition, different clinical types of COVID-19 have no significant difference in semen parameters, but total sperm count showed a descending trend. Interestingly, subjects with a longer recovery time showed worse data for sperm quality. Small sample size and lacking semen parameters before the infection are the major limitations of our study. DISCUSSION AND CONCLUSIONS: To the best of our knowledge, it is the largest cohort study with longest follow-up for urogenital evaluation comprehensively so far. Direct urogenital involvement was not found in the recovered COVID-19 male patients. SARS-CoV-2 RNA was undetectable in the urogenital secretions, and semen quality declined slightly, while hormonal profiles remained normal. Moreover, patients with a long time (≥90 days) since recovery had lower total sperm count. Great attention and further study should be conducted and follow-up on the reproductive function in the following months.


Subject(s)
COVID-19/virology , Prostate/virology , RNA, Viral/isolation & purification , SARS-CoV-2/isolation & purification , Semen/virology , Adult , COVID-19/diagnosis , COVID-19/therapy , COVID-19 Nucleic Acid Testing , Humans , Male , Middle Aged , RNA, Viral/genetics , RNA, Viral/urine , Remission Induction , SARS-CoV-2/genetics , Semen Analysis , Time Factors , Urine/virology , Young Adult
8.
J Voice ; 2020 Oct 16.
Article in English | MEDLINE | ID: covidwho-866951

ABSTRACT

OBJECTIVE: During COVID-19, government measures to prevent disease spread included advice to work from home. In addition to occupational risk factors, the increased use of telecommunication and changed work environment may contribute to voice and vocal tract discomfort (VTD). This study established the prevalence, incidence, characteristics and impact of self-perceived dysphonia and VTD in those working from home during COVID-19. METHODS: A cross-sectional, observational study using an online survey recruited 1575 participants. It captured information about dysphonia and VTD presence, onset, and severity. Those with dysphonia completed the voice-related quality of life to measure impact. Regression analyses identified risk factors for voice and vocal tract problems. RESULTS: Dysphonia and VTD prevalence rates were 33% and 68%, respectively, incidences were 28% and 50%. Perceived dysphonia severity was mild in 72% of cases. Dry throat was the most common VTD symptom at 66%. Mean voice-related quality of life score was 82.4 (standard deviation ± 13.2). Raising or straining the voice while working predicted new onset dysphonia and VTD. Increasing telecommunication use was associated with worse dysphonia and VTD onset. CONCLUSION: Those working from home have seen a rise in dysphonia and VTD, which were associated with communication modality and change in environment. If home offices become the 'new normal' post-COVID, workplaces should consider voice training for employees to limit potential difficulties.

9.
J Emerg Nurs ; 46(6): 791-801.e7, 2020 Nov.
Article in English | MEDLINE | ID: covidwho-803566

ABSTRACT

INTRODUCTION: The purpose of this study was to rapidly quantify the safety measures regarding donning and doffing personal protective equipment, complaints of discomfort caused by wearing personal protective equipment, and the psychological perceptions of health care workers in hospitals in Wuhan, China, responding to the outbreak. METHODS: A cross-sectional online questionnaire design was used Data were collected from March 14, 2020, to March 16, 2020, in Wuhan, China. Descriptive statistics and χ2 analyses testing were used. RESULTS: Standard nosocomial infection training could significantly decrease the occurrence of infection (3.6% vs 13.0%, χ2 = 4.47, P < 0.05). Discomfort can be classified into 7 categories. Female sex (66.0% vs 50.5%, χ2 = 6.37), occupation (62.7% vs 30.8%, χ2 = 5.33), working at designated hospitals (44.8% vs 26.7%, χ2 = 5.17) or in intensive care units (70.4% vs 57.9%, χ2 = 3.88), and working in personal protective equipment for > 4 hours (62.2% vs 39.2%, χ2 = 9.17) led to more complaints about physical discomfort or increased occurrence of pressure sores (all P < 0.05). Psychologically, health care workers at designated hospitals (60.0% vs 42.1%, χ2 = 4.97) or intensive care units (55.9% vs 41.5%, χ2 = 4.40) (all P < 0.05) expressed different rates of pride. DISCUSSION: Active training on infection and protective equipment could reduce the infection risk. Working for long hours increased the occurrence of discomfort and skin erosion. Reducing the working hours and having adequate protective products and proper psychological interventions may be beneficial to relieve discomfort.


Subject(s)
COVID-19/prevention & control , Cross Infection/prevention & control , Health Personnel/psychology , Infectious Disease Transmission, Patient-to-Professional/prevention & control , Personal Protective Equipment/adverse effects , Pneumonia, Viral/prevention & control , Adult , COVID-19/epidemiology , China/epidemiology , Cross-Sectional Studies , Female , Humans , Male , Pandemics , Pneumonia, Viral/epidemiology , Pneumonia, Viral/virology , SARS-CoV-2 , Surveys and Questionnaires
10.
3D Print Med ; 6(1): 27, 2020 Sep 29.
Article in English | MEDLINE | ID: covidwho-802427

ABSTRACT

PURPOSE: Many commonly used mask designs are secured by elastic straps looping around the posterior auricular region. This constant pressure and friction against the skin may contribute to increased wearer pain, irritation, and discomfort. The purpose of this work is to report a modified 3D printed mask extender to alleviate discomfort and increase mask wearability by relieving posterior auricular pressure from isolation masks. METHODS: Our institutional review board designated this project as non-human research and exempt. As part of resourcing 3D printing laboratories along with individual 3D printers to provide resources to healthcare workers, mask extenders were printed to relieve posterior auricular pressure from individuals wearing isolation masks. The authors modifed an existing mask extender, increasing its length with accompanying peripheral rungs for isolation mask securement. 3D printing was performed with Ultimaker S5 (Ultimaker B.V.; Geldermalsen, Netherlands) and CR-10 (Creality3D; Shenzhen, China) 3D printers using polylactic acid filaments. The author's modified extended mask extenders were printed and freely delivered to healthcare workers (physicians, nurses, technologists, and other personnel) at the authors' institution. RESULTS: The final mask extender design was printed with the two 3D printers with a maximum 7 straps printed simultaneously on each 3D printer. Mean print times ranges from 105 min for the Ultimaker S5 printer and 150 min for the CR-10. Four hundred seventy-five mask extenders were delivered to healthcare workers at the authors' institution, with the demand far exceeding the available supply. CONCLUSION: We offer a modification of a 3D printed mask extender design that decreases discomfort and increases the wearability of isolation mask designs with ear loops thought to relieve posterior auricular skin pressure and ability to control strap tension. The design is simple, produced with inexpensive material (polylactic acid), and have been well-received by healthcare providers at our institution.

11.
Eur Rev Med Pharmacol Sci ; 24(14): 7826-7833, 2020 07.
Article in English | MEDLINE | ID: covidwho-693444

ABSTRACT

OBJECTIVE: The outbreak of the 2019 Novel Coronavirus Disease (COVID-19) is seriously threatening the health of people all over China and the world. This study aims to investigate the clinical characteristics and outcomes of COVID-19 patients admitted at different time periods. PATIENTS AND METHODS: A total of 132 discharged cases and 10 deaths of laboratory or clinically confirmed cases were retrospectively collected from The First People's Hospital of Jingzhou, Hubei. All cases were divided into two groups according to different admission times (group 1 from 2020-1-23 to 2020-2-3 and group 2 from 2020-2-4 to 2020-2-15). Individual data, clinical data, laboratory indices and prognosis were collected for the two groups, and statistical analysis was performed using the t-test or chi-square test to assess differences between the groups. RESULTS: Among the 142 cases, there were 67 in the first group and 75 in the second group. According to the individual data and clinical manifestations of the two groups, the hospital stay in the first group was significantly longer than that of the second group (26 [9-39] compared with 20 [6-30], p=0.000). There were more clinical symptoms upon admission in group 1 than in group 2; although 66.2% of all patients had fever, the proportion of patients with fever on admission in the first group was significantly higher than that in the second group (79.1% compared with 54.7%, p=0.002). The proportion of patients with chills in the first group was higher than that in the second group (16.4% compared with 5.3%, p=0.032), and the proportion of patients with dyspnea was also higher than that in the second group (17.9% compared with 4%, p=0.007). Four of the 67 patients in the first group had symptoms of ocular discomfort, but none in the second group had this symptom (6.0% compared with 0, p=0.032). Based on laboratory examination, the inflammatory index of patients in the first group was higher than that in the second group, and the proportion of patients with a C-reactive protein (CRP) increase was also significantly higher (60% compared with 38.7%, p=0.020). The main difference in routine blood tests involved white blood cell and lymphocyte counts and the lymphocyte percentage. The proportion of patients with reduced white blood cell counts in the first group was higher than that in the second group (23.9% compared with 10.7% p=0.036). Moreover, more patients in the first group had a reduced lymphocyte count and percentage (71.6% compared with 30.7% p=0.000; 49.3% compared with 29.7% p=0.015, respectively), and the former was significantly lower than that in the second group (0.94 [0.24-2.42] compared with 1.365 [0.22-3.62], p=0.000). Regarding prognosis, the proportion of severe cases and mortality in the first group were slightly higher than in the second group (p>0.05). CONCLUSIONS: The clinical manifestations, blood changes and outcomes differed in patients admitted at different time periods. In the second group of patients, clinical symptoms were less common than in the first group, routine blood changes and inflammatory indices were milder, and the clinical prognosis was better.


Subject(s)
Coronavirus Infections/pathology , Pneumonia, Viral/pathology , Adolescent , Adult , Aged , Aged, 80 and over , Betacoronavirus/isolation & purification , C-Reactive Protein/analysis , COVID-19 , Coronavirus Infections/complications , Coronavirus Infections/mortality , Coronavirus Infections/virology , Dyspnea/diagnosis , Dyspnea/etiology , Female , Humans , Length of Stay , Lymphocyte Count , Male , Middle Aged , Pandemics , Pneumonia, Viral/complications , Pneumonia, Viral/mortality , Pneumonia, Viral/virology , Prognosis , Retrospective Studies , SARS-CoV-2 , Severity of Illness Index , Survival Rate , Time Factors , Young Adult
12.
Med Hypotheses ; 144: 109880, 2020 Nov.
Article in English | MEDLINE | ID: covidwho-361316

ABSTRACT

Fever has been reported as a common symptom occurring in COVID-19 illness. Over the counter antipyretics such as ibuprofen and acetaminophen are often taken by individuals to reduce the discomfort of fever. Recently, the safety of ibuprofen in COVID-19 patients has been questioned due to anecdotal reports of worsening symptoms in previously healthy young adults. Studies show that ibuprofen demonstrates superior efficacy in fever reduction compared to acetaminophen. As fever may have benefit in shortening the duration of viral illness, it is plausible to hypothesize that the antipyretic efficacy of ibuprofen may be hindering the benefits of a fever response when taken during the early stages of COVID-19 illness.


Subject(s)
Antipyretics/adverse effects , Antipyretics/therapeutic use , COVID-19/drug therapy , Fever/drug therapy , Ibuprofen/adverse effects , Ibuprofen/therapeutic use , Acetaminophen/therapeutic use , Fever/physiopathology , Humans , Models, Theoretical , Patient Safety , Treatment Outcome
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