<![CDATA[Current Respiratory Medicine Reviews (Volume 20 - Issue 1)]]> https://www.eurekaselect.com/journal/47 RSS Feed for Journals | BenthamScience EurekaSelect (+https://www.eurekaselect.com) 2024-02-28 <![CDATA[Current Respiratory Medicine Reviews (Volume 20 - Issue 1)]]> https://www.eurekaselect.com/journal/47 <![CDATA[The Journal and the Challenges of COVID-19 Vaccine-related Injuries]]>https://www.eurekaselect.com/article/1383242024-02-28 <![CDATA[Lipid-Based Nanocarriers in the Management of Pulmonary Complications in Cystic Fibrosis]]>https://www.eurekaselect.com/article/1358822024-02-28via LBCs has received more and more attention in recent years. Due to their simple production, physicochemical stability, and scalability, these nanocarriers have caught the attention of the industrial sector. Because of these qualities, LBCs are well suited for industrial manufacturing. Clinical trials are already being conducted on a number of LBC-containing items and are likely to swiftly grow in popularity. For commercial applications to produce enough formulations for clinical research, a large-scale manufacturing facility is necessary. The mainstay of treatment for CF, asthma, and chronic obstructive lung disease is the inhalation of corticosteroids and topical bronchodilators. These drugs are given through a metered-dose inhaler (MDI), a dry powder inhaler (DPI), a jet, or an ultrasonic nebulizer. Although the sheer number of gadgets may be overwhelming for patients and doctors, each has unique benefits.]]> <![CDATA[The Relationship between COVID-19 Severity and Plasma Levels of Vascular Endothelial Growth Factor (VEGF)]]>https://www.eurekaselect.com/article/1361092024-02-28Background: This study aimed to assess the relationship between COVID-19 severity and the plasma levels of vascular endothelial growth factor.

Methods: This cross-sectional study was conducted on 86 patients with COVID-19. A 5 ml venous blood sample was taken on the first day of hospitalization. VEGF was measured with the ELISA method using the Hangzhou East biopharm VEGF ELIZA Kit.

Results: The mean age of patients was 56 ± 15 years. The mean plasma level of VEGF was 2877.07 ± 104.77 ng/ml. There was no significant relationship between VEGF levels and COVID-19 severity (P = 0.55). The percentage of pulmonary infiltration > 50 in the severe group (72.7%) was higher than that of the non-severe group (2.4%) (P = 0.001). There was a significant relationship between COVID-19 severity and the levels of LDH, neutrophil/lymph ratio, and CRP. Regarding medications, remdesivir was used more in the severe group (70.5%) than in the non-severe group (45.2%) (P = 0.018).

Conclusion: Although plasma VEGF levels were higher in the severe group than in the non-severe group, no significant relationship was found between the plasma level of VEGF and COVID-19 severity, which might be due to the small sample size. VEGF may be a valuable scientific marker, but in this study, it was not as useful as other markers in identifying COVID-19 severity. In addition, there was a direct and significant relationship between COVID-19 severity and the inflammatory markers LDH, neutrophil/lymph, and CRP. Therefore, measurement of inflammatory markers can assist in the early identification and prediction of severity and disease progression in COVID-19.

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<![CDATA[Gaps in the Diagnosis and Treatment of Drug-resistant Tuberculosis in Mexico]]>https://www.eurekaselect.com/article/1356142024-02-28Objective: The study aimed to determine the critical gaps in the care of drug-resistant tuberculosis to implement strategies for its elimination.

Material and Methods: Cases with various resistance profiles that were presented to the National Advisory Group for Drug Resistance during the years 2019-2022 have been described.

Results and Discussion: 104 cases were included in this study. 41% of the patients had diabetes (41%) as a comorbidity. There have been observed delays in the reporting of rapid molecular tests; with the Xpert MTB/RIF, delays of 6.33 days have been reported. There have also been observed delays in the request for phenotypic drug susceptibility tests; from the time of initial diagnosis, patients have been found to receive their first drug susceptibility test, on average, after 20 months. The bacteriological follow-up during the treatment with monthly culture has been found to only be carried out in 8% of the cases. In the contact investigation, only 16% of the listed contacts had been studied for infection or active disease.

Conclusion: The elimination of these gaps requires the decentralization of susceptibility tests for fluoroquinolones, shortening the times between the diagnosis of drug resistance and the start of treatment, a close clinical and bacteriological follow-up, and an exhaustive investigation of contacts.

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<![CDATA[COVID-19 Vaccines and the Menstrual Cycle: A Cross-Sectional Study]]>https://www.eurekaselect.com/article/1361552024-02-28Objective: This study aimed to explore the impact of various COVID-19 vaccines on the menstrual cycle of Jordanian women.

Materials and Methods: We conducted a retrospective analysis of tracked menstrual changes using an anonymous questionnaire written in the local language. We received 732 responses, and after exclusions, 617 responses were analyzed. The questionnaire covered six sectors: demographics, medical history, COVID-19 infection and vaccination status, obstetric and gynecological history, menstrual cycle history, and specific questions about cycle length, flow, and any symptoms before and after each vaccine shot. Participants included Jordanian females who had received any type of COVID-19 vaccine.

Results: Among the participants analyzed, two-thirds were between the ages of 20-35, and the majority had a normal BMI (59.6%). Most participants were single, nulliparous, and had never used contraception methods (79.3%, 82.0%, and 93.8%, respectively). Only a small percentage had other risk factors influencing menstrual cycle changes, such as surgical procedures (10.5%) and specific medications (8.10%). Baseline menstrual information was recorded. Forty percent of participants experienced changes in menstrual duration, and approximately one-fifth reported heavier and more severe premenstrual syndrome (PMS) symptoms. Body mass index (BMI) was directly correlated with bleeding intensity after vaccination. Parity was weakly directly proportional to bleeding intensity after vaccination. However, BMI and parity did not significantly correlate with menstrual duration, menstrual cycle length, PMS symptoms, or cramps after vaccination.

Conclusion: In a population of young, non-sexually active women with a normal BMI, most participants did not experience significant changes in their menstrual cycles after receiving the COVID-19 vaccine. Only one-fifth of participants reported shorter duration, heavier bleeding, more frequent, more painful, and more severe PMS symptoms post-vaccination.

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<![CDATA[The Relationship between Endotypes and Exacerbation Events in COPD Patients]]>https://www.eurekaselect.com/article/1352482024-02-28Introduction: Acute exacerbations of COPD are responsible for 60% of health costs, reduce patients' quality of life, and accelerate disease progression. COPD endotypes are expected to provide new insights about clinical phenotypic variability and therapeutic response between individuals through certain biomarker approaches.

Objective: Our study aims to identify the relationship between COPD endotypes and exacerbation events.

Methods: In this cross-sectional study design, participants with stable COPD (n=40) were recruited from the outpatient clinic at Airlangga University Hospital in March-August 2022. Blood was obtained for endotype's biomarker examination, such as α1-antitrypsin (AAT), IL-17A, neutrophil, and eosinophil count. The relationship between COPD endotypes and exacerbation events was analyzed using a non-parametric statistical test.

Result: The lower limit normal of AAT levels obtained was 12.85ng/ml; 47.5% of subjects have low AAT levels. The average IL-17A levels and blood neutrophil counts were 0.478 ± 0.426 pg/ml and 5,916.95 ± 3,581.08 cells/μl, respectively. The average blood eosinophil count was 298.35 ± 280.44 cells/μl, 16 of 40 (40%) subjects with blood eosinophil count > 300 cells/μl. No significant association was observed between AAT levels (p = 1.000), IL-17A levels (p = 0.944), and blood eosinophil count (p = 0.739) with exacerbation events-only blood neutrophil count (p = 0.033) found to have a significant association with exacerbation events in COPD.

Conclusion: AAT levels, IL-17A levels, and blood eosinophil count were not significantly related to exacerbation events in COPD patients. In comparison, blood neutrophil count was the only one associated considerably with exacerbation events. Further research about COPD endotypes is needed to identify exacerbation susceptibility as a precision treatment strategy.

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<![CDATA[Utility of the Presence of Anti-SARS-CoV-2 Antibodies in Detecting COVID-19 in Symptomatic Children and Adolescents: An Analytical Cross-sectional Study]]>https://www.eurekaselect.com/article/1356582024-02-28 Background: Understanding immunoreactivity against SARS-CoV-2 provides a basis for the pathophysiology of COVID-19 while also providing a means to confirm the disease and reduce its transmission.

Methods: The present cross-sectional study was conducted from February 1st, 2020 to December 30th, 2022. The patients’ characteristics, clinical and laboratory data, Polymerase Chain Reaction (PCR) results, and the presence of anti-SARS-CoV-2 antibodies (serology testing) were recorded.

Results: A total of 182 children were included. PCR returned positive in 60.4%, while serology indicated infection in 86.4% of the participants. Sex as a factor was not significantly associated with the results of either of the tests. However, seropositive children were older (p < 0.001), while PCR-positive children were younger (p < 0.01). Those who presented with cough (p < 0.05) or Multisystem Inflammatory Syndrome (MIS-C) (p < 0.05) had higher seropositivity rates than those without. In contrast, those who presented with fever (p < 0.001) or seizures (p < 0.01) had higher chances of having a positive PCR for COVID-19. In individuals suffering from arthralgia, limping, or arthritis, positive serology was observed in 96.3%, 95.2%, and 96.9%, respectively. However, positive results from PCR were observed in 67.2%, 67.1%, and 30.3% of the mentioned individuals, respectively.

Conclusion: Anti-SARS-CoV-2 serology is a valuable diagnostic tool in individuals presenting late with arthralgia, arthritis, limping, MIS-C, or other delayed presentations, especially when PCR returns negative for the virus.

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<![CDATA[Comparison of Initial Thoracic CT Images of COVID-19 Patients with Non-Variant, Alpha, Delta, and Omicron Variants: A Retrospective Study]]>https://www.eurekaselect.com/article/1359062024-02-28 Background: CT findings and Ground glass opacity (GGO) volumes may differ between SARS CoV-2 non-variant, alpha, delta, and omicron variants.

Objective: To compare the thoracic CT findings, GGO volumes, and GGOs’ lung uptake rates among patients with COVID-19 variants.

Methods: Thoracic CT images of 83 patients with non-variant, 78 patients with alpha variant, 93 patients with delta variant, and 73 patients with omicron variant having positive Real-Time Polymerase Chain Reaction test results were analyzed retrospectively. GGO volumes and lung volumes were calculated by using the Cavalieri Principle. Differences in CT findings, ground-glass opacity volumes, and lung involvement rates between non-variant and variant groups were evaluated.

Results: There were significant differences found in the incidence of GGOs (p < 0.001), air bronchogram (p = 0.007), reticulation (p = 0.002) and subpleural lines, and linear opacities (p = 0.034) between non-variant and variant groups. GGO uptake rates (ground glass opacity volumes × 100 ÷ lung volume) were 8.88% in the non-variant, 4.83% in the alpha variant, 3.50% in the delta variant, and 2.02% in the omicron variant. In estimating variant groups, it was determined that the increase in the rate of GGOs in the right lung increased the probability of having an omicron variant, whereas the presence of nodules decreased it. The possibility of the delta variant increased with an increase in the rate of ground glass opacities in the left lung.

Conclusion: Thoracic CT findings solely can be helpful in distinguishing COVID-19 variants. Decreased frequency of uptake rates of GGOs suggested that the severity of COVID-19 disease was gradually decreasing.

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<![CDATA[Assessing Lung Function and Quality of Life in COVID-19 Patients: A Pilot Study]]>https://www.eurekaselect.com/article/1368832024-02-28 Background and Objective: Respiratory complications of COVID-19 should be considered as critical concerns that require prompt medical intervention. The aim of this study was to examine the impact of COVID-19 on pulmonary function and quality of life among recovered patients through a three-month follow-up period.

Methods: This pilot study aimed to assess the pulmonary functions and quality of life in 32 COVID-19 survivors at Afzalipour Hospital, Kerman, Iran. Pulmonary functions were evaluated using spirometry to evaluate FVC, FEV1, PEF, and FEV1/FVC. Quality of life was measured using the SF-36 questionnaire, which evaluated eight health-related concepts. Statistical analysis was performed using SPSS v23.

Results: Among the 32 survivors of COVID-19, 41.6% and 59.4% were male and female, respectively. The mean length of hospitalization for admitted patients (56.3% of all patients) was 10.89 days. Male survivors exhibited significantly lower values in FEV1 (3.06 vs. 4.05, p = 0.02), PEF (6.45 vs. 10.58, p = 0.002), and FEF-25-75 (3.17 vs. 4.94, p = 0.008) compared to healthy males of the same age. For female survivors, all pulmonary indices were significantly lower than healthy females of the same age. Regarding quality of life, there was no statistical significance between male and female survivors. However, when compared with healthy populations, survivors obtained lower scores in various quality-of-life items. Male survivors had notably lower scores in physical functioning (3.17 vs. 4.94, p = 0.008) and physical role (40.38 vs. 73.8, p = 0.008). Female survivors scored considerably lower than the healthy population in all quality of life items, except for role emotional and mental health.

Conclusion: COVID-19 survivors had lower pulmonary indices and quality of life compared to healthy individuals of the same sex and age, with female survivors exhibiting worse conditions.

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<![CDATA[<i>NAT2</i> Gene Variants as a Provocative Factor for the Severe Course of COVID-19 Pneumonia in Ukrainian Patients]]>https://www.eurekaselect.com/article/1361562024-02-28 Background: Previous studies indicate a close relationship between the severity of COVID-19 and oxidative stress. N-acetyltransferase 2 (NAT2) is an enzyme that metabolizes a wide range of xenobiotics and plays an important role in the regulation of reactive oxygen species, consequently contributing to the development of oxidative stress.

Aim: To determine the impact of NAT2 gene variants on the risk of developing and the progression of severe COVID-19-associated pneumonia in patients from the Poltava region of Ukraine.

Methods: The study included 117 patients who were diagnosed with severe COVID-19 pneumonia and received treatment in the intensive care unit. The NAT2 gene variants were identified through the PCR-RFLP method.

Results: The presence of the AA genotype of the A803G variant in patients with severe COVID-19 pneumonia is associated with an almost 3-fold reduction in the risk of lethal outcomes. The presence of the TT genotype of the C481T variant was associated with the need for artificial lung ventilation. Patients in the study group with a heterozygous GA genotype of the G590A variant demonstrated a notable rise in the risk of developing systemic inflammatory response syndrome and acute respiratory distress syndrome, with a nearly 2.5-fold and 3-fold increase, respectively. The G857A variant was not associated with the risk of developing the above-- mentioned complications in the examined patients.

Conclusion: The obtained results suggested that the NAT2 gene variants might influence the incidence, course, and adverse consequences of COVID-19.

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<![CDATA[Deteriorating Pulmonary Functions in Patients with Rheumatoid Arthritis- A Pilot Study from South India]]>https://www.eurekaselect.com/article/1368822024-02-28Background and Objective: Pulmonary involvement is a common extra-articular manifestation of rheumatoid arthritis (RA). The present study attempts to highlight the extent of involvement by assessing lung function using pulmonary function tests (PFTs) in patients with RA.

Methods: This pilot study involved 30 patients with RA and an equal number of age- and sexmatched healthy controls. All the study participants were subjected to spirometry and in RA patients, the test was repeated after 30 minutes of administering 400 mcg of salbutamol. PFT values of the controls and the pre and post-values of cases like forced vital capacity (FVC), forced expiratory volume in the first second (FEV1), Percentage of forced expiratory volume in the first second (FEV1%), forced expiratory flow at 25% to 75% of the lung volume (FEF25-75%) and peak expiratory flow rate (PEFR) were recorded. Independent sample t-test or Mann-Whitney U test were used for comparisons. The pre- and post-values of PFT were compared using paired t-test, Welsch’s test, or Wilcoxon tests. (p ≤ 0.05 implied statistical significance).

Results: PFT variables were significantly lower among patients with RA compared with controls (p<0.05). A significant negative correlation of FEF25%-75% and PEFR with BMI in obese patients (BMI >23) and FVC, FEV1, and PEFR significantly lower in post-menopausal women (p < 0.05) was seen.

Conclusion: Based on the pilot study findings, patients in south India with RA could manifest decreased pulmonary functions. Obese patients and post-menopausal females with RA could be at a higher risk, and the administration of nebulized salbutamol could improve pulmonary functions.

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<![CDATA[A Case Report of Chronic Inflammatory Demyelinating Polyneuropathy following COVID-19 Vaccination]]>https://www.eurekaselect.com/article/1379132024-02-28Introduction: Chronic Inflammatory Demyelinating Polyneuropathy (CIDP) is a peripheral polyneuropathy. Chronic damage to neuronal myelin by the immune system results in inflammation and demyelination of the peripheral nervous system. Several side effects have been reported with Coronavirus disease 2019 (COVID-19) vaccines. There are some reports of vaccineinduced- CIDP. In this study, we described the occurrence of CIDP in a patient with a history of receiving the first dose of a COVID-19 vaccine, Sputnik V.

Case Report: We presented a patient receiving the COVID-19 vaccine Sputnik V two weeks before progressive flaccid tetraparesis and dysautonomia. He was first diagnosed with Guillain- Barre Syndrome (GBS). Two episodes of worsening the weakness occurred within 8 weeks from the onset of the disease, and the treatment was repeated as GBS-Treatment-related Fluctuations (TRF) and relapse. Also, a few relapses happened eight weeks after the disease's onset. Hence, he was diagnosed with “acute-onset CIDP”. The patient received several intravenous immunoglobulin (IVIG) courses as maintenance therapy. No further deterioration was reported during the follow-up.

Conclusion: Post-vaccination GBS is a known phenomenon. However, there are several reports of vaccine-induced-CIDP. This is the first reported case of acute-onset CIDP associated with the Sputnik V vaccine in Iran. Subsequent studies are required to determine the definite relationship between COVID-19 vaccination and CIDP.

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