scholarly journals Herpesviruses. Part 2

2021 ◽  
Vol 6 (2) ◽  
pp. 211-220
Author(s):  
R. S. Nazaryan ◽  
◽  
Yu. V. Fomenko ◽  
N. A. Scheblykina ◽  
T. A. Kolesova ◽  
...  
Keyword(s):  
Epithelial Cells ◽  
Antiviral Treatment ◽  
Clinical Manifestations ◽  
Specific Treatment ◽  
Nucleoside Analogs ◽  
Symptomatic Treatment ◽  
Reproductive Activity ◽  
Herpes Infection ◽  
Therapeutic Measures ◽  
Accompanying Symptoms

The clinical manifestations of herpes infection depend on the pathogenic properties of the pathogen and on the state of immunity of the infected organism. Herpesviruses type 1-3 are predominantly neurotropic and cause diseases of the nervous system. The reproduction of the virus is carried out in the neurons of the nerve ganglia and epithelial cells, as they have a common ectodermal origin. Herpesviruses type 4, 5 and 8 are predominantly lymphotropic and cause diseases of the immune system. In a latent and persistent state, viruses are found in lymphocytes, monocytes, polymorphonuclear leukocytes, as they exhibit tropism for cells of mesenchymal origin. When the infection is reactivated, the virus is reproduced in cells of ectodermal origin, which leads to characteristic organ lesions. Type 6 and 7 viruses are both neurotropic and lymphotropic. They are capable to infect T-lymphocytes, B-lymphocytes, epithelial cells, endothelial cells, hepatocytes, fibroblasts, glial cells, stem cells, monocytes, macrophages, leukocytes, etc. They are able to promote the reactivation of other viruses, forming mixed forms, which leads to an aggravation of the clinical picture of the disease. Therapy of herpesvirus infections should be scientifically grounded, consistent, gradual, complex and include: specific antiviral treatment; immunotherapy; antibacterial therapy; detoxification therapy; symptomatic treatment and therapeutic measures aimed to eliminate various complications. Antiviral drugs for the treatment of herpes infection are divided into 4 groups: nucleoside analogs; drugs that cause the destruction of viruses located extracellularly; drugs that are active against intracellular viruses; drugs with a double effect. Modern therapy of herpesvirus infections is capable to suppress the reproductive activity of the reactivated virus, modulate the body's immune response, prevent and eliminate various complications of herpes infections, but is unable to affect the latent form of viruses. In the complex therapy of herpes infection, along with the specific treatment methods aimed to destroy the virus and to enhance the body's immunity, it is necessary to apply the entire range of therapeutic measures that help eliminate the accompanying symptoms and complications of diseases caused by herpesviruses

scholarly journals Animais Venenosos em Território Português: Abordagem Clínica de Picadas e Mordeduras

2021 ◽  
Vol 34 (11) ◽  
pp. 784
Author(s):  
Sofia R. Valdoleiros ◽  
Inês Correia Gonçalves ◽  
Carolina Silva ◽  
Diogo Guerra ◽  
Lino André Silva ◽  
...  
Keyword(s):  
Native Species ◽  
Severe Disease ◽  
Clinical Manifestations ◽  
Specific Treatment ◽  
Hospital Setting ◽  
Marine Species ◽  
Symptomatic Treatment ◽  
Thaumetopoea Pityocampa ◽  
Hermodice Carunculata ◽  
Spider Bites

There are many native species of animals with the potential to cause severe disease in Portugal. Of the four clinically relevant snake species, the vipers (Vipera latastei and Vipera seoanei) are the most concerning. They can cause severe disease and require in-hospital management, monitoring and specific treatment, including the administration of anti-snake venom serum. The Malpolon monspessulanus and Macroprotodon brevis snakes cause mostly localized clinical manifestations, which do not require specific treatment. Only a minority of the spider species in Portugal possess chelicerae (mouthparts of the Chelicerata, shaped as either articulated fangs or pincers, which may contain venom or be connected to the venom glands and are used for predation or capture of food) long enough to perforate the human skin. Nevertheless, Latrodectus tredecimguttatus and Loxosceles rufescens spider bites may require specialized treatment in a hospital setting, as well as careful active symptom surveillance. Diversely, the treatment for Scolopendra cingulata and Scolopendra oraniensis centipedes’ bites is merely symptomatic. The only existing scorpion species in Portugal is the Buthus ibericus; its sting typically causes local symptoms with intense pain, and its treatment consists essentially of analgesia. The insects of the Hymenoptera order, such as bees and wasps, have the ability to inject venom into the skin. Most people present only with local or regional inflammatory response, and symptomatic treatment is usually effective. Even so, individuals with hypersensitivity to bee venom may develop anaphylaxis. Several marine species in the Portuguese coast are venomous to humans, including weeverfish (Trachinidae family), stingrays (Dasyatis pastinaca, Taeniura grabata, Myliobatis aquila), red scorpion fish (Scorpaena scrofa), cnidaria (Pelagia noctiluca, Chrysaora hysoscella, Physalia physalis) and bearded fireworm (Hermodice carunculata); treatment is symptomatic. Contact with the larvae or bristles (chitinous structures with locomotor or tactile functions) of Thaumetopoea pityocampa (pine processionary) can cause cutaneous, ocular and, rarely, respiratory reactions; its management is also symptomatic.

scholarly journals SARS-CoV-2 drives JAK1/2-dependent local complement hyperactivation

2021 ◽  
Vol 6 (58) ◽  
pp. eabg0833
Author(s):  
Bingyu Yan ◽  
Tilo Freiwald ◽  
Daniel Chauss ◽  
Luopin Wang ◽  
Erin West ◽  
...  
Keyword(s):  
Epithelial Cells ◽  
Clinical Manifestations ◽  
Lung Epithelial Cells ◽  
Complement Factor ◽  
Respiratory Epithelial Cells ◽  
Signature Genes ◽  
Wide Range ◽  
Lung Epithelial ◽  
Gene Transcripts ◽  
Respiratory Epithelial

Patients with coronavirus disease 2019 (COVID-19) present a wide range of acute clinical manifestations affecting the lungs, liver, kidneys and gut. Angiotensin converting enzyme (ACE) 2, the best-characterized entry receptor for the disease-causing virus SARS-CoV-2, is highly expressed in the aforementioned tissues. However, the pathways that underlie the disease are still poorly understood. Here, we unexpectedly found that the complement system was one of the intracellular pathways most highly induced by SARS-CoV-2 infection in lung epithelial cells. Infection of respiratory epithelial cells with SARS-CoV-2 generated activated complement component C3a and could be blocked by a cell-permeable inhibitor of complement factor B (CFBi), indicating the presence of an inducible cell-intrinsic C3 convertase in respiratory epithelial cells. Within cells of the bronchoalveolar lavage of patients, distinct signatures of complement activation in myeloid, lymphoid and epithelial cells tracked with disease severity. Genes induced by SARS-CoV-2 and the drugs that could normalize these genes both implicated the interferon-JAK1/2-STAT1 signaling system and NF-κB as the main drivers of their expression. Ruxolitinib, a JAK1/2 inhibitor, normalized interferon signature genes and all complement gene transcripts induced by SARS-CoV-2 in lung epithelial cell lines, but did not affect NF-κB-regulated genes. Ruxolitinib, alone or in combination with the antiviral remdesivir, inhibited C3a protein produced by infected cells. Together, we postulate that combination therapy with JAK inhibitors and drugs that normalize NF-κB-signaling could potentially have clinical application for severe COVID-19.

scholarly journals A New Multiplatform Model for Outpatient Prenatal and Postpartum Care in a Cohort of COVID-19-Affected Obstetric Patients

2021 ◽  
Vol 18 (10) ◽  
pp. 5144
Author(s):  
Mar Muñoz-Chápuli Gutiérrez ◽  
Ana Durán-Vila ◽  
Javier Ruiz-Labarta ◽  
Pilar Payá-Martínez ◽  
Pilar Pintado Recarte ◽  
...  
Keyword(s):  
Clinical Manifestations ◽  
Specific Treatment ◽  
Rt Pcr ◽  
Good Adherence ◽  
Major Morbidity ◽  
Reference Hospital ◽  
The Mean ◽  
Discharge From Hospital ◽  
Over Time

Spain was one of the epicenters of the first wave of the COVID-19 pandemic. We describe in this article the design and results of a new telephone-and-telematic multiplatform model of systematic prenatal and postpartum follow-up for COVID-19-affected women implemented in a tertiary reference hospital in Madrid. We included patients with RT-PCR-confirmed COVID-19 during pregnancy or delivery from 10 March 2020 to 15 December 2020. We had a total of 211 obstetric patients: 148 (70.1%) were tested at the onset of suspicious clinical manifestations and 62 (29.4%) were tested in the context of routine screening. Of all the patients, 60 women (28.4%) were asymptomatic and 97 (46%) presented mild symptoms. Fifty-one women (24.2%) were admitted to our hospital for specific treatment because of moderate or severe symptoms. We had no missed cases and a good adherence. The mean number of calls per patient was 2.3. We performed 55 in-person visits. We analyzed the complexity of our program over time, showing a two-wave-like pattern. One patient was identified as needing hospitalization and we did not record major morbidity. Telemedicine programs are a strong and reproducible tool to reach to pregnant population affected by COVID-19, to assess its symptoms and severity, and to record for pregnancy-related symptoms both in an outpatient regime and after discharge from hospital.

scholarly journals Clinical Management of Hypertension, Inflammation and Thrombosis in Hospitalized COVID-19 Patients: Impact on Survival and Concerns

2021 ◽  
Vol 10 (5) ◽  
pp. 1073
Author(s):  
Patricia Martínez-Botía ◽  
Ángel Bernardo ◽  
Andrea Acebes-Huerta ◽  
Alberto Caro ◽  
Blanca Leoz ◽  
...  
Keyword(s):  
Arterial Hypertension ◽  
Clinical Management ◽  
Cox Regression ◽  
Angiotensin Receptor Blockers ◽  
Treatment Options ◽  
Clinical Manifestations ◽  
Specific Treatment ◽  
Hospitalized Patients ◽  
Thrombosis Prophylaxis ◽  
The Impact

The most severe clinical manifestations of the Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), are due to an unbalanced immune response and a pro-thrombotic hemostatic disturbance, with arterial hypertension or diabetes as acknowledged risk factors. While waiting for a specific treatment, the clinical management of hospitalized patients is still a matter of debate, and the effectiveness of treatments to manage clinical manifestations and comorbidities has been questioned. In this study, we aim to assess the impact of the clinical management of arterial hypertension, inflammation and thrombosis on the survival of COVID-19 patients. The Spanish cohorts included in this observational retrospective study are from HM Hospitales (2035 patients) and from Hospital Universitario Central de Asturias (72 patients). Kaplan Meier survival curves, Cox regression and propensity score matching analyses were employed, considering demographic variables, comorbidities and treatment arms (when opportune) as covariates. The management of arterial hypertension with angiotensin-converting enzyme 2 (ACE2) inhibitors or angiotensin receptor blockers is not detrimental, as was initially reported, and neither was the use of non-steroidal anti-inflammatory drugs (NSAIDs). On the contrary, our analysis shows that the use on itself of corticosteroids is not beneficial. Importantly, the management of COVID-19 patients with low molecular weight heparin (LMWH) as an anticoagulant significantly improves the survival of hospitalized patients. These results delineate the current treatment options under debate, supporting the effectiveness of thrombosis prophylaxis on COVID-19 patients as a first-line treatment without the need for compromising the treatment of comorbidities, while suggesting cautiousness when administering corticosteroids.

scholarly journals Neuropsychological and neuroimaging changes in preclinical Alzheimer's disease

2006 ◽  
Vol 12 (5) ◽  
pp. 707-735 ◽  
Author(s):  
ELIZABETH W. TWAMLEY ◽  
SUSAN A. LEGENDRE ROPACKI ◽  
MARK W. BONDI
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Temporal Lobe ◽  
Functional Neuroimaging ◽  
Neuropsychological Functioning ◽  
Clinical Manifestations ◽  
Symptomatic Treatment ◽  
Cross Sectional ◽  
Preclinical Ad ◽  
Normal Individuals

Alzheimer's disease (AD) is a common, devastating form of dementia. With the advent of promising symptomatic treatment, the importance of recognizing AD at its very earliest stages has increased. We review the extant neuropsychological and neuroimaging literature on preclinical AD, focusing on longitudinal studies of initially nondemented individuals and cross-sectional investigations comparing at-risk with normal individuals. We systematically reviewed 91 studies of neuropsychological functioning, structural neuroimaging, or functional neuroimaging in preclinical AD. The neuropsychological studies indicated that preclinical AD might be characterized by subtle deficits in a broad range of neuropsychological domains, particularly in attention, learning and memory, executive functioning, processing speed, and language. Recent findings from neuroimaging research suggest that volume loss and cerebral blood flow or metabolic changes, particularly in the temporal lobe, may be detected before the onset of dementia. There exist several markers of a preclinical period of AD, in which specific cognitive and biochemical changes precede the clinical manifestations. The preclinical indicators of AD reflect early compromise of generalized brain integrity and temporal lobe functioning in particular. (JINS, 2006,12, 707–735.)

Management of Plantar Keratodermas

2017 ◽  
Vol 107 (5) ◽  
pp. 428-435 ◽  
Author(s):  
Rebecca M. Porter ◽  
Albert A. Bravo ◽  
Frances J.D. Smith
Keyword(s):  
Gene Therapy ◽  
Salicylic Acid ◽  
Alternative Treatment ◽  
Autosomal Dominant ◽  
Treatment Options ◽  
Clinical Manifestations ◽  
Specific Treatment ◽  
Inherited Mutations ◽  
Pachyonychia Congenita

Plantar keratodermas can arise due to a variety of genetically inherited mutations. The need to distinguish between different plantar keratoderma disorders is becoming increasingly apparent because there is evidence that they do not respond identically to treatment. Diagnosis can be aided by observation of other clinical manifestations, such as palmar keratoderma, more widespread hyperkeratosis of the epidermis, hair and nail dystrophies, or erythroderma. However, there are frequent cases of plantar keratoderma that occur in isolation. This review focuses on the rare autosomal dominant keratin disorder pachyonychia congenita, which presents with particularly painful plantar keratoderma for which there is no specific treatment. Typically, patients regularly trim/pare/file/grind their calluses and file/grind/clip their nails. Topical agents, including keratolytics (eg, salicylic acid, urea) and moisturizers, can provide limited benefit by softening the skin. For some patients, retinoids help to thin calluses but may lead to increased pain. This finding has stimulated a drive for alternative treatment options, from gene therapy to alternative nongenetic methods that focus on novel findings regarding the pathogenesis of pachyonychia congenita and the function of the underlying genes.

Another Case Of Physical Abuse In Childhood Between Age 7-11 And Alice In Wonderland-Like Seizures Retrospectively Described By A 45 Years-Old Man In Detail

2021 ◽  
Author(s):  
Stefan Bittmann
Keyword(s):  
Symptomatic Treatment ◽  
Lewis Carroll ◽  
Neurological Deficits ◽  
Barr Virus ◽  
Children's Book ◽  
Alice In Wonderland ◽  
Sense Of Time ◽  
Epstein Barr ◽  
Primary Focus ◽  
Accompanying Symptoms

The phenomenon of Alice in Wonderland Syndrome is not considered a disease in its own right but usually occurs as an accompanying symptom of a migraine attack or as a precursor of an epileptic seizure in the form of an aura with pronounced visual perceptual disturbances [1]. However, an Alice in Wonderland syndrome can also be caused by the Epstein-Barr virus, influenza virus [18], drugs [3] or encephalitis [2]. The term "Alice in Wonderland syndrome" was named after the children's book Alice in Wonderland by Lewis Carroll and coined by John Todd as a possible, but not essential, concomitant of migraine and epilepsy [1]. Carroll suffered from migraines himself; it is believed that his experiences with the condition served as inspiration for the hallucination-like effects described in his work [1]. In addition, Carroll's narrative has been discussed as a description of a trip following consumption of mind-altering drugs. In one of the most famous sequences in the book, Alice changes size by biting off pieces from different sides of a mushroom. However, there is no evidence of drug use by Lewis Carroll. Alice in Wonderland syndrome results in changes in the perception of one's surroundings [6,7]. These changes include both micropsia and macropsia (everything appears reduced or enlarged), as well as altered auditory perception, altered tactile perception, an altered sense of time. The syndrome is particularly common in children. Attacks are often shorter and may also be completely painless, although accompanying symptoms such as nausea, vomiting, and sensitivity to light and sound is more pronounced. Neurological deficits may occur so that the affected child begins to hallucinate. He or she perceives his or her body as larger or smaller and/or begins to see "fantastic images“. The changes in perception can severely affect affected individuals, causing them to become disoriented and "unable to find their way around." In extreme cases, falls and other accidents may occur. The perceptual disturbances can lead to Alice in Wonderland syndrome being confused with other mental disorders or misinterpreted as "craziness". The primary focus is the treatment of the underlying condition, such as symptomatic treatment of migraine. Recent publications shed light on sexual abuse in childhood as the origin of AIWS-like visual disturbances [4,5].

scholarly journals Clinical analysis of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in children

2020 ◽  
Author(s):  
Guilang Zheng ◽  
Chuxing Xie ◽  
Dongli Liu ◽  
Guojing Ye ◽  
Xiaoqian Chen ◽  
...  
Keyword(s):  
Creatine Kinase ◽  
Body Weight ◽  
Severe Acute Respiratory Syndrome ◽  
Lymphocyte Count ◽  
Antiviral Treatment ◽  
Clinical Manifestations ◽  
Small Sample ◽  
Upper Respiratory Tract ◽  
Creatine Kinase Mb ◽  
The Mean

Abstract Background: The number of coronavirus disease 2019 (COVID-19) cases caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection has significantly increased, and the disease is rapidly spreading to all parts of the country and around the world. A retrospective study of children with SARS-CoV-2 provides a reference for the diagnosis and treatment of children during this epidemic.Methods: We retrospectively studied 12 cases of children with viral infection caused by SARS-CoV-2 admitted to 6 hospitals in Guangdong Province between January 25, 2020, and February 12, 2020, and analyzed the clinical features and outcomes of the patients.Results: A total of 12 children with SARS-CoV-2 infection from 6 hospitals were enrolled in the study; 6 were boys. The mean age was 9.8 ± 4.7 years, with a minimum age of 2 years and 10 months. The mean body weight was 37.3 ± 23.6 kg, with a minimum body weight of 13.0 kg. There were no severe cases or critical severe cases. There were 2 cases of mild pneumonia (16.7%), 7 cases of acute upper respiratory tract infection (58.3%), and 3 cases of latent infection (25.0%). In terms of symptoms, there were 7 cases of fever (58.3%), 5 cases of cough (41.7%), 3 cases of runny nose (25.0%), 2 cases of systemic fatigue and soreness (16.7%), and 4 cases of no symptoms (33.3%). Three patients (75.0%) showed decreased white blood cell (WBC) counts for their first complete blood count (CBC) after admission, and one patient (8.3%) had a low lymphocyte count. There were no obvious abnormalities in C-reactive protein (CRP, 1.53 ± 2.28 mg/l), procalcitonin (PCT, 0.21 ± 0.13 ng/ml), or coagulation function. No abnormalities were detected for creatine kinase (CK), creatine kinase-MB (CKMB), lactate dehydrogenase (LDH), aspartate aminotransferase (AST), alanine aminotransferase (ALT), blood urea nitrogen (BUN) and serum creatinine (Scr). Six cases (50.0%) were positive for Mycoplasma pneumoniae antibodies. 2 cases showed pulmonary exudative lesions on chest X-ray or computed tomography (CT). All children tested positive for SARS-CoV-2 by real-time reverse-transcription–polymerase-chain-reaction (RT-PCR) assays of throat swabs. 9 patients received antiviral treatment with lopinavir/ritonavir. All patients received symptomatic supportive treatment and were quarantined, and their conditions improved. There was no respiratory failure, acute respiratory distress syndrome, shock complications, or death observed for any case. All patients recovered and were discharged, with an average length of hospital stay of 14 days.Conclusions: This study with a small sample size suggests that all SARS-CoV-2-infected children had normal or reduced WBCs; however, fever was not as common as expected, and a decrease in lymphocyte count was rare. The clinical manifestations of SARS-CoV-2 infection in children are mild, COVID⁃19 is rare, and the prognosis is good. But the presence of latent SARS-CoV-2 infection in children presents new challenges for effective clinical prevention and control.

scholarly journals Nervous system injury in alcoholic disease

2019 ◽  
Vol 11 (2S) ◽  
pp. 83-88
Author(s):  
O. E. Zinovyeva ◽  
N. V. Vashchenko ◽  
O. E. Mozgovaya ◽  
T. A. Yanakaeva ◽  
A. Yu. Emelyanova
Keyword(s):  
Nervous System ◽  
Peripheral Nervous System ◽  
Alcohol Intoxication ◽  
Clinical Manifestations ◽  
Symptomatic Treatment ◽  
Chronic Alcohol ◽  
Neurological Manifestations ◽  
Chronic Alcohol Intoxication ◽  
Alcoholic Disease

The paper considers various variants of nervous system injury in alcoholic disease. It discusses the epidemiology, pathogenesis, diagnosis, and clinical manifestations of central and peripheral nervous system lesions in the presence of acute and chronic alcohol intoxication. Attention is paid to the issues of etiotropic, pathogenetic, and symptomatic treatment for neurological manifestations of alcoholic disease and to the role of neurotropic B vitamins in the treatment of alcohol-induced deficiency and non-deficiency states.

scholarly journals Clinical and Laboratory Profiles of 75 Hospitalized Patients with Novel Coronavirus Disease 2019 in Hefei, China

2020 ◽  
Author(s):  
Zonghao Zhao ◽  
Jiajia Xie ◽  
Ming Yin ◽  
Yun Yang ◽  
Hongliang He ◽  
...  
Keyword(s):  
T Cell ◽  
Treatment Effectiveness ◽  
Antiviral Treatment ◽  
Laboratory Data ◽  
Clinical Manifestations ◽  
Nasopharyngeal Swab ◽  
The Novel ◽  
Reactive Protein ◽  
Cell Counts ◽  
Novel Coronavirus

AbstractThe outbreak of the novel coronavirus disease 2019 (COVID-19) infection began in December 2019 in Wuhan, and rapidly spread to many provinces in China. The number of cases has increased markedly in Anhui, but information on the clinical characteristics of patients is limited. We reported 75 patients with COVID-19 in the First Affiliated Hospital of USTC from Jan 21 to Feb 16, 2020, Hefei, Anhui Province, China. COVID-19 infection was confirmed by real-time RT-PCR of respiratory nasopharyngeal swab samples. Epidemiological, clinical and laboratory data were collected and analyzed. Of the 75 patients with COVID-19, 61 (81.33%) had a direct or indirect exposure history to Wuhan. Common symptoms at onset included fever (66 [88.0%] of 75 patients) and dry cough (62 [82.67%]). Of the patients without fever, cough could be the only or primary symptom. The most prominent laboratory abnormalities were lymphopenia, decreased percentage of lymphocytes (LYM%), decreased CD4+ and CD8+ T cell counts, elevated C-reactive protein (CRP) and lactate dehydrogenase (LDH). Patients with elevated interleukin 6 (IL-6) showed significant decreases in the LYM%, CD4+ and CD8+ T cell counts. Besides, the percentage of neutrophils, CRP, LDH and Procalcitonin levels increased significantly. We concluded that COVID-19 could cause different degrees of hematological abnormalities and damage of internal organs. Hematological profiles including LYM, LDH, CRP and IL-6 could be indicators of diseases severity and evaluation of treatment effectiveness. Antiviral treatment requires a comprehensive and supportive approach. Further targeted therapy should be determined based on individual clinical manifestations and laboratory indicators.

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