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Prevalence and features of SARS-CoV-2 infection in prisons in Tuscany

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World Journal of Experimental Medicine 2024年第1期14卷 70-77页

作者： Cristina Stasi Martina Pacifici Caterina Milli Francesco Profili Caterina Silvestri Fabio Voller Epidemiology unit Regional Health Agency of TuscanyFlorence 50141Italy department of Medicine Surgery and NeuroscienceUniversity of SienaSiena 53100Italy

BACKGROUND Prisons can be a reservoir for infectious diseases,including severe acute respiratory syndrome coronavirus 2(SARS-CoV-2),due to the very intimate nature of the living spaces and the large number of people forced to share them.AIM To investigate the SARS-CoV-2 epidemiology in prisons,this study evaluated the infection incidence rate in prisoners who underwent nasopharyngeal swabs.METHODS This is an observational cohort study.Data collection included information on prisoners who underwent nasopharyngeal swab testing for SARS-CoV-2 and the results.Nasopharyngeal swab tests for SARS-CoV-2 were performed between 15 February 2021 and 31 May 2021 for prisoners with symptoms and all new arrivals to the facility.Another section included information on the diagnosis of the disease according to the International Classification of diseases,Ninth Revision,and Clinical Modification.RESULTS Up until the 31 May 2021,79.2%of the prisoner cohort(n=1744)agreed to a nasopharyngeal swab test(n=1381).Of these,1288 were negative(93.3%)and 85 were positive(6.2%).A significant association[relative risk(RR)]was found only for the risk of SARS-CoV-2 infection among foreigners compared to Italians[RR=2.4,95%confidence interval(CI):1.2-4.8].A positive association with SARS-CoV-2 infection was also found for inmates with at least one nervous system disorder(RR=4,95%CI:1.8-9.1).The SARS-CoV-2 incidence rate among prisoners is significantly lower than in the general population in Tuscany(standardized incidence ratio 0.7,95%CI:0.6-0.9).CONCLUSION In the prisoner cohort,screening and rapid access to health care for the immigrant population were critical to limiting virus transmission and subsequent morbidity and mortality in this vulnerable population.

关键词： SARS-CoV-2 Epidemiology Prison Prevalence Foreigners Swab tests

Changes in the pathogen spectrum of hospitalized adults with community-acquired pneumonia in Fujian Province: A multicenter, retrospective study from 2012 to 2018

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Chinese Medical Journal 2023年第8期136卷 989-991页

作者： Fan Wu Jian Wu Nengluan Xu Qunying Lin Dongfa Qiu Xuhua Lyu Ming Lin Wenxiang Yue Yan Xiao Lili Ren Yusheng Chen Hongru Li department of respiratory and critical care Medicine Fujian Provincial HospitalShengli Clinical College of Fujian Medical UniversityFuzhouFujian 350001China department of respiratory and critical care Medicine Putian University Affiliated HospitalPutianFujian 351100China department of respiratory and critical care Medicine Sanming First Hospital Affiliated to Fujian Medical UniversitySanmingFujian 353000China department of respiratory and critical care Medicine Wuyishan Municipal HospitalWuyishanFujian 354300China NHC Key Laboratory of Systems Biology of Pathogens and Christophe Mérieux Laboratory Institute of Pathogen BiologyChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijing 100730China Four diseases Research Office of Fujian Province FuzhouFujian 350001China Fujian Provincial Key Laboratory of Medical Big Data Engineering Fujian Provincial HospitalShengli Clinical College of Fujian Medical UniversityFuzhouFujian 350001China

To the Editor:Community-acquired pneumonia(CAP)in adults refers to inflammation of the lung parenchyma involving the alveolar wall.It occurs in the community environment(outside the hospital),including pneumonia cause... 详细信息

关键词： outside pneumonia acquired

Interventional bronchoscopic treatment of lung cancer

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Laparoscopic, Endoscopic and Robotic Surgery 2022年第2期5卷 52-56页

作者： Yafang Wang Enguo Chen department of respiratory and critical care Medicine Sir Run Run Shaw HospitalZhejiang University School of MedicineHangzhou 310016China Regional Medical Center for National Institute of respiratory diseases Hangzhou 310016China Cancer Center Zhejiang UniversityHangzhou 310058China

Interventional bronchoscopy has developed rapidly in the management of lung cancer. Besides ablativeresection of various modalities and balloon dilation/stent placement, which have been widely used in themanagement of malignant central airway obstruction, bronchoscopic brachytherapy and transbronchoscopic local injection of drugs are also developing. For early-stage peripheral lung cancer,transbronchoscopic ablation and the assisted localization of preoperative peripheral lung nodules bybronchoscopy are the new techniques. In addition, interventional bronchoscopy can manage complications related to lung cancer. Overall, interventional bronchoscopy has been an indispensable componentin the treatment of lung cancer and has vast space for development. The review summarizes the recentupdates.

关键词： Lung cancer Interventional bronchoscopy Malignant central airway obstruction

Harnessing immunity:Immunomodulatory therapies in COVID-19

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World Journal of Virology 2024年第2期13卷 34-47页

作者： Tsvetelina Velikova Hristo Valkov Anita Aleksandrova Monika Peshevska-Sekulovska Metodija Sekulovski Russka Shumnalieva Medical Faculty Sofia University St.Kliment OhridskiSofia 1407Bulgaria department of Gastroenterology University Hospital“Tsaritsa Yoanna-ISUL”Medical University of SofiaSofia 1527Bulgaria department of Immunology SMDL RamusSimitli 6000Bulgaria department of Gastroenterology University Hospital LozenetzSofia 1407Bulgaria department of Anesthesiology and Intensive care University Hospital LozenetzSofia 1407Bulgaria department of Rheumatology Clinic of RheumatologyUniversity Hospital"St.Ivan Rilski"Medical University-SofiaSofia 1612Bulgaria

An overly exuberant immune response,characterized by a cytokine storm and uncontrolled inflammation,has been identified as a significant driver of severe coronavirus disease 2019(COVID-19)cases.Consequently,deciphering the intricacies of immune dysregulation in COVID-19 is imperative to identify specific targets for intervention and modulation.With these delicate dynamics in mind,immunomodulatory therapies have emerged as a promising avenue for miti-gating the challenges posed by COVID-19.Precision in manipulating immune pathways presents an opportunity to alter the host response,optimizing antiviral defenses while curbing deleterious inflammation.This review article compre-hensively analyzes immunomodulatory interventions in managing COVID-19.We explore diverse approaches to mitigating the hyperactive immune response and its impact,from corticosteroids and non-steroidal drugs to targeted biologics,including anti-viral drugs,cytokine inhibitors,JAK inhibitors,convalescent plasma,monoclonal antibodies(mAbs)to severe acute respiratory syndrome coronavirus 2,cell-based therapies(i.e.,CAR T,etc.).By summarizing the current evidence,we aim to provide a clear roadmap for clinicians and researchers navigating the complex landscape of immunomodulation in COVID-19 treatment.CS Glucocorticoids are among the most widely prescribed drugs with their immune-suppressive and anti-inflammatory effect[84].The current guidelines for the treatment of COVID-19 recommend against the use of dexamethasone or other systemic CS in non-hospitalized patients in the absence of another indication[70].The RECOVERY trial demonstrates the reduced 28-d mortality among hospitalized patients with COVID-19 using dexamethasone compared to the usual standard of care,along with other investigators,such as Ahmed and Hassan[85].The benefit of dexamethasone was seen only among participants receiving either oxygen alone or invasive mechanical ventilation at randomization but not among those receiving no respiratory support at enrollment[85].In a systematic

关键词： Immunomodulation COVID-19 SARS-CoV-2 Immunotherapy Antiviral immune response Cytokine storm Adaptive immunity Therapeutic strategies Immune modulators Viral infection Host immune response

Clinical Value of Tumor Markers for Determining Cause of Pleural Effusion

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Chinese Medical Journal 2016年第3期129卷 253-258页

作者： Yan Gu Kan Zhai Huan-Zhong Shi department of respiratory and critical care Medicine Beijing Chao-Yang Hospital Beijing Institute of Respiratory Medicine Capital Medical University Beijing 100020 China Center of Medical Research Beijing Instiiute of Respiratory Diseases Beijing 100020 China department of respiratory diseases the Affiliated Hospital of Inner Mongolia Medical University Hohhot Inner Mongolia 010050 China

Background： It is often challenging to distinguish tuberculous pleural effusion （TPE） from malignant pleural effusion （MPE）;thoracoscopy is among the techniques with the highest diagnostic ability in this regard.However, such invasive examinations cannot be performed on the elderly, or on those in poor physical condition.The aim of this study was to explore the differential diagnostic value of carbohydrate antigen 125 （CA 125）, carbohydrate antigen 199 （CA 199）, carcinoembryonic antigen （CEA）, neuron-specific enolase （NS E）, and squamous cell carcinoma （SCC） associated antigen in patients with TPE and MPE.Methods： Using electrochemiluminescence, we measured the concentration of tumor markers （TMs） in the pleural effusion and serum of patients with TPE （n =35） and MPE （n =95）.We used receiver operating characteristic （ROC） curve analysis to evaluate the TMs and differentiate between TPE and MPE.Results： The cut-offvalues for each TM in serum were： CA125, 151.55 U/ml;CA199, 9.88 U/ml;CEA, 3.50 ng/ml;NSE, 13.27 ng/ml;and SCC, 0.85 ng/ml.Those in pleural fluid were： CA125, 644.30 U/ml;CA199, 12.08 U/ml;CEA, 3.35 ng/ml;NSE, 9.71 ng/ml;and SCC, 1.35 ng/ml.The cut-offvalues for the ratio ofpleural fluid concentration to serum concentration （P/S ratio） of each TM were： CA125, 5.93;CA199, 0.80;CEA, 1.47;NSE, 0.76;and SCC, 0.90.The P/S ratio showed the highest specificity in the case of CEA （97.14%）.ROC curve analysis revealed that, for all TMs, the area under the curve in pleural fluid （0.95） was significantly different from that in serum （0.85;P 〈 0.001）.Conclusions： TMs in TPE differ significantly from those in MPE, especially when detected in pleural fluid.The combined detection of TMs can improve diagnostic sensitivity.

关键词： Malignant Pleural Effusion Tuberculous Pleural Effusion Tumor Marker

Access block and prolonged length of stay in the emergency department are associated with a higher patient mortality rate

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World Journal of Emergency Medicine 2022年第1期13卷 59-64页

作者： Ting Cheng Qian Peng Ya-qing Jin Hong-jie Yu Pei-song Zhong Wei-min Gu Xiao-shan Wang Yi-ming Lu Li Luo department of respiratory and critical care Medicine Ruijin HospitalShanghai Jiaotong University School of MedicineShanghai 200025China Institute of respiratory diseases Shanghai Jiaotong University School of MedicineShanghai 200025China Shanghai Key Laboratory of Emergency Prevention Diagnosis and Treatment of Respiratory Infectious DiseasesShanghai 200025China School of Public Health Fudan UniversityShanghai 200032China Jiading District Center for Disease Control and Prevention Shanghai 201800China department of Statistical Information Ruijin HospitalShanghai Jiaotong University School of MedicineShanghai 201801China department of Emergency Ruijin HospitalShanghai Jiaotong University School of MedicineShanghai 200025China Key Laboratory of Public Health Safety of the Ministry of Education and Key Laboratory of Health Technology Assessment of the Ministry of Health Fudan UniversityShanghai 200032China

Access block,known as exit block or boarding,is defined as a situation in which patients who are admitted or planned for admission remain in the emergency department(ED)as they are unable to be transferred to an inpatient unit within a reasonable time frame(no longer than 8 hours).[1,2]Access block often occurs due to insufficient hospital capacity and is a major issue in emergency medicine.[3]

关键词： Access admitted transferred

Legionella sainthelensi Pneumonia with Abdominal Symptoms as Prominent Manifestations:A Case Report

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Infectious diseases & Immunity 2022年第4期2卷 285-288页

作者： Xin Yuan Fanglin Meng Xinting Yu Changqing Bai Rui Jia Fanping Meng Fu-sheng Wang Junliang Fu department of respiratory and critical care Medicine Senior Department of Infectious Diseasesthe Fifth Medical Center of PLA General HospitalNational Clinical Research Center for Infectious DiseasesBeijing 100039China Senior department of Infectious diseases the Fifth Medical Center of PLA General HospitalNational Clinical Research Center for Infectious DiseasesBeijing 100039China

Fewstudies have reported Legionella sainthelensi infection.This infection primarily presents with respiratorymanifestations.Here,we report an immunocompromised patient with cavitary pneumonia caused by L.sainthelensi who mainly had abdominal symptoms.The timely administration of moxifloxacin provided clinical improvement and resolution of symptoms.To our knowledge,this is one of the rare cases of L.sainthelensi infection presenting uniquelywith abdominal distension and liver function impairment butwithout obvious respiratory symptoms.

关键词： Next-generation sequencing Abdominal distension Cavitary pneumonia Legionella sainthelensi

Atrial of arbidol hydrochloride in adults with COVID-19

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Chinese Medical Journal 2022年第13期135卷 1531-1538页

作者： Jingya Zhao Jinnong Zhang Yang Jin Zhouping Tang Ke Hu Hui Sun Mengmeng Shi Qingyuan Yang Peiyu Gu Hongrong Guo Qi Li Haiying Zhang Chenghong Li Ming Yang Nian Xiong Xuan Dong Juanjuan Xu Fan Lin Tao Wang Chao Yang Bo Huang Jingyi Zhang hi Chen Qiong He Min Zhou Jieming Qu department of Pulmonary and critical care Medicine Rujin HospitalSchool of MedicineShanghai Jiao Tong UniversityShanghai 200025China institute of respiratory diseases School of MedicineShanghai Jiao Tong UniversityShanghai 200025China department of Emergency Union Medical College Affiliated to Tongji Medical CollegeHuazhong University of Science and TechnologyWuhanHubei 430058China department of respiratory and critical care Medicine Union Medical Collge Affiliated to Tongji Medical CollegeHuazhong University of Science and TechnologyWuhanHubei 430058China department of Neurology Tongji HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhanHubei 430030China department of respiratory and critical care Medicine Renmin HospitalWuhan UniversityWuhanHubei 430060China department of Endocrinology Union Medical Cllege Affiliated to Tongji Medical CollegeHuazhong University of Science and TechnologyWuhanHubei 430058China department of respiratory Medicine Wuhan Bauhinia HospitalWuhanHubei 430062China department of respiratory Medicine Guanggu Hospital DistrictThe Third Hospital of WuhanWuhanHubei 430074China department of respiratory and Crtical care Medicin Puren HosptalWuhan University of Science and TechnologyWuhanHubei 430081China department of respiratory Medicine The Third People's Hospital of Hubei ProvinceWuhanHubei 430030China department of Respiatory Medicine The Sixth General Hospital of Hubei ProvinceWuhanHubei 430015China Tuberculosis department of Chengdu Public Health Clinical Medical Center ChengduSichuan 610066China department of Neurology Wuhan Red Cross HospitalWuhanHubei 430015China department of Tuberculosis Jinyintan HospiaWuhanHubei 430048China department of Cardiology The Third People's Hospital of Hubei ProvinceWuhanHubei 430030China.

Background: To date, there is no effective medicine to treat coronavirus disease 2019 (COVID-19), and the antiviral efficacy of arbidol in the treatment for COVID-19 remained equivocal and controversial. The purpose of this study was to evaluate the efficacy and safety of arbidol tablets in the treatment of COVID-19.Methods: This was a prospective, open-label, controlled and multicenter investigator-initiated trial involving adult patients with confirmed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Patients were stratified 1:2 to either standard-of-care (SOC) or SOC plus arbidol tablets (oral administration of 200 mg per time, three times a day for 14 days). The primary endpoint was negative conversion of SARS-CoV-2 within the first week. The rates and 95% confidential intervals were calculated for each variable.Results: A total of 99 patients with laboratory-confirmed SARS-CoV-2 infection were enrolled;66 were assigned to the SOC plus arbidol tablets group, and 33 to the SOC group. The negative conversion rate of SARS-CoV-2 within the first week in patients receiving arbidol tablets was significantly higher than that of the SOC group (70.3% [45/64]vs. 42.4% [14/33];difference of conversion rate 27.9%;95% confidence interval [CI], 7.7%-48.1%;P=0.008). Compared to those in the SOC group, patients receiving arbidol tablets had a shorter duration of clinical recovery (median 7.0 daysvs. 12.0 days;hazard ratio [HR]: 1.877, 95% CI: 1.151-3.060,P=0.006), symptom of fever (median 3.0 daysvs. 12.0 days;HR: 18.990, 95% CI: 5.350-67.410,P 0.05). The most common adverse event in the arbidol tablets group was the elevation of transaminase (5/200, 2.5%), and no one withdrew from the study due to adverse events or disease progression.Conclusions: SOC plus arbidol tablets significant

关键词： Arbidol Coronavirus disease 2019(COVID-19) Severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)

Systemic juvenile idiopathic arthritis–associated lung disease: A retrospective cohort study

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World Journal of Clinical Pediatrics 2024年第1期13卷 73-83页

作者： Konstantin E Belozerov Natalia M Solomatina Eugenia A Isupova Alla A Kuznetsova Mikhail M Kostik department of Pediatric Saint-Petersburg State Pediatric Medical UniversitySaint-Petersburg 194100Russia St.Petersburg State Budgetary Institution of Health care Children's City Polyclinic No.29 of the Kalininsky District of St.PetersburgSt.Petersburg 195274Russia Research Laboratory of Autoimmune and Autoinflammatory diseases World-Class Research Centre for Personalized MedicineAlmazov National Medical Research CentreSt.Petersburg 197341Russia

BACKGROUND Lung damage in systemic juvenile arthritis(sJIA)is one of the contemporary topics in pediatric rheumatology.Several previous studies showed the severe course and fatal outcomes in some patients.The information about interstitial lung disease(ILD)in the sJIA is scarce and limited to a total of 100 cases.AIM To describe the features of sJIA patients with ILD in detail.METHODS In the present retrospective cohort study,information about 5 patients less than 18-years-old with sJIA and ILD were included.The diagnosis of sJIA was made according to the current 2004 and new provisional International League of Associations for Rheumatology criteria 2019.ILD was diagnosed with chest computed tomography with the exclusion of other possible reasons for concurrent lung involvement.Macrophage activation syndrome(MAS)was diagnosed with HLH-2004 and 2016 EULAR/ACR/PRINTO Classification Criteria and hScores were calculated during the lung involvement.RESULTS The onset age of sJIA ranged from 1 year to 10 years.The time interval before ILD ranged from 1 mo to 3 years.The disease course was characterized by the prevalence of the systemic features above articular involvement,intensive rash(100%),persistent and very active MAS(hScore range:194-220)with transaminitis(100%),and respiratory symptoms(100%).Only 3 patients(60%)developed a clubbing phenomenon.All patients(100%)had pleural effusion and 4 patients(80%)had pericardial effusion at the disease onset.Two patients(40%)developed pulmonary arterial hypertension.Infusion-related reactions to tocilizumab were observed in 3(60%)of the patients.One patient with trisomy 21 had a fatal disease course.Half of the remaining patients had sJIA remission and 2 patients had improvement.Lung disease improved in 3 patients(75%),but 1 of them had initial deterioration of lung involvement.One patient who has not achieved the sJIA remission had the progressed course of ILD.No cases of hyper-eosinophilia were noted.Four patients(80%)received canakinumab and one(20%)tocilizumab at the last

关键词： Systemic juvenile arthritis Interstitial lung disease Canakinumab Tocilizumab Interleukin-6 Interleukin-1