Covid-19 disease

COVID - 19 疾病
  • 文章类型: Journal Article
    幽门螺杆菌,顶级致癌物之一,与全球大多数胃癌相关死亡病例有关。在过去的二十年里,细菌中抗生素耐药性的上升降低了常规抗生素治疗的功效。这强调了持续研究和新治疗方法的紧迫性。建立全球公认的抗生素处方医师指南对于对抗抗生素耐药性和改善幽门螺杆菌感染管理至关重要。因此,重要的是应对使建立普遍接受的治疗方案复杂化的挑战,以开出根除幽门螺杆菌的抗生素方案.为什么常规标准三联疗法尽管疗效低,但仍是一线治疗选择的问题的答案,以及不同因素如何影响治疗选择,需要识别这些挑战。因此,这篇综述解决了与幽门螺杆菌治疗选择相关的问题,抗生素耐药性和患者依从性在治疗结果中的作用,第一行vs.二线治疗选择,以及用于增强现有治疗方法的方法。我们还提供了一张图表来帮助抗生素治疗处方,这可以支持医生在这方面的指导方针。根除幽门螺杆菌和患者的依从性对于克服细菌中的抗生素耐药性至关重要,我们的图表总结了关键考虑因素,并提出了实现这一目标的新方法。
    Helicobacter pylori, one of the top carcinogens, is associated with most cases of gastric cancer-related deaths worldwide. Over the past two decades, the rising rates of antibiotic resistance in the bacterium have reduced the efficacy of conventional antibiotic-based treatments. This underscores the urgency for continued research and novel treatment approaches. Establishing a worldwide accepted physician guideline for antibiotic prescription is crucial to combat antibiotic resistance and improve H. pylori infection management. Therefore, it is important to address the challenges that complicate the establishment of a universally accepted treatment protocol to prescribe an antibiotic regimen to eradicate H. pylori. The answers to the questions of why conventional standard triple therapy remains a first-line treatment choice despite its low efficacy, and how different factors affect therapy choice, are needed to identify these challenges. Hence, this review addresses concerns related to H. pylori treatment choice, role of antibiotic resistance and patient compliance in treatment outcomes, first-line vs. second-line therapy options, and methods for enhancing existing treatment methods. We also present a chart to aid antibiotic treatment prescription, which may support physician guidelines in this aspect. Eradication of H. pylori and patient adherence is paramount in overcoming antibiotic resistance in the bacterium, and our chart summarizes key considerations and suggests novel approaches to achieve this goal.
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  • 文章类型: Systematic Review
    COVID-19疾病是由冠状病毒家族“SARS-CoV-2”的突变株引起的。它尤其影响呼吸系统,但是已经报道了该系统以外的许多临床表现。口腔表现并不常见,然而,在没有共同迹象的情况下,它们可能代表COVID-19疾病的发作。这项系统评价的目的是观察SARS-CoV-2感染与口腔表现之间是否存在相关性。
    这项研究是在PubMed上进行的,Scopus,2020年3月至2023年5月的Google学者和Cochrane图书馆。每一项研究都进行了数据提取;包括作者,出版的年份和月份,研究类型,患者平均年龄,口腔病变的类型和定位,SARS-CoV-2病毒检测的阳性,和合并症。
    共有43项研究符合纳入标准,共纳入507例COVID-19患者,496例口腔病变。最常见的是溃疡,最常见的定位是舌头。
    我们的系统评价结果表明,COVID-19感染与口腔表现之间可能存在相关性。需要进一步的研究来确定病变是否与病毒直接相关。
    UNASSIGNED: COVID-19 disease is caused by a mutated strain of the coronavirus family \"SARS-CoV-2\". It affects especially the respiratory system, but many clinical manifestations outside this system have been reported. Oral manifestations are uncommon, however, with the absence of common signs, they may represent the onset of COVID-19 disease. The aim of this systematic review is to observe if there is a correlation between SARS-CoV-2 infection and oral manifestations.
    UNASSIGNED: The research was conducted on PubMed, Scopus, Google Scholars and Cochrane Library from March 2020 to May 2023. Each study was subjected to data extraction; including authors, year and month of publication, study type, patients\' average age, type and localization of oral lesions, the positivity of the SARS-CoV-2 virus test, and comorbidities.
    UNASSIGNED: A total of 43 studies met the inclusion criteria and a total of 507 COVID-19 patients with 496 oral lesions were included. The most frequent was ulceration and the most common localization was the tongue.
    UNASSIGNED: The results of our systematic review show a possible correlation between COVID-19 infection and oral manifestations. Further studies are required to determine if the lesions are directly connected to the virus.
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  • 文章类型: Journal Article
    严重急性呼吸系统综合症冠状病毒-2大流行严重影响了临床实践,也在儿科肿瘤科。尽管有SARS-CoV-2感染,癌症患者仍需要以足够的剂量密度进行治疗。平衡患严重COVID-19疾病的风险。
    尽管大流行在全球范围内蔓延,受影响儿童的患病率较低.患有严重疾病的儿童比例约为1-6%。儿科癌症患者代表了以前健康的免疫系统的原型,该免疫系统受到肿瘤本身和治疗的阻碍,比如化疗和类固醇.通过文献回顾,我们报道了SARS-CoV-2感染反应的免疫学基础,现有的抗病毒治疗用于儿科癌症患者,以及疫苗接种的重要性。总之,我们报告了大流行期间儿科肿瘤科的真实经历.
    从文献中可用的数据开始,和我们的经验,在患有实体瘤的儿科患者中显示出严重的COVID-19疾病的罕见,我们建议仔细调整所有肿瘤治疗(化疗/靶向治疗/干细胞移植/放疗).目的是保留治疗的时机,与对可能的严重COVID-19疾病的评估平衡。
    The severe acute respiratory syndrome coronavirus-2 pandemic significantly affected clinical practice, also in pediatric oncology units. Cancer patients needed to be treated with an adequate dose density despite the SARS-CoV-2 infection, balancing risks of developing severe COVID-19 disease.
    Although the pandemic spread worldwide, the prevalence of affected children was low. The percentage of children with severe illness was approximately 1-6%. Pediatric cancer patients represent a prototype of a previously healthy immune system that is hampered by the tumor itself and treatments, such as chemotherapy and steroids. Through a review of the literature, we reported the immunological basis of the response to SARS-CoV-2 infection, the existing antiviral treatments used in pediatric cancer patients, and the importance of vaccination. In conclusion, we reported the real-life experience of our pediatric oncology unit during the pandemic period.
    Starting from the data available in literature, and our experience, showing the rarity of severe COVID-19 disease in pediatric patients with solid tumors, we recommend carefully tailoring all the oncological treatments (chemotherapy/targeted therapy/stem cell transplantation/radiotherapy). The aim is the preservation of the treatment\'s timing, balanced with an evaluation of possible severe COVID-19 disease.
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  • 文章类型: Meta-Analysis
    血管紧张素II转换酶抑制剂(ACEI)和选择性血管紧张素II受体拮抗剂(ARAIIs)是广泛使用的抗高血压药。由于它们可能对感染COVID-19的慢性病患者的健康状况产生影响,因此它们的使用引发了争议。这项工作的目的是分析COVID-19对ACEI和ARAII抑制剂治疗的慢性高血压患者的影响。Pubmed数据库中的系统评价和荟萃分析,进行了Pro-Quest和Scopus。系统评价是根据系统评价和荟萃分析(PRISMA)指南的首选报告项目进行的。搜索方程描述符是从医学主题词(MeSH)词库中获得的。搜索方程式为:“老年人和高血压以及(COVID-19或冠状病毒)和初级保健”,西班牙语中的等价物。获得了19篇文章,n=10,806,159名受试者。一些研究将COVID-19与高血压患者的ACEI或ARAII治疗相关描述为保护因素,一些作为风险因素,和其他没有风险关联的人。在ACEI与ARAII,前者描述的风险的赔率比(OR)为0.55,而对于ARAII,OR为0.59。一些作者谈到与COVID-19和ACEI相关的死亡率,其半比率(HR)为0.97,并且ARAIIs与HR为0.98相关。建议在COVID-19疾病的背景下维持肾素-血管紧张素-醛固酮轴的使用。
    Angiotensin II-converting enzyme inhibitors (ACEIs) and selective angiotensin II receptor antagonists (ARAIIs) are widely used antihypertensive agents. Their use has generated controversy due to their possible influence on the health status of chronic patients infected with COVID-19. The objective of this work is to analyze the influence of COVID-19 on chronic hypertensive patients treated with ACEI and ARAII inhibitors. A systematic review and meta-analysis in the databases Pubmed, Pro-Quest and Scopus were carried out. The systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The search equation descriptors were obtained from the Medical Subject Headings (MeSH) thesaurus. The search equation was: \"Older AND hypertension AND (COVID-19 OR coronavirus) AND primary care\" and its equivalent in Spanish. Nineteen articles were obtained, with n = 10,806,159 subjects. Several studies describe the COVID-19 association with ACEI or ARAII treatment in hypertension patients as a protective factor, some as a risk factor, and others without a risk association. In the case of ACEI vs. ARAII, the risk described for the former has an odds ratio (OR) of 0.55, and for ARAII, an OR of 0.59. Some authors talk about mortality associated with COVID-19 and ACEI with a half ratio (HR) of 0.97, and also associated ARAIIs with an HR of 0.98. It is recommended to maintain the use of the renin-angiotensin-aldosterone axis in the context of the COVID-19 disease.
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  • 文章类型: Review
    横纹肌溶解症是一种肌肉分解可能导致肾功能不全的疾病。经常发生在沉淀因素之后。病毒或细菌感染是引发横纹肌溶解的常见沉淀剂。最近,世界各地的医疗保健系统都受到严重急性呼吸系统综合症冠状病毒2(SARS-CoV-2)大流行的挑战,导致“2019年冠状病毒病”(COVID-19)疾病。SARS-CoV-2感染被认为会导致呼吸道和心血管疾病,血栓栓塞事件,和急性肾损伤(AKI);然而,目前还不知道它是否能诱发横纹肌溶解症,迄今为止,仅报道了少数在横纹肌溶解之前的SARS-CoV-2感染病例。这里,我们报告了一例64岁女性,她在感染SARS-CoV-2和COVID-19后不久出现横纹肌溶解症.她最初表现为肌肉疼痛,肌酸激酶水平为119,301IU/L,肌酐水平轻度上升至92μmol/L,但静脉输液支持成功康复.我们还回顾了文献,以总结先前报道的SARS-CoV-2诱发的横纹肌溶解症病例,强调需要在患有SARS-CoV-2和肌痛的患者中考虑这种诊断。
    Rhabdomyolysis is a condition in which muscle breaks down potentially leading to renal dysfunction, and often occurs secondary to a precipitating factor. Viral or bacterial infections are common precipitants for initiating rhabdomyolysis. Recently, healthcare systems across the world have been challenged by a pandemic of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) causing \'coronavirus disease 2019\' (COVID-19) disease. SARS-CoV-2 infection is recognized to cause respiratory and cardiovascular compromise, thromboembolic events, and acute kidney injury (AKI); however, it is not known whether it can precipitate rhabdomyolysis, with only a limited number of cases of SARS-CoV-2 infection preceding rhabdomyolysis reported to date. Here, we report the case of a 64-year-old woman who developed rhabdomyolysis shortly after SARS-CoV-2 infection and COVID-19. She initially presented with muscular pain, a creatine kinase level of 119,301 IU/L, and a mild rise in her creatinine level to 92 µmol/L, but successfully recovered with intravenous fluid support. We also review the literature to summarise previously reported cases of rhabdomyolysis precipitated by SARS-CoV-2, highlighting the need to consider this diagnosis in patients presenting with SARS-CoV-2 and myalgia.
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  • 文章类型: Journal Article
    2019年冠状病毒病(COVID-19)是由严重急性呼吸道综合症冠状病毒2(SARS-CoV-2)引起的,截至2021年8月24日,全球已导致440多万人死亡。诸如SARS-CoV2的病毒感染与内质网(ER)应激有关,并且还增加了活性氧的水平。激活转录因子4(ATF4)在整合的应激条件下优先翻译,并控制参与蛋白质稳态的基因,氨基酸运输和代谢,以及免受氧化应激的保护。由ATF4直接或间接调节的GRP78是ER中的必需伴侣,并且在应激期间过度表达并出现在几乎所有细胞的表面上,并充当SARS-CoV2受体。在这篇迷你评论文章中,我们简要讨论了SARS-CoV2感染对ER应激的影响,然后强调了ATF4和GRP78作为新的治疗靶点的应激调节功能。最后,讨论了GRP78抑制成分作为COVID-19危重病例靶向治疗的潜在因素的作用.
    Coronavirus disease 2019 (COVID-19) is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and has resulted in more than 4.4 million deaths worldwide as of August 24, 2021. Viral infections such as SARS-CoV2 are associated with endoplasmic reticulum (ER) stress and also increased the level of reactive oxygen species. Activating transcription factor 4 (ATF4) is preferentially translated under integrated stress conditions and controls the genes involved in protein homeostasis, amino acid transport and metabolism, and also protection from oxidative stress. The GRP78, regulated either directly or indirectly by ATF4, is an essential chaperone in the ER and overexpressed and appears on the surface of almost all cells during stress and function as a SARS-CoV2 receptor. In this mini-review article, we briefly discuss the effects of SARS-CoV2 infection on the ER stress, and then the stress modulator functions of ATF4 and GRP78 as novel therapeutic targets were highlighted. Finally, the effects of GRP78 inhibitory components as potential factors for targeted therapies for COVID-19 critical cases were discussed.
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  • 文章类型: Journal Article
    BACKGROUND: The novel coronavirus disease (COVID-19), declared a global pandemic by the World Health Organization (WHO) on March 11, 2020, has constituted one of the most serious health challenges of the century, globally. The causative organism was initially named the 2019 novel coronavirus (2019 nCoV) but has subsequently been renamed Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). The pandemic has so far infected several million and killed about a million people worldwide. Diabetes mellitus (DM) is one of the leading causes of morbidity worldwide.
    OBJECTIVE: To examine the critical role diabetes plays in the pathogenesis and prognosis of COVID-19 and to assess the emerging therapies available to fight the pandemic.
    METHODS: Authors conducted a systematic review of literature to examine the role of diabetes as a comorbidity in the pathogenesis and prognosis of COVID-19.
    RESULTS: Both experimental and observational data from early 2020 suggested that most people with COVID-19 have comorbidities, the most dominant of which are diabetes, cardiovascular disease, and hypertension. Empirical evidence indicates that diabetic patients infected with the COVID-19 disease had the worst outcomes concerning morbidity and mortality.
    CONCLUSIONS: A combination of underlying chronic conditions such as hypertension, obesity, and cardiovascular diseases together with altered ACE receptor expression, immune dysregulation via cytokine storm, alveolar and endothelial dysfunction, increased systemic coagulation may put individuals with diabetes at risk for COVID-19 severity. More studies are needed to elucidate how glucose-lowering drugs may modulate the host immune response in diabetic individuals, especially following the administration of potential COVID-19 vaccines.
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