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Purpose: Practical considerations precluding health-related quality of life (HRQOL) monitoring in population and clinical research have spawned development of improved items for more brief surveys of frequently measured HRQOL outcomes. The aim of this study was to validate the use of the Quality of Life General (QGEN-8), a shorter 8-item alternative to the longer 36-item short form (SF)-36 Health Survey for measuring the same eight HRQOL domains across groups of adults with varying severity of acute respiratory symptoms, such as cough and sore throat. Methods: National Opinion Research Center (NORC) representative probability (N = 1,648) and supplemental opt-in (N = 5,915) U.S. adult samples were surveyed cross-sectionally online in 2020. Parallel analyses compared QGEN-8 and SF-36 estimates of group means for each of eight matching profile domains and summary physical and mental scores across groups differing in severity of acute symptoms and chronic respiratory conditions using analysis of covariance (ANCOVAs) controlling for socio-demographics and presence of chronic respiratory conditions. Results: In support of discriminant validity, ANCOVA estimates of QGEN-8 means with SF-36 estimates revealed the same patterns of declining HRQOL with the presence and increasing severity of symptoms and chronic condition severity. Conclusion: QGEN-8® shows satisfactory validity and warrants further testing in cross-sectional and longitudinal population and clinical survey research as a more practical method for estimating group differences in SF-36 profile and summary component HRQOL scores. Summary: Upper respiratory tract infections (URTI) with symptoms such as cough and sore throat are highly prevalent and negatively impact on health-related quality of life (HRQOL). Existing instruments that comprehensively measure HRQOL are lengthy, potentially increasing respondent burden and restricting their use in clinical studies and research. The aim of this study was to evaluate whether eight newly constructed survey items, the QGEN-8®, measure the same HRQOL outcomes as the 36-item SF-36 Health Survey well enough to serve as a more practical alternative for purposes of detecting the physical and mental HRQOL effects on differing severity of acute URTI symptoms, specifically cough and sore throat. The results showed that the QGEN-8® was psychometrically sound and able to differentiate between different levels of URTI symptoms, even in cases where respondents had chronic respiratory conditions. This indicates that the briefer QGEN-8® with 75% shorter response time is able to provide HRQOL measurements comparable to those derived from lengthier instruments thereby lending itself more readily to use in clinical studies and research of URTI symptoms, such as cough and sore throat. [ABSTRACT FROM AUTHOR]

Background: Heated humidified high-flow nasal cannula (HFNC) has gained popularity recently and is considered a standard respiratory support tool for pediatric patients with acute respiratory distress. However, data are limited on the bedside parameters that can predict HFNC failure in pediatric patients. Purpose: To evaluate the performance of SpO2/FiO2 (SF) ratio, pediatric respiratory rate-oxygenation (pROX) index, and clinical respiratory score (CRS), for predicting the HFNC outcomes. Methods: This prospective observational study included 1-month to 15-year-old patients with acute respiratory distress who required HFNC support. The HFNC setting, vital signs, CRS, and treatment outcomes were recorded. Data were analyzed to determine the predictors of HFNC failure. Eighty-two children participated in the study, 16 of whom (19.5%) did not respond to HFNC treatment (failure group). Pneumonia was the main reason for intubation (62.5%). Predictors of HFNC failure at 12 hours were: SF index ≤166 (sensitivity, 62.5%; specificity, 87.8%; area under the curve [AUC], 0.75), pROX index <132 (sensitivity, 68.7%; specificity, 84.8%; AUC, 0.77), and CRS ≥6 (sensitivity, 87.5%; specificity, 96.9%; AUC, 0.92). Conclusion: The CRS was the most accurate predictor of HFNC failure in pediatric patients. A CRS = 6 at 12 hours after HFNC initiation and pROX, a newly modified parameter, are helpful indicators of HFNC failure. [ABSTRACT FROM AUTHOR]

Copyright of INSPILIP. Revista Ecuatoriana de Ciencia, Tecnología e Innovacion en Salud Pública is the property of Instituto Nacional de Investigacion en Salud Publica (INSPI) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Acute Respiratory Infection (ISPA) is the diseases of acute respiratory top dan bottom breather that caused by infection of bacteria, virus even the rickettsia with or without parenkim bronchiolus injury. This diseases common strike to adult and child. At 2012 according to the report from all primary healthcare facility around of Kabupaten Bangka Selatan that found and caring of the pneumonia inn child the highest score at in Puskesmas Pongok (27,5%) meanwhile lower at the Puskesmas Rias around (3,5%) and Puskesmas Airgegas around (1,9%). This research used by descriptive quantitative with a cross sectional approach and with bivariate statistic chi-square. According to the result of research that found common of the patient, ISPA is Child baby (58,3%) and child (18,8%). Variable of obedience that shows the highest score (95.8%). Variable of family support that results of score around 97,9%. The result of chi-square test that shows value p=0,00 that mean Ho reject and meaning have a significant relationship between family support with ISPA medication adherence. Commonly of ISPA patient is toddler and child, and from chi-square test that shown have a relationship between family support with ISPA medication adherence.

Objective: To determine the epidemiological profile of children with acute respiratory infections from 1 month to 1 year of age attending the pediatric out patient department (OPD) of secondary care hospital in TMK, Sindh and determine the frequency of treatment methods used by mothers when encountered with acute respiratory infection in children. Study Design: A cross-sectional study. Place and Duration of Study: Pediatrics outpatient department, Taluka Headquarter Hospital District Tando Muhammad Khan (TMK), Sindh Pakistan, from Jul to Sep 2017. Material and Methods: During the study period of three months about 230 children from 1 month to 14 years of age were sampled through non-probability convenient sampling technique according to the set criteria and structured pro-forma was administered to their mothers to gather the required information. The proforma was pre-tested in the similar setting at THQ hospital, Kotri before its administration at the study setting. The findings of questionnaire were analyzed in SPSS version 22. Results: Out of 230 patients 53% (n =121) were males and 47% (n = 109) were females. The age group maximally affected was 5-14 years which were almost 47.9% (n=110) and the other age groups contributed to the remaining part of the patients that is 52.1% (n=120). Most of the patients belong to the lower class and lower middle class that approximately comprised 75% (n=170) of the patients and the remaining 25% (n=60) comprised of poor patients. Approximately 95% (n=218) of mothers were preferring medical practitioners for treatment with 5% (n= 12) going in favor of local remedies. Conclusion: Our study revealed that age group of 5-14 years is mostly the victims of the disease with male predominance as compared to females in this part of the world. Poor socioeconomic status seems to have no effect on occurrence of ARI. Future research is needed in this area to further enhance the study findings. [ABSTRACT FROM AUTHOR]

Acute Respiratory Distress Syndrome (ARDS) is a potential complication of cardiac surgery, given that patients undergoing CABG frequently have hypoxemia and pulmonary dysfunction during initial hours after surgery. Thus, ARDS criteria in these patients are more likely to be positive while these criteria may not match the patient`s clinical picture. We aimed to investigate frequency of rapid onset hypoxemia in Pressure of Arterial Oxygen to Fractional Inspired Oxygen Concentration (PaO2/FiO2) less than 200 and diffuse pulmonary infiltrates as two diagnostic criteria forwards and compared these criteria with the clinical picture of the patients after Coronary Artery Bypass Graft (CABG) in this study. The study was prospective case series which carried out in about six months. All patients admitted to intensive care unit of Tehran Heart Center, who had undergone CABG on cardiopulmonary pump (CPB) recruited in the study. After considering inclusion criteria, age, sex, duration of intubation, arterial blood gas and chest radiography, on 24 hours and 48 hours after admission to the ICU were recorded. Then, patients with rapid onset of hypoxemia (PaO2/FiO2≤200mmHg) and diffuse pulmonary infiltrates and without sign or symptoms of obvious heart failure (probable positive ARDS cases) criteria were recorded and comparison between these probable positive cases with clinician`s clinical diagnosis (blinded to the study) was performed. In this study, a total of 300 patients after on-pump coronary artery bypass surgery were included. Postoperatively, 2 (0.66 %) in the 24 hours and 4 (1.33%) patients in 48 hours after surgery were positive for the two ARDS criteria according to the checklists, but; nobody had saved persistently ARDS criteria persistently during 48 hours after surgery. At the same time, clinician did not report any case of ARDS among 300 patients. In this study patients with ARDS criteria had no significant differences in age (P.value=0.937) and sex (P.value=0.533). Duration of intubation in patients with ARDS (14.26 ± 4.25 hours) in the first 48 hours was higher but not statistically different from the group without ARDS (11.60 ± 5.45 hours) (P.value=0.236). ARDS diagnosis based on rapid onset of hypoxemia (PaO2/FiO2≤200 mmHg) and diffuse pulmonary infiltrates and without signs or symptoms of obvious heart failure criteria in patients undergoing CABG could lead to overdiagnosis or misdiagnosis in less than 24 hours follow up. We recommend following patients for more than 24 hours and revise the current ARDS criteria for CABG patients.

Objective: The aim: To study the of homeostasis links desorder and indicators imbalance in children with Coronavirus infection., Patients and Methods: Materials and methods: A clinical and laboratory study was conducted in children (50 persons) with Coronavirus infection. The children were used outpatient treatment., Results: Results: It was found that Direct bilirubin was increased in 3 times (10.55±7.67 vs. 3.63±0.49 μmol/l, p<0.01), Alanine aminotransferase - in 1.7 times (37,02±20.53 vs. 21.90±1.82 IU/l, p<0.01). An levels increassng of Ig G - in 12.3 times, Ig E - in 4.6 times, Ig M - in 3.4 times was observed. The CRP level was increased in 3.1 times (8.76 ± 2.16 vs. 2.54 ± 0.53 mg/l, p< 0.01), C-peptide (4.65±1.67 vs. 1.23±0.08 ng/ml, p<0.01) - in 3.8 times. Negative correlations of T3 with Procalcitonin (r=-0.30) and Creatinine (r=-34) were revealed. T4 values are correlated with Total cholesterol (r=-0.65) and Creatinine (r=0.29). Leptin was presented positive correlations with Alanine aminotransferase (r=0.48) and with C-peptide (r=0.39)., Conclusion: Conclusions: There was an increase in the Ig G levels in 12.3 times, Ig E - in 4.6 times, and the Ig M level - in 3.4 times. The Thyroid stimulating hormone level was significantly lower (in 4.7 times). An increase in the C-reactive protein levels (in 3.1 times) and C-peptide (in 3.8 times) was observed. It should be noted that the strongest negative correlation between T4 and Total cholesterol (r=-0.65) and the highest positive correlation between Leptin and Alanine aminotransferase (r=0.48) and C-peptide (r=0. 39).

Similar to other syndromes, patients are defined as having acute respiratory distress syndrome (ARDS) when they meet prespecified diagnostic criteria. These criteria have evolved over time, having gained and lost complexity, but the core principles have remained remarkably similar over the past 45 years. The specific diagnostic criteria allow clinicians and investigators to reliably identify patients with the syndrome of ARDS. ARDS is a form of acute diffuse lung injury occurring in patients with a predisposing risk factor. Lung injury is characterized by inflammation leading to increased endothelial and epithelial permeability and loss of aerated lung tissue resulting in hypoxemia and bilateral radiographic opacities on chest radiography. Additional physiological derangements include increased venous admixture and physiological dead space along with decreased respiratory system compliance. The corresponding pathological findings are lung edema, inflammation, hyaline membranes, and alveolar hemorrhage (i.e., diffuse alveolar damage). This article discusses the evolution of the definition of ARDS to the new Berlin definition of ARDS proposed in 2012 and its novel iterative refinement. [ABSTRACT FROM AUTHOR]

Summary: Background: The application and extent of simulation-based education use within cardiorespiratory physiotherapy postgraduate education (in-house/regional provisions) and emergency oncall services were previously unexplored. Objectives: This survey aimed to investigate the extent to which simulation-based education is currently utilised by physiotherapy services in the UK. Design: A national postal questionnaire-based survey. Setting: All 280 National Health Service Critical/Intensive Care Units in England, Northern Ireland, Scotland and Wales, providing emergency on-call physiotherapy services were included in the survey. Participants: Emergency on-call physiotherapy service leads. Method: A self-administered 20-item postal questionnaire survey was designed to establish the extent to which simulation-based education was currently being used within cardio-respiratory physiotherapy post-registration training. Results: A useable response rate of 55% (155/280) was achieved, representing a range of respiratory and emergency on-call service leads. Sixty-one Trusts (39%) currently use simulation within acute respiratory or emergency on-call postgraduate training. The provision of simulation equipment varied with respect to type, fidelity and accessible to the physiotherapy service. Simulation-based education featured in emergency on-call induction, updates, competency assessment, assessment skills, treatment skills and scenarios (75, 92, 39, 28, 82, 48% respectively). Conclusions: Simulation is currently used to teach a wide variety of cardio-respiratory physiotherapy skills relevant to the acute respiratory and on-call environments. Adoption was dependent upon local facilities, needs and training requirements. National inconsistencies in availability, fidelity and accessibility were identified. The evidence base surrounding the current use of simulation-based education within physiotherapy is limited and evidence of transferability to the practice arena remains relatively unknown. Future research is warranted to determine the education outcomes, impact on skill performance, competency, retention and patient safety when integrating SBE within EOC training activities. [Copyright &y& Elsevier]

Copyright of Jornal de Pediatria is the property of Sociedade Brasileira de Pediatria and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objectives. To describe the experience of an urban, commercial ambulance provider during the multistate August 2003 electrical power outage (EPO) and to identify how such an event can affect an emergency medical services (EMS) system. Methods. Data were abstracted from all dispatch and prehospital medical records generated during the 18-hour EPO. An hour-by-hour comparison was made between the median number of hourly EMS dispatches during the month of August 2003 and the total number of hourly EMS dispatches during the EPO. Presenting complaints were categorized, and all calls related to the EPO were identified. Results. During the first ten hours of the EPO, hourly call volume increased an average of 250% (range 50%–500%) as compared with all of August 2003. The greatest increase in call volume occurred during the first seven hours of the EPO. During the EPO, 16% ( n = 13) of patients presented with a heat-related complaint precipitated by the failure of air conditioning. In the same period, 37% ( n = 31) of patients presented with a respiratory-related complaint, 52% ( n = 16) of which were precipitated by the failure of home respiratory equipment such as ventilators, nebulizers, and oxygen concentrators. During the EPO, the average time spent on scene with patients increased 63%, from 11 to 18 minutes, when compared with the time spent 16 hours immediately prior and 14 hours immediately after the EPO. Average response and transport times did not change. Conclusion. Loss of power can cause a dramatic but short-term increase in call volume and lead to a disaster-like situation. EMS resources may be conserved by proactively assisting patients with home medical devices before they develop emergent conditions. Such a patient population might benefit, for example, from home deliveries of portable oxygen tanks or from the creation of temporary facilities that provide a climate-controlled environment and electrically powered medical devices. Key words: power outage; acute respiratory; emergency medical services; disaster preparedness; environmental emergency. [ABSTRACT FROM AUTHOR]

Background: The willingness of patients in the rural tropics to seek medical care at primary health care facilities is influenced by the distance they have to travel, but few studies have tried to estimate these distance effects.Methods: Distance decay effects in attendance rates were estimated from a database of 4348 attendances at a rural health centre in Papua New Guinea, linked to demographic and house position data for the catchment population. Small-scale spatial patterns and differences between diagnoses, age groups and gender are described.Results: Attendance decreased markedly with distance both overall (50% decrease at 3.5 km) and for patients with malaria or acute respiratory infections. This decrease was non-linear (on log scale) with distance. Although constant over time, there were big differences in this distance effect among age and gender groups: Female patients showed less distance decay in adolescents and adults, but higher in the infant group. Spatial patterns accounted for 32% of the variation in age- and gender-specific attendance rates. Of the spatial effects more than 50% were due to distance effects.Conclusions: Distance effects were similar in magnitude to those reported elsewhere, suggesting that distance effects may be generalizable to many parts of the rural tropics. The non-linearity of distance decay implies that a bell-shaped demand function should be used in health planning. [ABSTRACT FROM AUTHOR]

Brief Overview: Collectively the evidence obtained from across five clinical studies involving 936 adults indicate that mono-herbal preparations of Sambucus nigra L. berry ( S.nigra ), when taken within 48 hours of the onset of acute respiratory viral infection, may reduce the duration and severity of common cold and influenza symptoms in adults. There is currently no evidence to support the use of S.nigra berry for the treatment or prevention of COVID-19. Given the body of evidence from preclinical studies demonstrating the antiviral effects of S.nigra berry, alongside the results from clinical studies involving influenza viral infections included in this review, pre-clinical research exploring the potential effects of S.nigra berry on COVID-19 are encouraged., Verdict: The evidence included in this review is mostly derived from clinical studies involving adult participants and examining short-term use of commercial formulations of S.nigra berry for up to 16 days. Findings from included studies suggest that mono-herbal preparations of S.nigra berry (in extract or lozenge formulation) may reduce influenza-type symptoms, including fever, headache, nasal congestion and nasal mucous discharge in adults, when taken within the first 48 hours of symptom onset. Within 2-4 days of S.nigra treatment, most adult participants experienced significant symptom reduction, by an average of 50%. Evidence regarding the effectiveness of S.nigra berry on the symptom of cough, and need for/use of medicines (including antibiotics) to treat acute respiratory infections, is currently unclear and inconsistent. Adverse events were rare with no serious events reported. Adverse events, reported in two studies, were more common in comparators than in treatments. There is currently no reliable or sufficient scientific evidence to support the use of S.nigra in pregnant or lactating women., (© 2020 Published by Elsevier Ltd.)

Objectives: The study investigated treatment outcomes when respiratory physiotherapy was delivered by non-respiratory on-call physiotherapists, compared with specialist respiratory physiotherapists., Design: Prospective, randomised crossover trial., Setting: Paediatric, tertiary care hospital in the United Kingdom., Participants: Mechanically ventilated children requiring two physiotherapy interventions during a single day were eligible. Twenty two physiotherapists (10 non-respiratory) and 93 patients were recruited., Interventions: Patients received one treatment from a non-respiratory physiotherapist and another from a respiratory physiotherapist, in a randomised order. Treatments were individualised to the patients' needs, often including re-positioning followed by manual lung inflations, chest wall vibrations and endotracheal suction., Main Outcome Measures: The primary outcome was respiratory compliance. Secondary outcomes included adverse physiological events and clinically important respiratory changes (according to an a priori definition)., Results: Treatments delivered to 63 patients were analysed. There were significant improvements to respiratory compliance (mean increase [95% confidence intervals], 0.07 and 0.08ml·cmH2O(-1)·kg(-1) [0.01 to 0.14 and 0.04 to 0.13], p<0.01, for on-call and respiratory physiotherapists' treatments respectively). Case-by-case, there were fewer clinically important improvements following non-respiratory physiotherapists' treatments compared with the respiratory physiotherapists' (n=27 [43%] versus n=40 [63%], p=0.03). Eleven adverse events occurred, eight following non-respiratory physiotherapists' treatments., Conclusions: Significant disparities exist in treatment outcomes when patients are treated by non-respiratory on-call physiotherapists, compared with specialist respiratory physiotherapists. There is an urgent need for targeted training strategies, or alternative service delivery models, to be explored. This should aim to address the quality of respiratory physiotherapy services, both during and outside of normal working hours., Clinical Trial Registration Number: Clinicaltrials.gov, NCT01999426., (Copyright © 2015 Chartered Society of Physiotherapy. Published by Elsevier Ltd. All rights reserved.)

Objectives: To investigate differences, if any, in the delivery of respiratory treatments to mechanically ventilated children between non-respiratory on-call physiotherapists and specialist respiratory physiotherapists., Setting: Paediatric, tertiary care hospital in the United Kingdom., Participants: 93 children (aged between 3 days and 16 years), and 22 physiotherapists (10 specialist respiratory physiotherapists) were recruited to the study., Interventions: Recruited children received two physiotherapy treatments during a single day, one delivered by a non-respiratory physiotherapist, the other by a specialist respiratory physiotherapist in a randomised order. Selection, delivery and effects of techniques were recorded for each treatment., Outcome Measures: Primary outcomes were selection and application of treatment components. Secondary outcomes included respiratory effects (in terms of changes in flow, volume and pressure) of selected treatment components., Results: Both non-respiratory on-call physiotherapists and specialist respiratory physiotherapists used combinations of saline instillation, manual lung inflations, chest wall vibrations and endotracheal suction during treatments. However specialist respiratory physiotherapists used combinations of chest wall vibrations with suction, and recruitment manoeuvres, significantly more frequently than non-respiratory on-call physiotherapists (92% vs 52%, and 87% vs 46% of treatments respectively, P<0.001). Chest wall vibrations delivered by non-respiratory on-call physiotherapists were 15% less effective at increasing peak expiratory flow., Conclusion: Clinically important differences between non-respiratory and specialist respiratory physiotherapists' treatment outcomes may be related to differences in the selection and application of techniques. This suggests an important training need for non-respiratory on-call physiotherapists, particularly in the effective delivery of physiotherapy techniques., Trial Registration: Clinicaltrials.gov NCT01999426., (Copyright © 2015 Chartered Society of Physiotherapy. Published by Elsevier Ltd. All rights reserved.)