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Context Children with cancer and cardiac disease suffer with high symptom burden at end of life (EOL). Little is known about the EOL experience for children with other complex chronic conditions (CCCs). Objectives To evaluate symptoms and suffering at EOL for children with noncancer, noncardiac CCCs as well as parental distress related to child suffering. Methods This study is a secondary data analysis of a cross-sectional, single-center survey of bereaved parents of children with CCCs who died between 2006 to 2015. The primary outcome was parent-reported child suffering in the final two days of life. Results Among 211 eligible parents contacted for participation, 114 completed the survey, and 99 had complete primary outcome data (participation rate 47%). Most children had congenital/chromosomal (42%) or progressive central nervous system (22%) conditions. Twenty-eight percent of parents reported high child suffering in the final two days of life. Parents reported that pain and difficulty breathing caused the greatest suffering for children and distress among themselves. Some parents also reported distress related to uncertainty about child suffering. Parents were less likely to report high child suffering if they were confident in knowing what to expect when their child was dying (AOR 0.20; 95% CI 0.07–0.60) or felt prepared for medical problems at EOL (AOR 0.12; 95% CI 0.04–0.42). Conclusion Nearly one-third of parents of children with CCCs report high suffering in their child's final days of life. Parent preparedness was associated with lower perceived child suffering. Future research should target symptoms contributing to parent and child distress and assess whether enhancing parent preparedness reduces perceived child suffering.

This study is an attempt to understand the coronavirus and COVID-19 from the viewpoint of recovered patients at Civil Hospital Jhangi Wala, District Bahawalpur. It investigates the feelings and experiences of those patients who suffered due to being infected with the novel coronavirus and who ultimately defeated the disease. A total of 310 Corona patients shared their feelings, symptoms, coping strategies, level of fear, and perceptions about the disease. The study used inferential statistics to quantify the data and determine the results. The study concluded that those people who were unafraid of the disease and who did not follow the Corona SOPs got the infection in the district of Bahawalpur. By profession, they were shopkeepers and laborers. The majority of the patients were those who had co-morbidities such as asthma and diabetes. The study recommended that those who are feeling symptoms of the flu such as fever, sneezing, loss of taste, loss of smell, sore throat, and/or having difficulty breathing must observe social distances and quarantine themselves for proper curation. [ FROM AUTHOR] Copyright of Journal of Hospital Librarianship is the property of Taylor & Francis Ltd 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 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 . (Copyright applies to all Abstracts.)

Objective:Our objective was to compare care-seeking patterns in Mosul, Iraq, in 2018, 1 y after Islamic State of Iraq and Syria (ISIS) control, with findings from neighborhoods that had been sampled in 2017Methods:For this multi-stage randomized cluster household survey, we created one cluster in each of 20 neighborhoods randomly selected from the 40 neighborhoods in the 2016/17 survey; 12 in east Mosul, 8 in west Mosul. In each, 30 households were interviewed beginning at a randomly selected start house. Questions were derived from the 2016/2017 post-ISIS survey.Results:We interviewed the head of household or senior female in 600 households containing 3375 persons. One year after ISIS, some household demographic shifts had occurred. Diarrhea in children during the past 2 wk decreased from 50.1% to 7.5% (P < 0.001); however, cough/difficulty breathing increased from 15.5% to 33.6% (P < 0.01). Among adults, care-seeking for noncommunicable diseases increased from 22.3% to 43.5% (P < 0.001). Emotional and psychological complaints common in the previous survey were now nearly absent. Pregnancy complications diminished from 65.2% to 15.4% (P < 0.001).Conclusions:Communicable diseases predominated among children and noncommunicable diseases among adults. Access to health care substantially improved, although barriers remained. Satisfaction with services was mixed, with dissatisfaction expressed about testing, medicine access, and costs, but the work of health providers was rated highly.

PurposeThe current study examined police response, specifically identification and arrest decisions, to nonfatal strangulation occurring within the context of intimate partner violence.Design/methodology/approachData for the present study were derived from a sample of 117 possible nonfatal strangulation case reported to a police agency located in one of the fifth largest and most diverse US cities. A series of logistic regression models were employed to examine the role of victim, suspect and case characteristics on officer formal identification of strangulation and officer arrest decisions.FindingsResults revealed that 14% of all intimate partner violence (IPV) cases reported to the police agency involved possible nonfatal strangulation and less than half of all possible nonfatal strangulation cases were formally identified as such by officers. The odds of formal identification of strangulation by police increased when strangulation was manual and when victims reported difficulty breathing. Injury and formal identification increased the odds of arrest.Originality/valueThis study is the first to examine predictors of police formal identification and arrest decisions in nonfatal strangulation occurring within intimate partner violence incidents.

Aims: To measure the degree to which the Ha’il community is willing to test for COVID-19 and assess the possible factors that may influence their decision. Study Design: Descriptive and analytical cross-sectional study. Place and Duration of Study: The study was conducted in Ḥaʼil Community. And the data was collected from October to November of 2020. Methodology: Participants comprised of both Saudi and non-Saudi males and females who were 18 years or older and living within the Ha’il region. Participants were recruited via convenience sampling by distributing the electronic questionnaire throughout various social media platforms. Results: Of the 664 participants, 80.9% reported their willingness to test for COVID-19 if they had olfactory dysfunction with, 80.3% reporting their willingness to test if they had difficulty breathing. However, only 61.7% of participants said that they would be willing to be tested if they had been in contact with someone who had tested positive, whilst they themselves were asymptomatic. More than half of the participants reported that they were confident in the results (81%). Bio-demographic factors that influence the degree of public trust were as follows; females (83.8%); living with others (81.8%); history of not gathering with more than 10 people outside their household (87.9%). Conclusion: Our finding revealed that the vast majority of the Ha’il community are willing to test for COVID-19, with a high proportion of females, participants who are living with others and participants who do not usually mix with more than 10 people at the same time showing a greater degree of trust in the results of the COVID-19 test. Furthermore, when participants had experienced olfactory dysfunction or\and breathing difficulties themselves, they tended to exhibit greater trust in the COVID-19 test results.

We reported a rare case demonstrating that the hyperbaric oxygen chamber provided faster clinical improvement in a patient with a variant of Guillain-Barre Syndrome (GBS). A patient with progressive, acute weakness of upper extremity locomotor muscles and with difficulty breathing and swallowing was diagnosed with axonal GBS. Despite life-saving conventional therapies, there was no significant improvement until day 5. During hyperbaric oxygen therapy, there were daily gradual improvements until day 20, at which time the patient was capable of walking slowly without using a walking aid.

While many patients fully recover from the acute phase of COVID-19, many others have been showing ongoing symptoms such as headache, difficulty breathing, fatigue, difficulty concentrating, etc., l...

Volcanic ash occurs due to volcanic eruptions that can cause adverse health effects if inhaled. One of which is can cause respiratory problems in the form of respiratory tract irritation, increased phlegm secretion, irritation and inflammation of the throat, dry cough, chest pain, and difficulty breathing. This aimed at determining the correlation between volcanic ash exposure and ARI accident at Public Health Center Rendang Karangasem District Health Center. This study used a correlational research design with the approach used is cross-sectional. The sample in this study was 43 people affected by ARI in September 2017 in the area of Puskesmas Rendang Karangasem. Data analysis was using the Mann-Whitney test. The results of this study showed that no significant correlation from this study based on the Mann Whitney test value of 832.5 and the value of p = 0.138 (P> 0.05), meaning at alpha 5%. It is expected that people who suffer from ARI disease to use masks so as not to aggravate the condition of illness due to ARI and the health center to always provide counseling about healthy lifestyles and avoid ARI.

Infant outcomes after maternal severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection are not well described. In a prospective US registry of 263 infants, maternal SARS-CoV-2 status was not associated with birth weight, difficulty breathing, apnea, or upper or lower respiratory infection through 8 weeks of age.

الملخص: أهداف البحث: يعد تعرض طلاب الطب لتشريح الجثث تجربة مرهقة مرتبطة بمجموعة من الأعراض. أجريت هذه الدراسة لتحديد الأعراض لطلاب الطب المقبولين حديثا بعد تعرضهم الأول للجثث في جامعة نيجيرية. طرق البحث: خلال الأعوام الأكاديمية ٢٠١٨-٢٠١٩ و٢٠١٩-٢٠٢٠. أجرينا مسحا على ٨٧ طالب طب من السنة الثانية في جامعة النيل النيجيرية. واستخدمت استبانة الأعراض التي تعبأ ذاتيا ومقياس تقييم أحداث الحياة لجمع البيانات. النتائج: كان متوسط الدرجات من مقياس تقييم أحداث الحياة لمجالي التهديد والتحدي للتوتر ٣٠⁄٦ (٢٠.٣٣٪) و١٦ ⁄٣٠ (٥٥.٥٪). وكان متوسط درجة الخسارة ٥ ⁄ ٢٠ (٢٦.١٥٪). عند التعرض للجثة، ذكر معظم الطلاب أنهم شعروا بالفضول والحماس ولكن في نفس الوقت شعروا بالقلق. وظهرت هذه الأعراض على شكل خفقان، وصعوبة في التنفس، وغثيان، وإغماء ودوار. ومن أجل تخفيف هذه الأعراض، ركز معظم الطلاب على مهمة التشريح، أو ممارسة نشاطات دينية، أو الاسترخاء أو طلب المساعدة من المعلمين. الاستنتاجات: على الرغم من أن التعرض الأولي للجثة كان مجهدا، أظهرت نتائجنا أن الطلاب لم يثقل عليهم ذلك. رأى الطلاب أنها إيجابية على نطاق واسع وبذلوا جهودا للتغلب على هذه المشاعر. من غير المرجح أن تشكل المشاعر المجهدة تأثيرا سلبيا على طلاب الطب من خلال دراستهم في قاعة التشريح. Abstract: Objective: Exposure to the dissection of human cadavers is a stressful experience that causes a wide range of symptoms among medical students. This study examined the symptoms experienced by newly enrolled medical students of a Nigerian university following their first exposure to cadavers. Methods: During the academic years 2018–2019 and 2019–2020, we conducted a survey among 87 second-year medical students who belonged to the Nile University of Nigeria. A self-administered questionnaire that assessed different symptoms and the Appraisal of Life Events (ALE) Scale were used to collect data. Results: The participants obtained mean scores of 6 out of 30 (20.33%), 16 out of 30 (55.50%), and 5 out of 20 (26.15%) on the threat, challenge, and loss dimensions of the ALE Scale, respectively. When they were exposed to the cadaver, a majority of the students reportedly felt not only curious and excited but also anxious. Additionally, they reported experiencing symptoms such as palpitations, difficulty breathing, nausea, and feeling faint and dizzy. In order to alleviate such feelings, most of the students focused on the task at hand (i.e. dissection), engaged in religious activities, tried to relax, or sought the help of their lecturers. Conclusions: Our findings revealed that, even though their first exposure to a cadaver was stressful, the students were resilient. The students appraised this experience positively and had taken efforts to cope with their symptoms. This is unlikely that stressful feelings pose negative influence on the medical students during their study in anatomy dissection hall. الكلمات المفتاحية: التشريح, طلاب الطب, الأعراض, التوتر, Keywords: Anatomy, Dissection, Medical students, Stress, Symptoms

Asthma is a chronic respiratory illness that often first presents in childhood but can also present in adults. Individuals with asthma experience recurrent episodes of difficulty breathing ...

The threat of contagious infectious diseases is constantly evolving as demographic explosion, travel globalization and changes in human lifestyle increase the risk of speeding pathogens, leading to accelerate changes in disease landscape.(1) Tuberculosis and Covid-19 are both infectious diseases that attack primarily the lungs. Both diseases have similar symptoms such as cough, fever and difficulty breathing. Tuberculosis has a longer incubation period with a slower reset of disease. Experience on Covid-19 infection in TB patient remains limited. 8 studies reported a total of 80 patients with this co-infection. These patients were reported from 9 different countries, with Italy reporting the largest number of cases.(2) The aim of this study is to evaluate the characteristic of TB and Covid-19 co-infection in 10 patients who were admitted in the Pulmonology Hospital of Sibiu between 01.05.2020-30.04.2021. All of these patients were with nosocomial infection Covid-19 and were previously diagnosed with TB.

BackgroundThunderstorm asthma is often characterised by a sudden surge in patients presenting with exacerbated symptoms of asthma linked to thunderstorm activity. On 17 June 2021, Public Health England (PHE) observed a large spike in health care seeking behaviour by patients presenting with asthma and difficulty breathing symptoms across parts of England.ObjectivesTo describe the epidemiology of the observed asthma spike and explore available meteorological and environmental data to understand potential causes of this episode.DesignA retrospective observational study was conducted of patient visits to health care services in England as monitored through surveillance systems routinely operated by PHE. The number of presentations during the asthma event was compared to expected levels for the overall population and across specific regions.SettingHealthcare services in England.Main outcome measuresNumber of patients presenting to healthcare services for asthma- and difficulty breathing-type symptoms.ResultsSpikes in asthma and difficulty breathing were detected across several PHE syndromic surveillance systems. Across affected areas ED attendances for asthma increased by 560% on 17 June compared to the average number of weekday daily attendances during the previous 4 weeks. GP out of hours contacts increased by 422%, NHS 111 calls 193%, NHS 111 online assessments 581% and ambulance call outs 54%. Increases were particularly noted in patient age groups 5-14 and 15-44 years. In non-affected regions, increases were small (ConclusionsAn unprecedented episode of asthma was recorded in England, characterised by significant surges in health care seeking behaviour. However, the links to meteorologically defined thunderstorm activity were not as clear as previous episodes, with less evidence of severe thunderstorm activity in those areas affected, prompting further discussion about the causes of these events and implications for public health management of the risk.

Lymphedema of an extremity at birth can be an alarming finding. Our patient presented with difficulty breathing and productive cough and was found to have primary lymphedema of the right upper extremity since birth. Further testing was mostly unremarkable except for imaging that revealed many splenic lesions.

Background Manual assessment of respiratory rate (RR) in children is unreliable, but remains the main method to diagnose pneumonia in low-resource settings. While automated RR counters offer a potential solution, there is currently no gold standard to validate these diagnostic aids. A video-based reference tool is proposed that allows users to annotate breaths and distortions including movement periods, allowing the exclusion of distortions from the computation of RR measures similar to how new diagnostic aids account for distortions automatically. This study evaluated the interrater agreement and acceptability of the new reference tool. Methods Annotations were based on previously recorded reference videos of children under five years old with cough and/or difficulty breathing (n = 50). Five randomly selected medical experts from a panel of ten annotated each video. RR measures (breaths per minute, bpm) were computed as the number of annotated certain breaths divided by the length of calm periods after removing annotated distorted periods. Results Reviewers showed good interrater agreement on continuous RR {standard error of measurement (SEM) [4.8 (95%CI 4.4–5.3)]} and substantial agreement on classification of fast breathing (Fleiss kappa, κ 0.71). Agreement was lowest in the youngest age group [< 2 months: SEM 6.2 (5.4–7.4) bpm, κ 0.48; 2–11 months: 4.7 (4.0–5.8) bpm, κ 0.84; 12–59 months: 2.6 (2.2–3.1) bpm, κ 0.8]. Reviewers found the functionalities of the tool helpful in annotating breaths, but remained uncertain about the validity of their annotations. Conclusions Before the new tool can be considered a reference standard for RR assessments, interrater agreement in children younger than 2 months must be improved.

Wolfram syndrome is a rare, fatal disease that usually stems from defects in the gene for the protein wolframin. Researchers now have a better understanding of the disease and for the first time are testing potential treatments that might slow its progress. Wolfram syndrome results in symptoms such as blindness, hearing loss, difficulty with movement and coordination, and difficulty breathing. It causes cells throughout the body to die and is usually fatal before the age of 40. Scientists have discovered the disease involves a malfunction by the endoplasmic reticulum called ER stress, and that discovery enabled them to identify several drugs that are now in clinical trials for the illness. Researchers also hope to use genetic engineering and the CRISPR gene-editing tool to correct Wolfram syndrome9s underlying defects. Because ER stress also drives more common illnesses such as Alzheimer9s disease and type 2 diabetes, Wolfram syndrome could also provide insight into the mechanisms of these diseases.

In the ongoing COVID-19 pandemic, the global fraternity of researchers has been assiduously investigating pharmacological interventions against the SARS-CoV2. This novel virus is known to gain entry through the ACE 2 receptor of pulmonary epithelial cells lining the respiratory tract. Many of its initial symptoms (e.g. difficulty breathing) resemble acute high altitude illnesses, particularly HAPE. Based on these overt symptoms, a number of high altitude researchers have speculated on repurposing of drugs used to treat acute altitude illnesses (especially HAPE). However, eminent high altitude researchers with medical expertise as well as some studies on the deeper causes underlying the overt symptoms have found that such repurposing maybe counter-productive. Other factors, (e.g. contra-indications of these drugs), make their use in COVID-19 patients hazardous. The fit-for-repurposing options maybe experimental prophylactic interventions (e.g. silymarin, curcumin) which have proven anti-oxidant and anti-inflammatory effects. Another line of thought focuses on proteomics-based investigations of such patients. However, apart from the logistical and safety issues, a targeted proteomics approach based on prior sound molecular investigations is a more logical approach instead of mere shotgun proteomics. In this commentary, we shed light on such issues associated with COVID-19.

BACKGROUND AND OBJECTIVES: Exposure to airborne fine particles with diameters ≤2.5 μm (PM2.5) pollution is a well-established cause of respiratory diseases in children; whether wildfire-specific PM2.5 causes more damage, however, remains uncertain. We examine the associations between wildfire-specific PM2.5 and pediatric respiratory health during the period 2011–2017 in San Diego County, California, and compare these results with other sources of PM2.5. METHODS: Visits to emergency and urgent care facilities of Rady’s Children Hospital network in San Diego County, California, by individuals (aged ≤19 years) with ≥1 of the following respiratory conditions: difficulty breathing, respiratory distress, wheezing, asthma, or cough were regressed on daily, community-level exposure to wildfire-specific PM2.5 and PM2.5 from ambient sources (eg, traffic emissions). RESULTS: A 10-unit increase in PM2.5 (from nonsmoke sources) was estimated to increase the number of admissions by 3.7% (95% confidence interval: 1.2% to 6.1%). In contrast, the effect of PM2.5 attributable to wildfire was estimated to be a 30.0% (95% confidence interval: 26.6% to 33.4%) increase in visits. CONCLUSIONS: Wildfire-specific PM2.5 was found to be ∼10 times more harmful on children’s respiratory health than PM2.5 from other sources, particularly for children aged 0 to 5 years. Even relatively modest wildfires and associated PM2.5 resolved on our record produced major health impacts, particularly for younger children, in comparison with ambient PM2.5.

Traditional Chinese Medicine (TCM) has a unique set of therapeutic methods for plagues. COVID-19 is a severe type of pneumonia caused by a new coronavirus, which manifests in fever, cough, headache, fatigue, difficulty breathing, and other symptoms. TCM has fully displayed its advantages of various approaches in this epidemic, including herbal decoction, patent herbs, aroma packets, acupuncture, massage, etc. These methods have played an essential role in the prevention, treatment, and nursing of COVID-19, not only in alleviating the early clinical symptoms of patients but reducing the progression from mild to severe symptoms. Thanks to the advantages of treating the pandemic, we should pay more attention to TCM modalities.

Corona virus (CoV) was first discovered in 1960 among adults and children suffering from respiratory infection...

BACKGROUND: During the Coronavirus disease 2019 (COVID-19) pandemic, wearing facemasks became obligatory worldwide. OBJECTIVES: The objective of this study was to evaluate the effects of facemasks on gas exchange. METHODS: Healthy adults were assessed at rest and during slow and brisk 5-minute walks, with and without masks. We monitored O2 saturation, end-tidal carbon dioxide (EtCO2), and heart and respiratory rates. Participants graded their subjective difficulty and completed individual sensations questionnaires. RESULTS: Twenty-one participants with a median age of 38 years (range, 29-57 years) were recruited. At rest, all vital signs remained normal, without and with masks. However, during slow and brisk walks, EtCO2 increased; the rise was significantly higher while wearing masks: slow walk, mean EtCO2 (mmHg) change +4.5 ± 2.4 versus +2.9 ± 2.3, P = .004; brisk walk EtCO2 change +8.4 ± 3.0 versus +6.2 ± 4.0, P = .009, with and without masks, respectively. Wearing masks was also associated with higher proportions of participant hypercarbia (EtCO2 range, 46-49 mmHg) compared with walking without masks, though this was only partially significant. Mean O2-saturation remained stable (98%) while walking without masks but decreased by 1.2 % ± 2.2 while walking briskly with a mask (P = .01). Mild desaturation (O2 range, 93% to 96%) was noted during brisk walks among 43% of participants with masks, compared with only 14% without masks (P = .08). Borg's scale significantly increased while walking with a mask, for both slow and brisk walks (P < .001). Sensations of difficulty breathing and shortness of breath were more common while walking with masks. CONCLUSION: While important to prevent viral spread, wearing facemasks during brisk 5-minute walks might be associated with mild hypercarbia and desaturation. The clinical significance of these minor gas exchange abnormalities is unclear and should be further investigated.

ImportanceAccurate understanding of COVID pandemic during the first viral wave in Canada could help prepare for future epidemic waves.ObjectiveTo track the early course of the pandemic by examining self-reported COVID symptoms over time before testing became widely available.DesignAdults from the nationally representative Angus Reid Forum were randomly invited to complete an online survey in May/June 2020. The study is a part of the Action to Beat Coronavirus antibody testing study.SettingA 20-item internet survey.Participants14,408 adults age 18 years of age.ExposuresThe months that respondents and any household members first experienced various respiratory, neurological, sleep, skin or gastric symptoms.Main Outcomes and Measure“COVID symptom-positive,” defined as fever (or fever with hallucinations) plus at least one of difficulty breathing, a dry severe cough, loss of smell or “COVID toe.”ResultsIn total, 14,408 panel members (48% male and 52% female) completed the survey. Despite overrepresentation of higher levels of education, the prevalence of obesity, smoking, diabetes and hypertension were similar to national census and health surveys. A total of 811 (5.6%) were COVID symptom-positive; highest rates were at ages 18-44 years (8.3% among), declining at older ages. Females had higher odds of reporting COVID symptoms (OR = 1.32, 95%CI 1.11 – 1.56) as did visible minorities (OR = 1.74, 1.29 – 2.35). COVID symptom positivity for respondents and their household members peaked in March (OR = 1.93, 95% CI = 1.59 – 2.34 compared to earlier months).Conclusions and RelevanceThis study enhances our current understanding of the progression of the COVID epidemic in Canada, with few laboratory-confirmed cases in January and February, peaking in April. The results suggest substantial viral transmission in March, before widespread testing began, and a gradual decline in cases since May.

Each day since December 2019, increasing numbers of cases of the novel coronavirus 2019 (COVID-19) infection are being detected as it spreads throughout all continents of the world except Antarctica. The virus is transmitted through contact with an infected environment or person, and the symptoms include fever, cough, and difficulty breathing. The healthcare systems of many countries are overwhelmed due to limited therapeutic options and the absence of an approved vaccine. Due to its poor healthcare systems, Africa may be the worst hit continent if other therapeutic alternatives are not explored. This review explores the source and origin of the COVID-19 infection, and alternative therapeutic options derived from available and cheap medicinal foods and plants that have been shown to alleviate similar infections. The results demonstrate the inhibitory activities of selected food crops and plants against human viruses similar to the novel COVID-19.

Agonal factors, the conditions that occur just prior to death, can impact the molecular quality of postmortem brains, influencing gene expression results. Nevertheless, study designs using postmortem brain tissue rarely, if ever, account for these factors, and previous studies had not documented nor adjusted for agonal factors. Our study used gene expression data of 262 samples from ROSMAP with the following terminal states recorded for each donor: surgery, fever, infection, unconsciousness, difficulty breathing, and mechanical ventilation. Performed differential gene expression and weighted gene co-expression network analyses (WGCNA), fever and infection were the primary contributors to brain gene expression changes. Fever and infection also contributed to brain cell-type specific gene expression and cell proportion changes. Furthermore, the gene expression patterns implicated in fever and infection were unique to other agonal factors. We also found that previous studies of gene expression in postmortem brains were confounded by variables of hypoxia or oxygen level pathways. Therefore, correction for agonal factors through probabilistic estimation of expression residuals (PEER) or surrogate variable analysis (SVA) is recommended to control for unknown agonal factors. Our analyses revealed fever and infection contributing to gene expression changes in postmortem brains and emphasized the necessity of study designs that document and account for agonal factors.

In April 2020, the first-ever nationally representative survey in Canada polled 4,240 adults age 18 years and older about their COVID experience in March, early in the epidemic. We examined determinants of COVID symptoms, defined as fever plus difficulty breathing/shortness of breath, dry cough so severe that it disrupts sleep, and/or loss of sense of smell; and testing for SARS-CoV-2 by respondents and/or household members. About 8% of Canadians reported that they and/or one or more household members experienced COVID symptoms. Symptoms were more common in younger than older adults, and among visible minorities. Overall, only 3% of respondents and/or household members reported testing for SARS-CoV-2. Being tested was associated with having COVID symptoms, Indigenous identity, and living in Quebec. Periodic nationally representative surveys—including high-risk older populations—of symptoms, as well as SARS-CoV-2 antibodies, are required in many countries to understand the pandemic and prepare for the future.

We hereby report a case of a 55-year-old male with fever and difficulty breathing over several days who treated for presumed COVID-19 pneumonia despite testing negative thrice via reverse transcription polymerase chain reaction (RT-PCR) nasal swab. We explore several possible reasons for serially negative SARS-CoV-2 testing and other potential avenues of diagnosis.

Last Thursday, the first cat tested positive for the new coronavirus The feline had diarrhea, vomiting, and difficulty breathing, and it had come down with COVID-19 about 1 week after its owner did, Belgian health officials announced The same day, Hong Kong’s Agriculture, Fisheries and Conservation Department reported that a 17-year-old Pomeranian—which had initially tested “weak positive” for SARS-CoV-2—had indeed been infected by the virus, likely by its owner or another human

Acute Respiratory Infection is defined as an acute respiratory disease caused by an infectious agent that is transmitted from human to human. Symptoms include shortness of breath, difficulty breathing, sore throat, fever, wheezing, runny nose, and cough. This research implements CBR to help diagnose ARI. The diagnosis process is done by entering a new problem that contains the symptoms and risk factors that will be diagnosed in the system. The normalized nearest neighbor method with expert confidence is used to calculate the similarity between new problems and cases stored on a case basis. The results of testing the system using 112 case data with 78 case stored in a case base and 34 data used as new cases data, the system has identified four types of ARI disease with a system performance measurement 97.06%.

In the summer of 2002, my mother, Margie DuBois, began to have difficulty breathing. Her gait gradually slowed from brisk and purposeful to exaggerated and awkward. Over the course of a year, Margie began experiencing muscle weakness and extreme fatigue. Her skin, once a beautiful shade of olive, turned red and flakey, sloughing off to reveal gaping wounds that oozed clear fluid in their place. Something was incredibly wrong. Though fearful of what it might entail, it was hope that urged us to persist in our search for treatment for this mysterious disease. As “Vinz (2013) asserts, ‘Hope is a call to action,’” and it was our love for her and Margie’s willful determination to live that pushed us to persevere (Sieben, 2018). Though we encountered many setbacks—including doctors that did not believe her illness was real, experimental medications that threatened the financial stability of our family, and the complications that followed in the wake of her treatments—our hope for Margie’s survival never faltered. It is my hope that as an educator I can share this mindset with my students, to enable each of them tap into own inner strength to find meaning and purpose in life. Hope may very well determine a person’s ability to survive in this world.

A 56 year old female requires an emergency central venous catheter to commence dialysis for AKI. This is your second attempt at line. You insert it into the left internal jugular vein under direct ultrasound guidance using the technique you have been taught. After advancing the guidewire the patient begins to complain of chest pain and difficulty breathing. Your supervisor comments the patient has reduced air entry with hyper-resonance on the left.

Chest reconstruction in transmen, sometimes referred to as “top surgery,” or chest masculinization, is often an important part of the transition process. It is often the initial procedure performed and sometimes the only procedure performed. In a survey of transgender men, the majority reported either having had chest surgery (36%) or desiring it in the future (61%). Chest reconstruction can also be important for nonbinary individuals who are distressed by the presence of their breasts. While cross-sex hormone treatment goes a long way in allowing female-to-male (FTM) patients to “pass” in public as their preferred gender, distress over the presence of their breasts contributes to numerous social, physical, and psychological problems. Many bind their breasts daily with tight wraps and restrictive garments in order to conceal them, a process that is uncomfortable, is cumbersome, and can lead to rashes, acne, restriction in activity, and even difficulty breathing. Studies suggest that FTM chest reconstruction improves self-esteem and body image and as a result improves quality of life. The goals of FTM chest surgery are to provide smooth masculine chest contours, minimize and camouflage scars along anatomic lines, and create an aesthetic male nipple-areolar complex (NAC).

In-office dermatologic procedures have been performed in increasing numbers in the recent years due to improved technology with minimal complication rates and improved clinical expertise. While procedures oftentimes carry risk, the purpose of this chapter is to summarize potential clinical emergencies that may be encountered while performing some of these in-office procedures. Those emergencies are largely centered upon airway protection, difficulty breathing, and circulatory issues that have the potential to create a life-threatening situation. We hope that the information enclosed in this chapter is useful and will serve as a reference in the event such challenges are indeed encountered.

A 16-year-old boy was admitted with cough and difficulty breathing after aspiration of hydrocarbon 1 week before presentation. He accidentally ingested and aspirated about 15 mL of diesel on spitting out its jet over an open flame while performing a fire-breathing act as a stunning stunt in a village fair. Immediately following the aspiration, he had three to four episodes of vomiting. Within a few hours, he started developing dry cough and difficulty breathing, which progressively worsened. He was previously healthy and did not …

DOI: https://doi.org/10.3126/jnps.v38i2.19329 Tuberculosis in early infancy was not so common earlier also and has become rare these days. Since the disease is occasionally encountered, pediatricians should suspect tuberculosis in infants not responding to standard therapy. Here we report a case of three months old female who had presented with complaints of fever for two months, cough for one and half months and difficulty breathing for seven days and was being treated in line of bacterial pneumonia without improvement. She was found to be mycobacterium positive and was treated with anti-tubercular therapy leading to improvement and discharge. So, though rare, it is important to consider tuberculosis even in early infancy not responding to standard antibiotic therapy. Keywords: Tuberculosis, infant, diagnosis

Using respiratory protective equipment (RPE) including N95 respirators is one of the most important ways to protect health care workers (HCWs) against respiratory hazards. The aim of this study was to identify and prioritize the problems and obstacles in using N95 respirators among HCWs in Iran. In this cross-sectional study, problems and obstacles in using N95 respirators were identified and ranked by experts, using Fuzzy Delphi and Fuzzy Analytic Hierarchy Process (FAHP). Additionally, HCWs were asked to give their opinions about obstacles in using N95 respirators in order to form an opinion. Of 15 important obstacles in using N95 respirators identified by Fuzzy Delphi method, 6 factors were entered into the FAHP model: heat around the face, inaccessibility to respirator, difficulty breathing, pressure on the nose, trouble communicating with patients and colleagues, and no one does it. Identified problems and obstacles in using N95 respirators could be controlled during the selection of respirators, as well as by training and administrative measures.

To evaluate heart failure (HF) patients' disease knowledge and preferences for avoiding different disease outcomes.An online survey was administered to 400 individuals with a self-reported diagnosis of HF to elicit relative importance weights (RIWs) for avoiding 11 potential HF symptoms and outcomes using best-worst scaling. The survey also included questions about individuals' HF knowledge, and demographic and disease-experience characteristics. Differences in RIWs among sub-groups, defined by HF knowledge, caregiver support, age, recent hospitalization or emergency room visit for HF, health-related quality-of-life, and cardiac device experience were examined.Relative to limitations in usual activities (RIW 1.00), respondents preferred avoiding severe, infrequent cardiovascular events (e.g. stroke [RIW 8.51], heart transplant [RIW 7.84], or heart attack [RIW 5.3]) most, followed by difficulty breathing (RIW 2.55), inability to enjoy life (RIW 1.84), cardiac device implantation (RIW 1.74), and atrial fibrillation (RIW 1.57). Patients preferred avoiding swelling (RIW 0.47) and fatigue (RIW 0.58) least. RIWs for avoiding severe, infrequent events were higher among those with high disease knowledge, those without caregivers, and those without a recent hospitalization or emergency room visit.Patients' preferences for avoiding HF outcomes vary across outcomes and by individuals' knowledge, caregiver status, and age. Healthcare providers should solicit and incorporate insights about patients' knowledge of HF and their preferences for avoiding HF outcomes into HF education and management planning efforts.

We investigated the consequence of varying hypoxia severity during an initial set of repeated cycling sprints on performance, neuromuscular fatigability, and exercise-related sensations during a subsequent set of repeated sprints in normoxia.Nine active males performed ten 4-s sprints (recovery = 30 s) at sea level (SL; FiOMean power decrement during Sprint 10 was exacerbated in SH compared to SL and MH (- 34 ± 12%, - 22 ± 13%, - 25 ± 14%, respectively, p 0.05). Sprint performance during Sprint 11 recovered to that of Sprint 1 in all conditions (p = 0.267). All exercise-related sensations at Sprint 11 recovered significantly compared to Sprint 1, with no difference for Set 2 (p 0.05). Ratings of overall perceived discomfort, difficulty breathing, and limb discomfort were exacerbated during Set 1 in SH versus SL (p 0.05). Compared to SL, the averaged MPO value for Set 2 was 5.5 ± 3.0% (p = 0.003) lower in SH. Maximal voluntary force and twitch torque decreased similarly in all conditions immediately after Set 1 (p 0.05), without further alterations after Set 2. Peripheral and cortical voluntary activation values did not change (p 0.05).Exercise-related sensations, rather than neuromuscular function integrity, may play a pivotal role in influencing performance of repeated sprints and its recovery.