scholarly journals COVID-19 symptoms reduce with targeted hydration of the nose, larynx and trachea

2022 ◽  
Author(s):  
Carolin Elizabeth George ◽  
Gerhard Scheuch ◽  
Ulf Seifart ◽  
Leeberk Inbaraj ◽  
Sindhulina Chandrasingh ◽  
...  
Keyword(s):  
Oxygen Saturation ◽  
Low Income ◽  
Human Subjects ◽  
Droplet Generation ◽  
Saline Control ◽  
Control Group ◽  
Upper Airways ◽  
Two Phase ◽  
Total Body Mass ◽  
Tract Infections

Abstract Dirty air and poor access to healthcare threatens the lives of billions of people in low-income regions of the world. We investigated whether upper-airway hydration might alter two-phase flow in the airways on normal tidal breathing and be a useful, safe, easily distributed non-drug intervention for limiting risks of COVID-19. In observational human volunteer studies involving 464 human subjects in Marburg, Germany (357 normal subjects), Boston, US (20 healthy subjects), and Bangalore, India (87 subjects recently tested positive for COVID-19), we find that respiratory droplet generation increases by up to 4 orders of magnitude with up to 1% total body mass dehydration (n=20), and in dehydration-associated states of advanced age (n=357), elevated BMI-age (n=148), and SARS-CoV-2 infection (n=87). Hydration of the nose, larynx and trachea in a protocol of exercise-induced dehydration by the nasal inhalation of calcium-rich hypertonic salt droplets of mean diameter 8-12 µm diminished respiratory droplet numbers and increased oxygenation relative to a non-treatment control (P<0.05). In a randomized double-blinded nasal-saline control study, thrice-a-day delivery of the calcium-rich hypertonic salts (active) over three days suppressed respiratory droplet generation by 51% +/- 11% and increased oxygen saturation by 48.08% ± 9.61% (P<0.001) in COVID-19 positive subjects (n=20), while no changes in exhaled aerosol (P=0.235) or oxygen saturation (P=0.533) were observed in the nasal-saline control group (n=20). In the active group 47% of patients discharged with no self-reported symptoms while all of the subjects in the nasal saline group discharged with lingering symptoms. Hydration of the upper airways appears promising as a non-drug approach for reducing risks of lower respiratory-tract infections such as COVID-19.

scholarly journals COVID-19 symptoms reduce with targeted hydration of the nose, larynx and trachea

2021 ◽  
Author(s):  
Carol George ◽  
Gerhard Scheuch ◽  
Ulf Seifart ◽  
Leeberk Inbaraj ◽  
Sindhulina Chandrasingh ◽  
...  
Keyword(s):  
Oxygen Saturation ◽  
Low Income ◽  
Human Subjects ◽  
Droplet Generation ◽  
Saline Control ◽  
Control Group ◽  
Upper Airways ◽  
Two Phase ◽  
Total Body Mass ◽  
Tract Infections

Abstract Dirty air and poor access to healthcare threatens the lives of billions of people in low-income regions of the world. We investigated whether upper-airway hydration might alter two-phase flow in the airways on normal tidal breathing and be a useful, safe, easily distributed non-drug intervention for limiting risks of COVID-19. In observational human volunteer studies involving 464 human subjects in Marburg, Germany (357 normal subjects), Boston, US (20 healthy subjects), and Bangalore, India (87 subjects recently tested positive for COVID-19), we find that respiratory droplet generation increases by up to 4 orders of magnitude with up to 1% total body mass dehydration (n=20), and in dehydration-associated states of advanced age (n=357), elevated BMI-age (n=148), and SARS-CoV-2 infection (n=87). Hydration of the nose, larynx and trachea in a protocol of exercise-induced dehydration by the nasal inhalation of calcium-rich hypertonic salt droplets of mean diameter 8-12 μm diminished respiratory droplet numbers and increased oxygenation relative to a non-treatment control (P<0.05). In a randomized double-blinded nasal-saline control study, thrice-a-day delivery of the calcium-rich hypertonic salts (active) over three days suppressed respiratory droplet generation by 51% +/- 11% and increased oxygen saturation by 48.08% ± 9.61% (P<0.001) in COVID-19 positive subjects (n=20), while no changes in exhaled aerosol (P=0.235) or oxygen saturation (P=0.533) were observed in the nasal-saline control group (n=20). In the active group 47% of patients discharged with no self-reported symptoms while all of the subjects in the nasal saline group discharged with lingering symptoms. Hydration of the upper airways appears promising as a non-drug approach for reducing risks of lower respiratory-tract infections such as COVID-19.

Succinylcholine Dosage and Apnea-induced Hemoglobin Desaturation in Patients

2005 ◽  
Vol 102 (1) ◽  
pp. 35-40 ◽  
Author(s):  
Mohamed Naguib ◽  
Abdulhamid H. Samarkandi ◽  
Khaled Abdullah ◽  
Waleed Riad ◽  
Saleh W. Alharby
Keyword(s):  
Oxygen Saturation ◽  
Upper Airway ◽  
Study Drug ◽  
Face Mask ◽  
Saline Control ◽  
Control Group ◽  
Double Blind Study ◽  
Double Blind ◽  
The Face ◽  
End Tidal

Background The authors examined the notion that a reduction in succinylcholine dose from 1 mg/kg to approximately 0.6 mg/kg would allow a faster recovery of spontaneous ventilation and reduction in the incidence of hemoglobin desaturation during the period of apnea in simulated complete upper airway obstruction situations. Methods This prospective, randomized, double-blind study involved 60 patients. After preoxygenation to an end-tidal oxygen concentration &gt;90%, patients were anesthetized with 2 microg/kg fentanyl and 2 mg/kg propofol. After loss of consciousness, patients were randomly allocated to receive 0.56 or 1.0 mg/kg succinylcholine or saline (control group). Oxygen saturation was monitored continuously at the index finger. When the patient became apneic, the face mask was removed and the patient's airway was left unsupported. If the oxygen saturation decreased to 90%, the face mask was reapplied, and ventilation was assisted until the patient was awake. Time from injection of the study drug to the first visible spontaneous diaphragmatic movements was noted. Results Oxygen saturation decreased &lt;90% in 45%, 65%, and 85% of patients in the control, 0.56 mg/kg, and 1.0 mg/kg succinylcholine groups, respectively (P = 0.03). Corresponding times (mean +/- SD) to spontaneous of diaphragmatic movements were 2.7 +/- 1.2, 4.8 +/- 2.5, and 4.7 +/- 1.3 min, respectively. These times were longer (P &lt; 0.001) after either dose of succinylcholine compared with controls. Conclusions Reduction in succinylcholine dose from 1.0 mg/kg to 0.56 mg/kg decreased the incidence of hemoglobin saturation &lt;90% from 85% to 65% but did not shorten the time to spontaneous diaphragmatic movements. A significant fraction of patients would be at risk if there were failure to intubate and ventilate whether succinylcholine is administered or not and regardless of the dose of succinylcholine administered.

scholarly journals Inhaled Water and Salt Suppress Respiratory Droplet Generation and COVID-19 Incidence and Death on US Coastlines

2021 ◽  
pp. 1-13
Author(s):  
Rachel D. Field ◽  
Nathan Moelis ◽  
Jonathan Salzman ◽  
Adriaan Bax ◽  
Dennis Ausiello ◽  
...  
Keyword(s):  
Water Balance ◽  
Human Subjects ◽  
The United States ◽  
Droplet Generation ◽  
Chloride Salt ◽  
Upper Airways ◽  
Healthy Human ◽  
Dry Air ◽  
Calcium And Magnesium ◽  
Salt And Water Balance

Dry air alters salt and water balance in the upper airways and increases the risks of COVID-19 among other respiratory diseases. We explored whether such upper airway variations in salt and water balance might alter respiratory droplet generation and potentially contribute to observed impacts of airway hydration on respiratory disease. In a randomized 4-arm study of 21 healthy human subjects we found that the breathing of humid air, the wearing of cotton masks, and the delivery of (sodium, calcium, and magnesium chloride) salt droplets sized to deposit in the nose, trachea, and main bronchi similarly reduce the exhalation of respiratory droplets by approximately 50% ([Formula: see text] ¡ 0.05) within 10 minutes following hydration. Respiratory droplet generation returns to relatively high baseline levels within 60–90 minutes on return to dry air in all cases other than on exposure to divalent (calcium and magnesium) salts, where suppression continues for 4–5 hours. We also found via a preliminary ecological regression analysis of COVID-19 cases in the United States between January 2020 and March 2021 that exposure to elevated airborne salt on (Gulf and Pacific) US coastlines appears to suppress by approximately 25%–30% ([Formula: see text] ¡ 0.05) COVID-19 incidence and deaths per capita relative to inland counties — accounting for ten potential confounding environmental, physiological, and behavioral variables including humidity. We conclude that the hydration of the upper airways by exposure to humidity, the wearing of masks, or the breathing of airborne salts that deposit in the upper airways diminish respiratory droplet generation and may reduce the risks of COVID-19 incidence and symptoms.

Dynamics of symptoms of genitourinary menopausal syndrome and the frequency of recurrence of lower urinary tract infection in women in periand postmenopausal patients with combined therapy with Trioginal®

GYNECOLOGY ◽  
2018 ◽  
Vol 20 (6) ◽  
pp. 67-72
Author(s):  
D Yu Pushkar ◽  
M Yu Gvozdev
Keyword(s):  
Urinary Tract ◽  
Lower Urinary Tract ◽  
Urine Culture ◽  
Objective Assessment ◽  
Control Group ◽  
Urination Disorders ◽  
Menopausal Syndrome ◽  
Tract Infections ◽  
Two Stages ◽  
Lower Urinary

Material and methods. The study included patients (n=164) in peri- and postmenopause, having a laboratory-confirmed picture of the genitourinary menopausal syndrome - atrophic vulvovaginitis and suffering from recurrent lower urinary tract infections (UTI) - cystitis and urethritis. All patients underwent standard antibacterial therapy (ABT) UTI in accordance with the results of bacteriological urine culture according to Russian clinical guidelines on urology. Against the background of ABT, 164 patients received additional therapy with Trioginal® (the study group - SG) containing estriol, micronized progesterone and Lactobacillus casei rhamnosus Doderleini 35 (LCR 35) lactobacillus strain. Trioginal® was administered intravaginally in two stages: for 20 days, 2 capsules per day, then for 10 days, 1 capsule per day. In the comparison group - CG (n=67) with ABT, Ovipol Klio® (estriol monopreparation) was additionally intravaginally used in two stages: for 14 days, 1 suppository per day, then for 2 weeks, 1 suppository 2 times a week. The control group consisted of 30 patients receiving only standard ABT UTI, local hormone therapy for vulvovaginal atrophy (VVA) was not performed. The observation period was 12 months after the end of the course of therapy. At all stages of treatment, a subjective and objective assessment of the severity of urination disorders and urogenital atrophy (UDI-6 questionnaire), their impact on the quality of life of patients (questionnaire IIQ-7), indicators of bacteriuria, bacterial urine culture and vaginal biocenosis, frequency of undesirable phenomena were carried out. According to the initial characteristics of the group of patients were comparable. Results. At all stages of the study, in the group of patients who received therapy with the use of the Trioginal® drug, there was a significant improvement in the clinical picture of urination disorders compared to the CG and the control (main) group - MG (in SG - 18% at the end of therapy versus 100% before the start of therapy; CG - 26 % versus 100% respectively; Ledger - 58% versus 100% respectively; p

RESULTS OF LOWER GENITAL TRACT INFECTION INTERVENTION AMONG KHMER WOMEN OF CHILDBEARING AGE IN CAN THO IN 2016

2018 ◽  
pp. 83-89
Author(s):  
Trung Thuan Phan ◽  
Dinh Binh Tran ◽  
Thanh Hue Dinh ◽  
Phong Son Dinh ◽  
Kieu Oanh Truong ◽  
...  
Keyword(s):  
Genital Tract ◽  
Common Knowledge ◽  
Intervention Group ◽  
Effective Intervention ◽  
Control Group ◽  
Childbearing Age ◽  
Lower Genital Tract ◽  
Genital Tract Infections ◽  
Tract Infections ◽  
Can Tho City

Objectives: To find a model that is effective intervention to reduce the incidence of lower genital tract infections in Khmer women. Subjects and Methods: The intervention study is carried which compared the test group with the control group of 400 Khmer women, aged 15 to 49 in Can Tho city. Results: The common knowledge of the prevention of lower genital tract infections in the intervention group increased from 30.9% in the control group to 54.5% in the intervention group. The general attitude toward the use of lower genital tract infections increased from 22.3% in the control group to 78.0% in the intervention group. This is a very significant improvement. The prevalence of subclinical infection of the intervention group (26.0%) was significantly lower than that of the control group (39.3%), the difference was statistically significant. Conclusion: Intervention effectiveness is good in both knowledge, attitudes and practices, especially the effectiveness of interventions in practice in Khmer women. Key words: Effective intervention, lower genital tract infections, Khmer women, Can Tho city

Humoral factors of innate immunity in the saliva of patients with infectious inflammatory respiratory diseases

2018 ◽  
pp. 13-17
Author(s):  
Oleg Melnikov ◽  
Diana Zabolotnaya ◽  
Alexander Bredun ◽  
Bogdan Bil ◽  
Oksana Rylska ◽  
...  
Keyword(s):  
Innate Immunity ◽  
Chronic Rhinosinusitis ◽  
Inflammatory Diseases ◽  
Activity Level ◽  
Chronic Tonsillitis ◽  
Control Group ◽  
Quantitative Composition ◽  
Upper Airways ◽  
Humoral Factors ◽  
Immune Modulators

Introduction: In recently ears factors of innate immunity both cellular and humoral have been paid considerable attention as they are a protective barrier of a fast response and that is why they are largely concentrated at the intersection of the digestive tract and airways. The data concerning the activity level of factors of innate immunity in the upper airways affected by nonspecific inflammatory processes is insufficient and sparse and therefore the purpose of this research was to study the content of humoral factors of innate immunity in the oropharyngeal secretion (ORS) of patients with chronic infectious inflammatory diseases of the upper airways in remission. Materials and Methods: There was an examination of 16 patients with chronic rhinosinusitis (CRS) of bacterial genesis (15-40 years old), 12 patients with rhinopharyngitis of post-viral genesis (8-16 years old), 12 people with scleroma from 30 tо 52 years of age (atrophic form), 10 patients with chronic tonsillitis in remission (from 10 to 33 years of age) and 11 patients of a control group (practically healthy donors from 12 tо 40 years of age). The content of MIP-1b, defensin-1β, lactoferrin, lysozyme, α-interferon was studied in the nonstimulated OPS. Statistics were carried out using Mann-Whitney U-test. Results: The greatest number of deviations in the decrease in the content of the examined nonspecific protective factors was found in cases of scleroma, chronic tonsillitis and chronic rhinosinusitis (p<0,05). The lack of protective humoral factors of innate immunity can be evidence of local immunodeficiency even in remission, which is a pathophysiological component of the maintenance of chronic inflammation. Conclusion: The decrease int he quantitative composition of factors of innate immunity in the oropharyngeal secretion of patients with chronic infectious inflammatory diseases of the airways is an objective ground not only for a replacement therapy, but also for the use of immune response modifiers from photo-immune modulators to “genuine immune modulators” controlling the state of the factors of both innate immunity and immunoglobulins, primarily of secretory type, the level and functionality of various groups of immunocompetent and accessory cells.

scholarly journals A Decade in Trying to Increase Hand Hygiene—Finally Success

2020 ◽  
Vol 41 (S1) ◽  
pp. s93-s94
Author(s):  
Linda Huddleston ◽  
Sheila Bennett ◽  
Christopher Hermann
Keyword(s):  
Hand Hygiene ◽  
Hand Hygiene Compliance ◽  
Compliance Rate ◽  
Bloodstream Infections ◽  
Central Line ◽  
Second Phase ◽  
Two Phase ◽  
Hygiene Compliance ◽  
Tract Infections ◽  
The Voice

Background: Over the past 10 years, a rural health system has tried 10 different interventions to reduce hospital-associated infections (HAIs), and only 1 intervention has led to a reduction in HAIs. Reducing HAIs is a goal of nearly all hospitals, and improper hand hygiene is widely accepted as the main cause of HAIs. Even so, improving hand hygiene compliance is a challenge. Methods: Our facility implemented a two-phase longitudinal study to utilize an electronic hand hygiene reminder system to reduce HAIs. In the first phase, we implemented an intervention in 2 high-risk clinical units. The second phase of the study consisted of expanding the system to 3 additional clinical areas that had a lower incidence of HAIs. The hand hygiene baseline was established at 45% for these units prior to the voice reminder being turned on. Results: The system gathered baseline data prior to being turned on, and our average hand hygiene compliance rate was 49%. Once the voice reminder was turned on, hand hygiene improved nearly 35% within 6 months. During the first phase, there was a statistically significant 62% reduction in the average number of HAIs (catheter associated urinary tract infections (CAUTI), central-line–acquired bloodstream infections (CLABSIs), methicillin-resistant Staphylococcus aureus (MRSA), multidrug-resistant organisms (MDROs), and Clostridiodes difficile experienced in the preliminary units, comparing 12 months prior to 12 months after turning on the voice reminder. In the second phase, hand hygiene compliance increased to >65% in the following 6 months. During the second phase, all HAIs fell by a statistically significant 60%. This was determined by comparing the HAI rates 6 months prior to the voice reminder being turned on to 6 months after the voice reminder was turned on. Conclusions: The HAI data from both phases were aggregated, and there was a statistically significant reduction in MDROs by 90%, CAUTIs by 60%, and C. difficile by 64%. This resulted in annual savings >$1 million in direct costs of nonreimbursed HAIs.Funding: NoneDisclosures: None

scholarly journals Health-Related Quality of Life and Related Factors in Persons with Preserved Ratio Impaired Spirometry: Data from the Korea National Health and Nutrition Examination Surve

Medicina ◽  
2020 ◽  
Vol 57 (1) ◽  
pp. 4
Author(s):  
I Re Heo ◽  
Ho Cheol Kim ◽  
Tae Hoon Kim
Keyword(s):  
Quality Of Life ◽  
Low Income ◽  
Control Group ◽  
Poor Hrqol ◽  
Related Factors ◽  
Health And Nutrition ◽  
Prism Group ◽  
Related Quality ◽  
Health Related

Background and Objectives: preserved ratio impaired spirometry (PRISm) is a common spirometric pattern that causes respiratory symptoms, systemic inflammation, and mortality. However, its impact on health-related quality of life (HRQOL) and its associated factors remain unclear. We aimed to identify these HRQOL-related factors and investigate the differences in HROOL between persons with PRISm and those with normal lung function. Materials and Methods: we reviewed the Korea National Health and Nutrition Examination Survey data from 2008 to 2013 to evaluate the HRQOL of persons with PRISm, as measured while using the Euro Quality of Life-5D (EQ-5D) and identify any influencing factors. PRISm was defined as pre-bronchodilator forced expiratory volume in 1 s (FEV1) <80% predicted and FEV1 to forced vital capacity (FVC) ratio (FEV1/FVC) ≥0.7. Individuals with FEV1 ≥80% predicted and FEV1/FVC ≥0.7 were considered as Controls. Results: of the 27,824 participants over the age of 40 years, 1875 had PRISm. The age- and sex-adjusted EQ-5D index was lower in the PRISm group than in the control group (PRISm, 0.930; control, 0.941; p = 0.005). The participants with PRISm showed a significantly higher prevalence of hypertension (p < 0.001), diabetes (p < 0.001), obesity (p < 0.001), low physical activity (p = 0.001), ever-smoker (p < 0.001), and low income (p = 0.034) than those in the control group. In participants with PRISm, lower EQ-5D index scores were independently associated with old age (p = 0.002), low income (p < 0.001), low education level (p < 0.001), and no economic activity (p < 0.001). Three out of five EQ-5D dimensions (mobility, self-care, and usual activity) indicated a higher proportion of dissatisfied participants in the PRISm group than the control group. Conclusions: the participants with PRISm were identified to have poor HRQOL when compared to those without PRISm. Old age and low socioeconomic status play important roles in HRQOL deterioration in patients with PRISm. By analyzing risk factors that are associated with poor HRQOL, early detection and intervention of PRISm can be done in order to preserve patients’ quality of life.

scholarly journals Participatory continuous nursing using the WeChat platform for patients with spinal cord injuries

2021 ◽  
Vol 49 (5) ◽  
pp. 030006052110161
Author(s):  
Jing Li ◽  
Qiao-Ping Li ◽  
Bi-Hong Yang
Keyword(s):  
Spinal Cord ◽  
Urinary Tract ◽  
Urinary Tract Infections ◽  
Muscle Atrophy ◽  
Spinal Cord Injuries ◽  
Control Group ◽  
Observation Group ◽  
Family Function ◽  
Tract Infections ◽  
Compliance Behaviour

Objective The study aim was to analyse the effect of participatory continuous nursing using the WeChat platform on the complications, family function and compliance of patients with spinal cord injuries. Methods This was a randomized controlled trial. Seventy-eight patients with stable disease treated by internal fixation were enrolled in the study from August 2017 to August 2019 and assigned equally to an observation group and a control group. The control group received regular care from the time of discharge. The observation group used the WeChat platform to participate in continuous care. Results Six months after discharge, the continuous nursing group had a significantly lower incidence of pressure ulcers, urinary tract infections, joint contractures and muscle atrophy than the control group. The continuous nursing group showed a significant improvement in family function level and compliance behaviour at 3 and 6 months after discharge. Conclusion A participation-based continuous nursing intervention using the WeChat platform can reduce the incidence of pressure ulcers, urinary tract infections, joint contracture and muscle atrophy; improve patient family function; and promote healthy compliance behaviour.

scholarly journals Impact of Different Levels of Supervision on the Recovery of Severely Malnourished Children Treated by Community Health Workers in Mali

Nutrients ◽  
2021 ◽  
Vol 13 (2) ◽  
pp. 367
Author(s):  
Pilar Charle-Cuéllar ◽  
Noemí López-Ejeda ◽  
Mamadou Traore ◽  
Adama Balla Coulibaly ◽  
Aly Landouré ◽  
...  
Keyword(s):  
Community Health ◽  
Community Health Workers ◽  
Low Income ◽  
Community Intervention ◽  
Health Workers ◽  
Acute Malnutrition ◽  
Control Group ◽  
Supportive Supervision ◽  
Supervision Group ◽  
Different Levels

(1) Background: The Ministry of Health in Mali included the treatment of severe acute malnutrition (SAM) into the package of activities of the integrated community case management (iCCM). This paper evaluates the most effective model of supervision for treating SAM using community health workers (CHWs). Methods (2): This study was a prospective non-randomized community intervention trial with two intervention groups and one control group with different levels of supervision. It was conducted in three districts in rural areas of the Kayes Region. In the high supervision group, CHWs received supportive supervision for the iCCM package and nutrition-specific supervision. In the light supervision group, CHWs received supportive supervision based on the iCCM package. The control group had no specific supervision. (3) Results: A total of 6112 children aged 6–59 months with SAM without medical complications were included in the study. The proportion of cured children was 81.4% in those treated by CHWs in the high supervision group, 86.2% in the light supervision group, and 66.9% in the control group. Children treated by the CHWs who received some supervision had better outcomes than those treated by unsupervised CHWs (p < 0.001). There was no difference between areas with light and high supervision, although those with high supervision performed better in most of the tasks analyzed. (4) Conclusions: Public policies in low-income countries should be adapted, and their model of supervision of CHWs for SAM treatment in the community should be evaluated.

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