Pulmonary rehabilitation improves functional outcomes and quality of life in post-SARS-CoV-2 mild-to-moderate infection patients: a pilot study

: SARS-CoV-2 infection impairs functional outcomes and quality of life, even in its mild-to-moderate form. It is therefore appropriate to draw attention to the role played by respiratory rehabilitation and physiotherapists in the pulmonary rehabilitation process that post-SARS-CoV-2 patients must undergo. We enrolled 80 patients in a prospective case-control study; 40 cases (mild-to-moderate post-SARS-CoV-2 infection patients) and 38 control subjects (i.e. patients affected by other respiratory diseases) completed a full pulmonary rehabilitation cycle. 6 Minute Walking Distance, Borg CR10 Scale, modified Medical Research Council (mMRC) Dyspnoea scale, EuroQoL EQ-5D-3L questionnaire, Barthel scale, arterial blood gas test and peripheral oxygen saturation (SpO2) were compared for all patients before and after rehabilitation. All patients experienced significant improvements in all parameters analyzed, except for arterial blood gas test. Results were similar for both groups, in particular both groups experienced improvements in mMRC scale, EuroQoL questionnaire, Barthel scale and 6-minute walking distance. Pulmonary rehabilitation appears to improve exercise tolerance, dyspnea and quality of life in patients recovering from mild-to-moderate SARS-CoV-2 infection. Further studies are needed on larger sample size population to validate these results

Herpes zoster ophthalmicus and varicella zoster virus vasculopathy

Herpes zoster (HZ) corresponds to the reactivation of varicella zoster virus (VZV). Among adults, the ophthalmic division of the trigeminal nerve is one of the most common sites of involvement. Vasculopathy caused by HZ is associated with significant morbidity and mortality, affecting structures such as the brain, which can lead to stroke. In this review, we analyzed the epidemiological and clinical aspects of the vascular involvement of VZV, focusing on the peculiarities of its association with ocular HZ. A review of the available literature indicated that ocular involvement of HZ was a risk factor for vasculopathy after adjusting for age, sex, body mass index, smoking, indicators of metabolic syndrome, and vascular and heart diseases. Considering the severity of this complication, vascular disease mediated by VZV requires early diagnosis and aggressive treatment. Finally, the anti-HZ vaccine has been recommended as a prophylactic measure in the elderly, but it should be used with caution in immunocompromised individuals.Univ Fed Sao Paulo UNIFESP, EPM, Dept Ophthalmol & Visual Sci, Sao Paulo, SP, BrazilSoc Brasileira Imunizacao, Sao Paulo, SP, BrazilInst Visao, Sao Paulo, SP, BrazilUniv Fed Sao Paulo UNIFESP, EPM, Dept Ophthalmol & Visual Sci, Sao Paulo, SP, BrazilWeb of Scienc

Amiodarone induced lung toxicity: a radiological overview that simulating COVID19 infection disease

Amiodarone-induced pulmonary toxicity (AIPT) is among the most serious adverse effects and is one of the leading causes of death associated with its use. It is a clinical pathology that is conditioned by dose, patient’s age, and pre-existent pulmonary pathologies. Those effects reach a plateau at a cumulative dose bigger than 150g. Patient’s comorbidities; oxygen therapy, invasive procedures or surgical interventions can trigger the pulmonary symptoms induced by amiodarone toxicity. The increased risk of developing amiodarone-induced pulmonary fibrosis is directly related to the dose and the duration of the intake. Despite significant advances in the understanding of AIPT, its aetiology and pathogenesis remain incompletely understood. The role of steroids in the management of pulmonary toxicity from amiodarone is debatable, however, most reports of improvement after amiodarone withdrawal di"er little from those in which concomitant steroid therapy was employed. Therefore, the addition of therapeutic doses of corticosteroids in amiodarone induced pneumopathy may be indicated. Typically, prednisone is started in doses of 40 to 60 mg/day orally and slowly reduced. Again, the pharmacodynamics of amiodarone dictate a treatment period of four to 12 months. The case report describes a patient with AIPT who after therapy with Prednisone at a dosage of 50mg/day by gradually scaling down the doses as reported in the above clinical studies, had a clinical, functional and CT radiological picture that was markedly improved with disappearance of most of the scattered ground glass areas and the previously reported thickening with associated bi-apical fibrotic outcomes

The use of wireless technology for thoracic physical examination: a pilot case based on a literature review

Auscultation is a standard method of physical examination used by physicians and is widely accepted by doctors and patients for its simplicity, repeatability and non-invasiveness. Artificial intelligence is the 'new integrated frontier' of the thoracic examination, yet there are still concordance discrepancies in obstructive pulmonary diseases; on the contrary, for fibrotic diseases, the degree of concordance increases significantly, as shown by previous clinical studies conducted mainly in children. However, there are data in the literature that appear to be very discordant on certain types of lung noises, such as wet crackles and dry noises; therefore, the application of these devices in daily use in outpatient and hospital settings needs to be further expanded. The integrated data allowed us to make the right diagnosis, also avoiding costs for the national health system and possible invasive procedures such as bronchoscopy, which today remains the “gold standard” for the histological diagnosis of sarcoidosis with lung localisation. Integrated technology could improve the diagnostic capacity in restrictive lung diseases, as shown in this clinical case. Several randomised controlled trials are still needed to increase the significance of this initial integrated research work performe

Research data communication strategy at the time of pandemics: a retrospective analysis of the Italian experience.

Coronavirus pandemic has radically changed the scientific world. During these difficult times, standard peer-review processes could be too long for the continuously evolving knowledge about this disease. We wanted to assess whether the use of other types of network could be a faster way to disseminate the knowledge about Coronavirus disease. We retrospectively analyzed the data flow among three distinct groups of networks during the first three months of the pandemic: PubMed, preprint repositories (biorXiv and arXiv) and social media in Italy (Facebook and Twitter). The results show a significant difference in the number of original research articles published by PubMed and preprint repositories. On social media, we observed an incredible number of physicians participating to the discussion, both on three distinct Italian-speaking Facebook groups and on Twitter. The standard scientific process of publishing articles (i.e., the peer-review process) remains the best way to get access to high-quality research. Nonetheless, this process may be too long during an emergency like a pandemic. The thoughtful use of other types of network, such as preprint repositories and social media, could be taken into consideration in order to improve the clinical management of COVID-19 patients