Effect of treatment of depression and anxiety on physiological state of severe COPD patients

AbstractBackgroundAnxiety and depression are mental health problems that result in reduced health-related quality of life (HRQL), and increased mortality. Patients with COPD have a higher risk of anxiety and depression compared to healthy individuals. Recent studies reported a significant relationship between the presence of anxiety and depression and the functional status of COPD patients.ObjectivesTo study the effect of treatment of anxiety and depression on the physiological status in COPD patients.Materials and methodsThe study included 50 severe COPD patients with depression and/or anxiety as evaluated and scored by Montgomery and Asberg Depression Rating Scale (MADRS) and Hamilton Anxiety Rating (HAM-A) Scale. They were classified into 2 groups: group I included 25 patients who received antidepressant/anxiolytic therapy in addition to COPD treatment and group II included 25 patients who received COPD treatment only. Modified Borg scale dyspnea score, spirometry (vital capacity, forced vital capacity, forced expiratory volume in first second and forced expiratory flow through 25–75% of expiration), arterial blood, MADRS and HAM-A scale were assessed in all patients at the start of the study and after 3months.ResultsPatients with severe COPD who were treated for depression and/or anxiety showed a significant improvement in MADRS, HAM-A and dyspnea scales, spirometeric parameters and oxygenation. MADRS and HAM-A scale showed a significant negative correlation to FEV1.ConclusionTreatment of depression and anxiety in COPD patients is recommended as it is associated with a significant improvement in pulmonary physiological status and HRQL. Further studies on larger scales are recommended

6S rRNA of a Bacillus isolate 16S rRNA characterization of a Bacillus isolate and its tolerance profile after subsequent subculturing

ABSTRAC

Thyrotoxic burden in the ICU and the value of bedside thyroid ultrasound in the diagnosis of thyrotoxicosis and thyrotoxic cardiac emergencies in critically-ill patients

Background: Thyrotoxicois is not uncommonly suspected in many ICU patients. There are many clinical and laboratory fallacies that may hinder the rapid diagnosis of thyrotoxicosis in ICU patients especially those presenting with cardiac emergencies. Aim: First, to estimate the thyrotoxic burden in the ICU. Second, to assess the usefulness of thyroid ultrasound in early evaluation of suspected thyroid disease in critically ill patients especially those with life threatening cardiac emergencies. Patients and methods: 854 patients admitted in 2 general intensive care units from Jan to November 2011 were evaluated. All patients suspected to have thyrotoxicosis were assessed by thyroid ultrasound and by measurement of serum levels of Ft3,Ft4,TSH, echocardiography and continuous ECG monitoring. Radioisotope scanning was done in selected cases. Results: Out of 854 admitted patients, 113 (13.2%) were suspected to have thyrotoxicosis. Thyrotoxicosis was proved in 28 patients (24.7% of suspected cases and 3.3% of all admitted cases): 15% of all suspected cases had Graves’ disease and 9.7% had toxic nodules. Most diagnosed patients (No: 16, 59.3%) had masked thyrotoxicosis. Seventy-six patients (67.3% of suspected patients) were admitted as critically ill cardiac patients and presented mainly by cardiac arrhythmias, heart failure, acute chest pain and malignant hypertension and 21 of these patients (27.6%) were proved to be thyrotoxic. Conclusion: Thyrotoxicosis and thyrotoxic cardiac emergencies are not uncommon in the ICU and should be thoroughly investigated as most cases are clinically masked. Thyroid ultrasound is a feasible, rapid and accurate bedside diagnostic tool for suspected thyrotoxic emergencies in ICU

Interspecies transmission of SARS CoV-2 with special emphasis on viral mutations and ACE-2 receptor homology roles

ABSTRACTCOVID-19 outbreak was first reported in 2019, Wuhan, China. The spillover of the disease caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), to a wide range of pet, zoo, wild, and farm animals has emphasized potential zoonotic and reverse zoonotic viral transmission. Furthermore, it has evoked inquiries about susceptibility of different animal species to SARS-CoV-2 infection and role of these animals as viral reservoirs. Therefore, studying susceptible and non-susceptible hosts for SARS-CoV-2 infection could give a better understanding for the virus and will help in preventing further outbreaks. Here, we review structural aspects of SARS-CoV-2 spike protein, the effect of the different mutations observed in the spike protein, and the impact of ACE2 receptor variations in different animal hosts on inter-species transmission. Moreover, the SARS-CoV-2 spillover chain was reviewed. Combination of SARS-CoV-2 high mutation rate and homology of cellular ACE2 receptors enable the virus to transcend species barriers and facilitate its transmission between humans and animals