Aim: To analyze the features of antibacterial treatment in children hospitalized for community-acquired pneumonia and the potential influence of dysbiosis.

Materials and Methods: The work analyzed medical records of 51 children, aged 2 to 13 years, who were hospitalized with community-acquired pneumonia. Clinical symptoms, severity of the course, structure and duration of basic treatment measures, their cost, and signs of dysbiosis were studied in the patients.

Results: The average duration of hospital treatment for patients with community-acquired pneumonia was 13.3 ± 0.62 days, with 28 cases lasting between 14 and 30 days. Given the community-acquired nature of the infection, the initial use of cephalosporins was irrational and significantly increased the cost of treatment. After one week, signs of intestinal swelling, increased peristalsis, and unstable defecation, assessed as gut dysbiosis, appeared. Some symptoms, such as irritation in the throat, persistent cough, difficulty clearing mucus, shortness of breath, wheezing, and others, were regarded as signs of respiratory dysbiosis. The use of probiotics was initiated.

Conclusions: The study established the irrational use of third- and fourth-generation cephalosporins as first-line antibacterial treatment. Symptoms of intestinal discomfort and manifestations of mucociliary respiratory tract dysfunction should be regarded as gut-lung axis phenomena of dysbiosis.

We conducted a systematic review to assess the impact of the COVID-19 pandemic on measles vaccination coverage. We searched for articles published between January 2021 and December 2023 in Portuguese, English, and Spanish in the Web of Science, ScienceDirect, PubMed, and LILACS databases. The final sample consisted of 32 studies, which demonstrated that most countries had a 1% to 10% decrease on measles vaccination coverage during the pandemic. However, the influence of the pandemic varied worldwide, ranging from 1% to 60% based on the region. The COVID-19 pandemic has had a relatively modest impact on measles immunization, with a complex intersection of several factors associated with the decrease in measles vaccination coverage.

The cough reflex is a primary defensive mechanism for airway protection. Cough disorders are characterized by a change in the threshold for initiating the cough reflex. Various afferent inputs influence the onset and sensitivity of the cough reflex. The study aimed to determine and compare the cough reflex sensitivity between adults with asthma and healthy adults with no history of allergic, respiratory, cardiovascular, gastrointestinal, or endocrine diseases, using European Respiratory Society guidelines on the assessment of cough. We created a group of 52 healthy volunteers (mean age 33.8 years) to serve as a control group for future research into the cough reflex in defined patient groups in upcoming clinical-physiological studies. We found that in the group of healthy volunteers, the threshold concentration of capsaicin required to elicit at least two coughs (C2) was 8.46 micromol/l, while the threshold concentration for inducing at least five coughs (C5) was 26.62 micromol/l. We then compared the reactivity of afferent nerve endings in the airways of healthy adults and adults with asthma by evaluating the differences in the concentrations of capsaicin that elicited C2 and C5 in these two groups. In a group of 19 asthmatic adults (mean age 33 years), the threshold concentration of capsaicin required to induce C2 was 2.03 micromol/l, while the threshold concentration for C5 was 3.02 micromol/l. We demonstrated a significant increase in cough reflex sensitivity in adults with asthma, expressed as the C2 capsaicin concentration (P<0.01) and the C5 concentration (P<0.001). Key words Cough " Cough reflex sensitivity " Capsaicin " Asthma.

To evaluate the effectiveness of interventions in addressing the impact of coronavirus disease-2019 on the mental health status of healthcare workers.

The systematic review was conducted from January to August 2023 in line with the Preferred Reporting Items for Systematic Reviews and Meta- Analyses guidelines, and comprised search on Medical Literature Analysis and Retrieval System Online, Excerpta Medica database, Allied and Complementary Medicine Database Cumulative Index to Nursing and Allied Health Literature and Cochrane Central Register of Controlled Trials databases for relevant randomised clinical trials published till January 25, 2022, focussing on assessing the effectiveness of interventions addressing the impact of coronavirus disease-2019 on healthcare workers. The risk of bias of the studies was assessed using the revised Cochrane risk of bias tool for randomised clinical trials RoB 2.0.

There were 17 randomised clinical trials with 4,511 participants. Overall findings showed that mindfulness-based interventions, yoga/music, music therapy/meditation, psychological interventions, creative arts therapy, and acupuncture could be effective in improving mental health outcomes for healthcare workers dealing with coronavirus disease-2019 patients. Pharmacological interventions and transcendental meditation may not be as effective.

Implementing non-pharmacological interventions to support the mental health of healthcare workers during times of crisis could be a positive approach.

Oxygen therapy is a critical component of postoperative care, particularly after general anesthesia. Although generally safe, its improper administration can lead to serious complications. This report details an incident of lung overinflation during postoperative oxygen therapy that resulted in pneumothorax and pneumoperitoneum.

A 63-year-old female patient with tracheostomy underwent pressure sore reconstruction under general anesthesia. Postoperatively, the patient was transferred to the recovery room, and oxygen therapy was initiated. During oxygen administration, the anesthesiology nurse omitted the connection of a heat-moisture exchanger and thereby inadvertently administered excessive dry positive pressure ventilation. Subsequently, the patient developed acute respiratory distress.

Clinical examination revealed decreased bilateral breathing sounds and abdominal distension. Computed tomography confirmed bilateral pneumothorax and pneumoperitoneum.

Conservative management was chosen.

The patient's condition stabilized, and she was discharged after 3 weeks with no long-term complications.

This case highlights the importance of careful monitoring and adherence to appropriate techniques during postoperative oxygen therapy. Overinflation of the lungs can lead to life-threatening conditions such as pneumothorax and pneumoperitoneum. This incident highlights the need for rigorous training and vigilance among healthcare professionals to prevent such occurrences. Although oxygen therapy is essential for patients recovering from general anesthesia, this case illustrates the potential risks associated with improper administration. Awareness and preventive measures are crucial for avoiding similar adverse events and ensuring patient safety and optimal outcomes.

The emergence of extracellular vesicles with nanostructure characteristics signifies a novel acellular therapeutic approach at the nanoscale, influencing cellular processes such as proliferation, differentiation, and apoptosis, as well as serving as vehicles for precise drug delivery. Substantial evidence supports their involvement in tissue regeneration, immune modulation, targeted tumor diagnosis and therapy effects. This review seeks to establish a theoretical framework for investigating the impact of extracellular vesicles derived from mesenchymal stem cells on respiratory system disorders in future research.

While poststroke rehabilitation primarily addresses motor, linguistic, cognitive, and swallowing impairments, pulmonary dysfunction (PD) is frequently neglected. PD following stroke, attributed to cortical-diaphragm pathway damage, can lead to increased mortality and prolonged hospitalization. Tracheostomy in such patients can exacerbate PD by increasing airway resistance and the risk of respiratory infections. This case study aims to report the successful integration of early pulmonary rehabilitation (PR) in a high-risk patient with poststroke tracheostomy complicated by unilateral tuberculous pleural effusion, underscoring its critical role in mitigating PD and improving outcomes.

A 72-year-old male with left-sided hemiplegia and dysphagia for over 3 months was admitted for rehabilitation following recurrent pulmonary infections post-cerebral infarction, which necessitated tracheostomy and indwelling tracheal cannula placement in the intensive care unit 3 months prior.

Cranial and thoracic computed tomography scans of the patient demonstrated infarctive lesions within the brainstem and the right semioval center, as well as evidence of infection in the lower lobe of the right lung. Additionally, atelectasis of the left lung and a significant amount of left-sided pleural effusion were observed. The patient's T-cell spot test confirmed a positive result for tuberculosis infection. Due to the presence of dysphagia and bile reflux, a nasojejunal tube was inserted to facilitate enteral feeding. Furthermore, a tracheostomy was performed with the placement of an indwelling tracheostomy tube to manage respiratory difficulties. The patient was subsequently diagnosed with poststroke tracheostomy complicated by left-sided pleural effusion.

For this elderly patient who underwent tracheostomy following a cerebral infarction and subsequently developed pleural effusion, our team performed an integrated rehabilitation evaluation and treatment protocol, prioritizing PR strategies.

The patient's thoracic drainage tube and tracheostomy tube were successfully removed, with subsequent improvements in pulmonary function and overall motor function, leading to a reduction in the level of dependence on daily living activities.

For patients with pulmonary dysfunction following a stroke, PR should be considered an integral component of the rehabilitation plan. This approach is crucial for enhancing respiratory function, improving overall physical capacity, and thereby accelerating the recovery process.

The intricate relationship between the immune system and obstructive sleep apnea syndrome (OSAS) is an area of active research, with conflicting findings regarding immune inflammation and OSAS. In this study, we employed a 2-sample Mendelian randomization approach using publicly available genetic datasets (ebi-a-GCST90018916 and finn-b-G6) to investigate the causal link between 731 immune cell characteristics and susceptibility to OSAS. We conducted comprehensive sensitivity analyses to ensure the reliability and consistency of our results and to mitigate the impact of confounding factors. Our analysis revealed a significant genetic association between OSAS and 3 specific immune cell traits: activated and secreting regulatory autophagic T cells, and absolute plasma blast/plasma cell count. These associations were statistically significant (P < .01) with odds ratios < 1, providing valuable insights into the complex interplay between immune cell dynamics and OSAS. These findings underscore the need for further clinical investigations to explore potential therapeutic targets and improve our understanding of the pathophysiology of OSAS.

This study aimed to estimate the prevalence of obesity in school children by severity and to assess the coronavirus disease 2019 (COVID-19) pandemic's impact on changes in the prevalence of obesity. In addition, the prevalence of obesity-related metabolic complications was calculated.

We used data from 390,580 school-aged children in the 2017-2021 Korea National School Health Examination to estimate the prevalence of obesity and assess secular trends in prevalence. We estimated the prevalence of metabolic complications in overweight and obese students with serological data and assessed their association with the degree of obesity, which was classified as overweight, obesity, and severe obesity per the criteria of the American Academy of Pediatrics.

In 2021, the prevalence of overweight, obesity, and severe obesity among school children was 12.5%, 17.6%, and 4.9%, respectively, for boys and 10.8%, 11.9%, and 2.9%, respectively, for girls, and these values have been increasing significantly since 2017. Compared with the pre-COVID-19 period, the increase in the prevalence of obesity and severe obesity was remarkable, especially in elementary school students. The linear relationship between the prevalence of metabolic complications and the degree of obesity was evident in high school students. In elementary school students, similar relationships were found with nonalcoholic fatty liver disease and high blood pressure.

The severity of obesity in school-age children (especially younger children) is worsening, and this may predict an increase in the prevalence of related metabolic complications. To prevent long-term complications, it is essential to expand health screening programs.

Background: On the basis of recent clinical trial data for the treatment of drug-susceptible and drug-resistant tuberculosis (TB), the American Thoracic Society, U.S. Centers for Disease Control and Prevention, European Respiratory Society, and Infectious Diseases Society of America have updated clinical practice guidelines for TB treatment in children and adults in settings in which mycobacterial cultures, molecular and phenotypic drug susceptibility tests, and radiographic studies, among other diagnostic tools, are available on a routine basis. Methods: A Joint Panel representing multiple interdisciplinary perspectives convened with American Thoracic Society methodologists to review evidence and make recommendations using the GRADE (Grading of Recommendations Assessment, Development and Evaluation) and GRADE-ADOLOPMENT (adoption, adaptation, and, as needed, de novo development of recommendations) methodology. Results: New drug-susceptible TB recommendations include the use of a novel 4-month regimen for people with pulmonary TB and a shortened 4-month regimen for children with nonsevere TB. Drug-resistant TB recommendation updates include the use of novel regimens containing bedaquiline, pretomanid, and linezolid with or without moxifloxacin. Conclusions: All-oral, shorter treatment regimens for TB are now recommended for use in eligible individuals.