Tuesday, April 28, 2020

New study shows loss of smell may indicate mild to moderate Covid-19

People who experience loss of smell as one of the symptoms of coronavirus are likely to have a clinical course of the disease ranging from mild to moderate, according to a study which might help healthcare providers determine which patients need hospitalisation, PTI reported.

The findings of the study, published in the journal International Forum of Allergy and Rhinology, follow an earlier study which stated that loss of smell and taste were indicators of a coronavirus infection.

Scientists from the University of California (UC) San Diego Health in the United States, said patients who reported loss of smell and taste were 10 times less likely to be hospitalised for the disease when compared to those without the symptom.


Carol Yan, a rhinologist from the UC Sand Diego Health and first author of the study, said, “One of the immediate challenges for health care providers is to determine how to best treat persons infected by the novel coronavirus.”

Yan said that it appears that loss of smell may predict that a SARS-CoV-2 infection will not be as severe, and less likely to require hospitalisation.

Other studies have stated age and underlying medical conditions such as chronic lung disease, serious heart conditions, diabetes and obesity as the risk factors for COVID-19.

The current study includes a retrospective analysis done on data of 128 out of 169 COVID-19 patients between March 3 and April 8, 26 of whom required hospitalisation.

Researchers said that patients who were hospitalised for treatment were less likely to report loss of smell (anosmia) — 26.9 per cent compared to 66.7 per cent for COVID-19-infected persons treated as outpatients. Similar percentages were observed for loss of taste (dysgeusia)

“The site and dosage of the initial viral burden, along with the effectiveness of the host immune response, are all potentially important variables in determining the spread of the virus within a person and, ultimately the clinical course of the infection,” said Adam S DeConde, study co-author.

Scientists suggested that if the virus initially concentrates in the nose and upper airway, it might result in an infection which is less severe and sudden in onset, decreasing the risk of overwhelming the host immune response, respiratory failure and hospitalisation.

The study said that loss of smell may also indicate a robust immune response which has been localised to the nasal passages, limiting effects elsewhere in the body.

Scientists cited the limitations of the study and said that they relied upon self-reporting of anosmia from participants, posing a higher chance of recall bias among patients once they had been diagnosed with the disease, adding that patients with more severe respiratory disease may not be as likely to recall or recognise the loss of smell. Hence more expansive studies were needed to validate the results.


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Monday, December 02, 2019

Networks in brain play crucial role in suicide risk

Researchers have identified key networks within the brain which they say plays a crucial role in fostering a person to commit suicide.

The facts in relation to suicide are stark: 800,000 people die globally by suicide every year, the equivalent of one every 40 seconds. Suicide is the 2nd leading cause of death globally among 15-29 year olds. More adolescents die by suicide than from cancer, heart disease, AIDS, birth defects, stroke, pneumonia, influenza and chronic lung disease combined. As many as 1 in 3 adolescents think about ending their lives and 1 in 3 of these will attempt suicide.


Imagine having a disease that we knew killed almost a million people a year, a quarter of them before the age of 30, and yet we knew nothing about why some individuals are more vulnerable to this disease, said the 1st author of the study.


This is where we are with suicide. We know very little about what's happening in the brain, why there are sex differences, and what makes young people especially vulnerable to suicide the authir said.
The team of researchers in order to understand the study well carried out a review of 2 decades' worth of scientific literature relating to brain imaging studies of suicidal thoughts and behaviour. In total, they look at 131 studies, which covered more than 12,000 individuals, looking at alterations in brain structure and function that might increase an individual's suicide risk.


Combining the results from all of the brain imaging studies available, the team looked for evidence of structural, functional and molecular alterations, in the brain that could increase the risk of suicide. They identifies 2 brain networks and the connections between them that appear to play an important role.


The first of these networks involve areas towards the front of the brain known as the medial and lateral ventral prefrontal cortex and their connections to other brain regions involved in emotion. Alteration in this network may lead to excessive negative thoughts and difficulties regulating emotions, stimulating thoughts of suicide.


The 2nd network involves regions known as the dorsal prefrontal cortex and inferior gyrus system. Alterations in this network may influence suicide attempt, in part, due to its role in decision making, generating alternative solutions to problems and controlling behaviour.


The majority of studies so far have been cross-sectional, meaning that they take a ' snapshot' of the brain, rather than looking over a period of time, and so can only relate to suicidal thoughts or behaviours in the past. The researchers say there is an urgent need for more research that looks at whether their proposed model relates to future suicide attempts and whether any therapies are able to change the structure or function of these brain networks and thereby perhaps reduce suicide risk.


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Friday, November 10, 2017

Steroids ineffective for chest pains in non-asthmatic patients

According to a new research, Oral steroids should not be used for treating acute lower respiratory tract infection or chest pains in adults who don't have asthma or other chronic lung diseases, as they do not reduce the duration or severity of symptoms. 

In the study, 398 non-asthmatic adults with acute chest infections but no evidence of pneumonia and not requiring immediate antibiotic treatment were randomly split into two groups.

One group received 40mg of the oral steroid 'prednisolone' for five days (198 participants) and other received an identical placebo over the same time period (200 participants). 

The team found there was no reduction in the duration of cough, the main symptom of chest infections, or the severity of the accompanying symptoms between two and four days after treatment (when symptoms are usually at their most severe) in the prednisolone group compared with the placebo group.

The results suggest that steroids are not effective in the treatment of chest infections in non-asthmatic adult patients. 

“Chest infections are one of the most common problems in primary care and often treated inappropriately with antibiotics. 

Corticosteroids, like prednisolone, are increasingly being used to try to reduce the symptoms of chest infections, but without sufficient evidence,” said the study’s lead author.

Adding, “Our study does not support the continued use of steroids as they do not have a clinically useful effect on symptom duration or severity. We would not recommend their use for this group of patients.”
 

Study’s co-author added, “Oral and inhaled steroids are known to be highly effective in treating acute asthma as well as infective flares of other long-term lung conditions but need to be used carefully because of the risk of unwanted side effects.” He concluded by saying, “We chose to test the effect of steroids for chest infections as some of the symptoms of chest infections, such as shortness of breath, wheeze and cough with phlegm, overlap with acute asthma. However, we have conclusively demonstrated they are not effective in this group of patients.” 

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