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Topic review
Updated time: 09 Aug 2021
Submitted by: Shu Yuan
Definition: The coronavirus disease 2019 (COVID-19) has spread over the world for more than one year. COVID-19 often develops life-threatening hypoxemia. Endothelial injury caused by the viral infection leads to intravascular coagulation and ventilation-perfusion mismatch, alveolar edema also plays a key role in the disease progression. Diffuse alveolar damage (DAD) is the histopathological pattern commonly described in COVID-19. Endothelial barrier disruption induces interstitial flooding via activation of the actin-myosin contractile apparatus. Then alveolar edema leads to hypoxia at the injured alveolar units. Hypoxia in turn inhibits edema fluid clearance, due in part to the disassembly of the keratin intermediate filament network, a fundamental element of the cellular cytoskeleton, therefore destructing the epithelial barrier. Therefore, a long-term hypoxia aggravates the disease by inducing more alveolar edema, which forms a vicious circle.
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Topic review
Updated time: 24 Mar 2021
Submitted by: Tiina Mattila
Definition: Asthma is one of the most common chronic diseases worldwide affecting all age groups from children to the elderly. In addition to other factors such as smoking, air pollution and atopy, some environmental chemicals are shown or suspected to increase the risk of asthma, exacerbate asthma symptoms and cause other respiratory symptoms.
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Topic review
Updated time: 28 Jul 2021
Submitted by: Yulia Denisenko
Definition: Asthma is a widespread chronic disease of the bronchopulmonary system with a heterogeneous course due to the complex etiopathogenesis. Natural-climatic and anthropogenic factors play an important role in the development and progression of this pathology.
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Topic review
Updated time: 24 May 2021
Submitted by: Carmine Izzo
Definition: Recent scientific literature has investigated the cardiovascular implications of COVID-19. The mechanisms of cardiovascular damage seem to involve the protein angiotensin-converting enzyme 2 (ACE2), to which severe acute respiratory syndrome (SARS) coronavirus-2 (CoV-2) binds to penetrate cells and other mechanisms, most of which are still under study. Cardiovascular sequelae of COVID-19 include heart failure, cardiomyopathy, acute coronary syndrome, arrhythmias, and venous thromboembolism.
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Topic review
Updated time: 02 Jul 2021
Submitted by: Diletta Cozzi
Definition: Viral pneumonia is one the most frequent respiratory diseases among very young people and the elderly, contributing to an increase in the number of hospitalizations and deaths, mainly in subjects over 60 years of age. To assess the presence of pulmonary involvement and extension of disease, diagnostic imaging techniques are traditional chest radiographs (CXR) and computed tomography (CT). CXR may show a negative radiological pattern or otherwise areas of monolateral or bilateral consolidations, in association with nodular opacities, bronchial wall thickening, and small pleural effusions.
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Topic review
Updated time: 16 Sep 2021
Submitted by: Lars-Olav Harnisch
Definition: Extracorporeal membrane oxygenation (ECMO) is increasingly used for acute respiratory failure with few absolute but many relative contraindications. The contraindications to the initiation of ECMO therapy are not uniformly agreed upon, and each center, as well as each provider involved in the indication for the initiation of ECMO, weights them differently. Whereas absolute contraindications immediately discourage ECMO therapy, relative contraindications should trigger a very thorough consideration of this option. Although relative contraindications should not per se exclude patients from a life-saving procedure such as ECMO, their concurrence may lead to the decision to forgo this procedure. When relative contraindications add up, they might accumulate to a point where they (should) be considered absolute contraindications.
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Topic review
Updated time: 14 Jul 2021
Submitted by: Kaschin Jamal Jameel
Definition: In smoking-induced chronic obstructive pulmonary disease (COPD), various comorbidities are linked to systemic inflammation and infection-induced exacerbations. The underlying mechanisms are unclear but might provide therapeutic targets. T-cell activity is central in systemic inflammation and for infection-defense mechanisms and might be influenced by comorbidities. Hypothesis: Circulating biomarkers of comorbidities modulate the activity of T-cells of the T-helper type 1 (Th1) and/or T-cytotoxic type 1 (Tc1). T-cells in peripheral blood mononuclear cells (PBMCs) from non-smokers (NS), current smokers without COPD (S), and COPD subjects (total n = 34) were ex vivo activated towards Th1/Tc1 and were then stimulated with biomarkers for metabolic and/or cardiovascular comorbidities (Brain Natriuretic Peptide, BNP; chemokine (C-C motif) ligand 18, CCL18; C-X3-C motif chemokine ligand 1, CX3CL1; interleukin-18, IL-18) or for asthma- and/or cancer-related comorbidities (CCL22; epidermal growth factor, EGF; IL-17; periostin) each at 10 or 50 ng/mL. The Th1/Tc1 activation markers interferon-γ (IFNγ), tumor necrosis factor-α (TNFα), and granulocyte-macrophage colony-stimulating factor (GM-CSF) were analyzed in culture supernatants by Enzyme-Linked Immunosorbent Assay (ELISA). Ex-vivo activation induced IFNγ and TNFα without differences between the groups but GM-CSF more in S vs. NS. At 10 ng/mL, the different biomarkers increased or reduced the T-cell activation markers without a clear trend for one direction in the different categories of comorbidities or for the different T-cell activation markers. At 50 ng/mL, there was a clear shift towards suppressive effects, particularly for the asthma— and cancer-related biomarkers and in cells of S and COPD. Comorbidities might suppress T-cell immunity in COPD. This could explain the association of comorbidities with frequent exacerbations.
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Topic review
Updated time: 05 Jul 2021
Submitted by: Paolo Pozzi
Definition: Coronaviruses (CoVs) are known in veterinary medicine affecting several species, and causing respiratory and/or enteric, systemic diseases and reproductive disease in poultry. Animal diseases caused by CoVs may be considered from the following different perspectives: livestock and poultry CoVs cause mainly “population disease”; while in companion animals they are a source of mainly “individual/single subject disease”. Therefore, respiratory CoVs diseases in high-density, large populations of livestock or poultry may be a suitable example for the current SARS-CoV-2/COVID-19 pandemic.
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Topic review
Updated time: 27 Apr 2021
Submitted by: Danilo Buonsenso
Definition: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the virus responsible for the pandemic viral pneumonia that was first identified in Wuhan, China, in December 2019, and has since rapidly spread around the world. The number of COVID-19 cases recorded in pediatric age is around 1% of the total. The immunological mechanisms that lead to a lower susceptibility or severity of pediatric patients are not entirely clear. At the same time, the immune dysregulation found in those children who developed the multisystem inflammatory syndrome (MIC-S) is not yet fully understood.
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Topic review
Updated time: 05 May 2021
Submitted by: Massimo Franchini
Definition: Translating the experience from previous viral epidemics, passive immunotherapy by means of plasma from individuals recovered from COVID-19 has been intensively investigated since the beginning of the pandemic.
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