Post-infection functional gastrointestinal disorders following coronavirus disease-19: a prospective follow-up cohort study | Canada News Media
Connect with us

Health

Post-infection functional gastrointestinal disorders following coronavirus disease-19: a prospective follow-up cohort study

Published

 on

Study design

This prospective cohort study was conducted on adults between July 2022 and February 2023. At the time of the study, China was tough on COVID-19 dominated by Omicron [14, 15], a variant of SARS-CoV-2 and all people were in a population-wide COVID screening in hospital or community with regular universal reverse transcription polymerase chain reaction (RT-PCR) test. All suspicious COVID persons even for asymptomatic infection were referred to local hospitals or large square cabin hospitals for mandatory quarantine. All suspicious infected persons undergoing a diagnostic procedure, such as a nasopharyngeal polymerase chain reaction (PCR) test or chest radiograph to show their lung involvement, had a definite diagnosis of coronavirus infection by their physician. Patients with COVID−19 are included in the study according to inclusion or exclusion criteria as soon as the diagnosis of COVID−19 is confirmed. Gastroenteroscopy including endoscopic biopsy, blood sampling(Blood count, white blood cell count, CPR, PCT, IL−6, IgG and IgM antibody tests for viruses) and other tests (X-rays and ultrasound, Urine routine, stool routine) were needed to exclude other bacterial and viral infections in the whole body or any part of the body or acute gastroenteritis (AG) that could cause GI symptoms. The lag time from diagnosis of COVID−19 to study inclusion is no more than 1 day. All patients received the national protocol of standard treatment without changes.

It consisted of 2 cohorts, a case group that included COVID-19 patients consecutively recruited from Fangcai Hospital, a dedicated COVID care center, in Haikou of Hainan Province, China. Healthy control group included COVID serology negative screeners at our hospital in the same time period. Participants were followed up either outpatient physical or over the telephone at 1, 3, and 6 months using validated Rome III and Rome IV questionnaire and limited objective assessment [1]. The follow-up period from July-August 2022 to February 2023 was more than 6 months. The data from case groups were compared with the 6-month follow-up data on the development of FGID in an age- and sex-matched cohort of healthy subjects. In addition, subjects who met the various diagnostic criteria for FGID in Rome at 6 months of follow-up were advised to come to the clinic for further examination by laboratory and endoscopic methods as well as clinical indications to exclude some diseases such as gastroparesis, SIBO, microscopic colitis, etc. Clinical indicators include duration and frequency of diarrhea, consistency of stool and presence of blood, history of vomiting, fever, cramping abdominal pain and weight loss. The included COVID-19 patients and healthy controls were tested for COVID-19 at 3 and 6 months to exclude COVID-19 reinfection. The questionnaires also included co-morbidities (Hypertension or diabetes), anxiety, irregular diet, sleep quality, and regular exercise sections.

Inclusion criteria of case group were as follows: (1) age between 18 and 85 years old, having a definitive diagnosis of coronavirus with different severity [16, 17] (mild and moderate) using biochemical test data (such as COVID19-SARS-CoV-2 positive, and anti-SARS-CoV-19 IgG and IgM negative) or computed tomography scan of chest and observation of lung involvement;(2) no previous history of clinical confirmation of the diagnosis of any FGID, no GI tumors, reflux esophagitis, ulcerative colitis or other GI diseases, no co-morbidities (Hypertension or diabetes), no history of abdominal surgery, and no any recurrent baseline symptoms of FGID or GI symptoms such as diarrhea, constipation, or abdominal pain; (3) blood sampling, and other tests were needed to exclude AG, bacterial and viral infections;(4) normal findings of gastroscopy and other laboratory tests from the last 6 months of medical examination were required. Healthy control group had no history of COVID-19 or FGID. Biochemical test data (such as COVID19-SARS-CoV-2 negative, and anti-SARS-CoV-19 IgG and IgM negative) are required and the rest of the criteria were the same as for the case group.

The objectives of this study were explained in detail to all participants, and also, partici-pating in this study was fully conscious and based on their desire. Further, written informed consent was obtained from each participant. Meanwhile, Each participant provided a written or electronic informed consent form and the study was approved by the institutional ethics committee of the Second Hospital of Hainan Medical University (reference number: LW2022270).

Definitions

RT-PCR was used to detect SARS-CoV-2 in nasopharyngeal and oropharyngeal samples of subjects [18]. The diagnosis of IBS by the Rome IV diagnostic criteria has changed significantly, the new diagnostic criteria have increased the frequency required to diagnose IBS, and the incidence of IBS has decreased [1]. We used Rome III rather than the most recently described Rome IV criteria as the latter is 50% less sensitive to diagnose IBS [1]. Other types of FGID were diagnosed based on the Rome IV criteria [1].

Dyspepsia refer to postprandial discomfort syndrome, which often manifests itself as postprandial fullness and early satiety (inability to complete a normal meal). Dyspepsia means the same as Functional dyspepsia, and refers only to postprandial discomfort syndrome.

AG was defined as the presence of at least two of the followings: (i) diarrhea, (ii) vomiting, (iii) fever, and (iv) stool culture isolating entero-pathogens [6]. Stool sample of each COVID-19 patient was examined under a microscope for detection of pus cell, RBC or parasites. All suspected stool samples were cultured for Vibrio cholerae, Salmonella, Shigella, Campylobacter and Aeromonas using standard techniques to identify the pathogenic strains.

Patients who showed signs of organ failure (such as persistent oliguria, severe respiratory distress) or required ventilator support or admission to an intensive care unit during treatment for COVID-19 infection were defined as having severe COVID-19. The severity of the COVID-19 [16, 17, 19] was assessed as described: (i) critical (required ventilator), (ii) severe (needed oxygen), (iii) moderate (though pneumonia present, did not require oxygen), and (iv) mild (only upper respiratory symptoms). Those without symptoms at the time of diagnosis of COVID-19 were classified as asymptomatic as categorical variables (yes or no).

Living with frequent (> 5 times/month) infrequent meals and irregular meal times was defined as an irregular diet. The Pittsburgh Sleep Quality Index (PSQI) [20] was used to investigate the sleep quality of patients. The total score of PSQI ranges from 0 to 21, where 7 is the threshold value of sleep quality problem, and the higher score above 7 indicates the poorer sleep quality of the patients, while the opposite indicates the better sleep quality of the patients. Regular exercise is defined by the latest World Health Organization (WHO) Guidelines for Exercise and Sedentary Behavior 2020 [21]. Adults should engage in at least 150–300 min of moderate-intensity aerobic exercise per week, or at least 75–150 min of high-intensity aerobic activity, or an equivalent combination of moderate-intensity and high-intensity exercise; Older adults should have at least 150–300 min of moderate intensity aerobic exercise per week, or at least 75–150 min of high intensity aerobic exercise, or an equivalent combination of moderate and high intensity exercise. The Hamilton Anxiety Scale [22] was used to evaluate the psychological status of the case group, and possible anxiety was considered when the scale score was > 7.

Statistical analysis

Sample size calculation

In this study, the sample size was calculated as 90% power, 99% confidence interval (bilateral) based on previous studies [12, 23, 24] that showed that the mean incidence of FGIDs after acute gastroenteritis is about 21% and a Chinese study that showed the incidence of PI-FGIDs in controls of 8.2% [25]. A total of 155 COVID-19 patients and 155 healthy controls were required in this study, while 194 COVID-19 patients and 194 controls were enrolled since about 10–20% loss could occur at follow-up. Four of 194 COVID-19 patients and 34 of 194 healthy controls were excluded because they had inadequate documentation or were lost during follow-up. Finally, 190 COVID-19 patients and 160 healthy controls were analyzed (Fig. 1).

Fig. 1

Flowchart of this study

Data collection and analysis

SPSS (version 26; SPSS Inc, Chicago, IL) was used for all statistical analyses. Categorical data were presented as proportions, while continuous data were expressed as mean ± standard deviation (SD) or median and range or interquartile range (IQR). Categorical variables were analyzed using χ2 test with Yates correction, where applicable. Parametric and nonparametric continuous data were analyzed using unpaired t-test and Mann-Whitney U test, respectively. Multivariate analysis was performed using stepwise logistic regression. A two-tailed P value < 0.05 was considered significant.

 

Source link

Continue Reading

Health

What’s the greatest holiday gift: lips, hair, skin? Give the gift of great skin this holiday season

Published

 on

Give the gift of great skin this holiday season

Skinstitut Holiday Gift Kits take the stress out of gifting

Toronto, October 31, 2024 – Beauty gifts are at the top of holiday wish lists this year, and Laser Clinics Canada, a leader in advanced beauty treatments and skincare, is taking the pressure out of seasonal shopping. Today, Laser Clincs Canada announces the arrival of its 2024 Holiday Gift Kits, courtesy of Skinstitut, the exclusive skincare line of Laser Clinics Group.

In time for the busy shopping season, the limited-edition Holiday Gifts Kits are available in Laser Clinics locations in the GTA and Ottawa. Clinics are conveniently located in popular shopping centers, including Hillcrest Mall, Square One, CF Sherway Gardens, Scarborough Town Centre, Rideau Centre, Union Station and CF Markville. These limited-edition Kits are available on a first come, first served basis.

“These kits combine our best-selling products, bundled to address the most relevant skin concerns we’re seeing among our clients,” says Christina Ho, Senior Brand & LAM Manager at Laser Clinics Canada. “With several price points available, the kits offer excellent value and suit a variety of gift-giving needs, from those new to cosmeceuticals to those looking to level up their skincare routine. What’s more, these kits are priced with a savings of up to 33 per cent so gift givers can save during the holiday season.

There are two kits to select from, each designed to address key skin concerns and each with a unique theme — Brightening Basics and Hydration Heroes.

Brightening Basics is a mix of everyday essentials for glowing skin for all skin types. The bundle comes in a sleek pink, reusable case and includes three full-sized products: 200ml gentle cleanser, 50ml Moisture Defence (normal skin) and 30ml1% Hyaluronic Complex Serum. The Brightening Basics kit is available at $129, a saving of 33 per cent.

Hydration Heroes is a mix of hydration essentials and active heroes that cater to a wide variety of clients. A perfect stocking stuffer, this bundle includes four deluxe products: Moisture 15 15 ml Defence for normal skin, 10 ml 1% Hyaluronic Complex Serum, 10 ml Retinol Serum and 50 ml Expert Squalane Cleansing Oil. The kit retails at $59.

In addition to the 2024 Holiday Gifts Kits, gift givers can easily add a Laser Clinic Canada gift card to the mix. Offering flexibility, recipients can choose from a wide range of treatments offered by Laser Clinics Canada, or they can expand their collection of exclusive Skinstitut products.

 

Brightening Basics 2024 Holiday Gift Kit by Skinstitut, available exclusively at Laser Clincs Canada clinics and online at skinstitut.ca.

Hydration Heroes 2024 Holiday Gift Kit by Skinstitut – available exclusively at Laser Clincs Canada clinics and online at skinstitut.ca.

Continue Reading

Health

Here is how to prepare your online accounts for when you die

Published

 on

 

LONDON (AP) — Most people have accumulated a pile of data — selfies, emails, videos and more — on their social media and digital accounts over their lifetimes. What happens to it when we die?

It’s wise to draft a will spelling out who inherits your physical assets after you’re gone, but don’t forget to take care of your digital estate too. Friends and family might treasure files and posts you’ve left behind, but they could get lost in digital purgatory after you pass away unless you take some simple steps.

Here’s how you can prepare your digital life for your survivors:

Apple

The iPhone maker lets you nominate a “ legacy contact ” who can access your Apple account’s data after you die. The company says it’s a secure way to give trusted people access to photos, files and messages. To set it up you’ll need an Apple device with a fairly recent operating system — iPhones and iPads need iOS or iPadOS 15.2 and MacBooks needs macOS Monterey 12.1.

For iPhones, go to settings, tap Sign-in & Security and then Legacy Contact. You can name one or more people, and they don’t need an Apple ID or device.

You’ll have to share an access key with your contact. It can be a digital version sent electronically, or you can print a copy or save it as a screenshot or PDF.

Take note that there are some types of files you won’t be able to pass on — including digital rights-protected music, movies and passwords stored in Apple’s password manager. Legacy contacts can only access a deceased user’s account for three years before Apple deletes the account.

Google

Google takes a different approach with its Inactive Account Manager, which allows you to share your data with someone if it notices that you’ve stopped using your account.

When setting it up, you need to decide how long Google should wait — from three to 18 months — before considering your account inactive. Once that time is up, Google can notify up to 10 people.

You can write a message informing them you’ve stopped using the account, and, optionally, include a link to download your data. You can choose what types of data they can access — including emails, photos, calendar entries and YouTube videos.

There’s also an option to automatically delete your account after three months of inactivity, so your contacts will have to download any data before that deadline.

Facebook and Instagram

Some social media platforms can preserve accounts for people who have died so that friends and family can honor their memories.

When users of Facebook or Instagram die, parent company Meta says it can memorialize the account if it gets a “valid request” from a friend or family member. Requests can be submitted through an online form.

The social media company strongly recommends Facebook users add a legacy contact to look after their memorial accounts. Legacy contacts can do things like respond to new friend requests and update pinned posts, but they can’t read private messages or remove or alter previous posts. You can only choose one person, who also has to have a Facebook account.

You can also ask Facebook or Instagram to delete a deceased user’s account if you’re a close family member or an executor. You’ll need to send in documents like a death certificate.

TikTok

The video-sharing platform says that if a user has died, people can submit a request to memorialize the account through the settings menu. Go to the Report a Problem section, then Account and profile, then Manage account, where you can report a deceased user.

Once an account has been memorialized, it will be labeled “Remembering.” No one will be able to log into the account, which prevents anyone from editing the profile or using the account to post new content or send messages.

X

It’s not possible to nominate a legacy contact on Elon Musk’s social media site. But family members or an authorized person can submit a request to deactivate a deceased user’s account.

Passwords

Besides the major online services, you’ll probably have dozens if not hundreds of other digital accounts that your survivors might need to access. You could just write all your login credentials down in a notebook and put it somewhere safe. But making a physical copy presents its own vulnerabilities. What if you lose track of it? What if someone finds it?

Instead, consider a password manager that has an emergency access feature. Password managers are digital vaults that you can use to store all your credentials. Some, like Keeper,Bitwarden and NordPass, allow users to nominate one or more trusted contacts who can access their keys in case of an emergency such as a death.

But there are a few catches: Those contacts also need to use the same password manager and you might have to pay for the service.

___

Is there a tech challenge you need help figuring out? Write to us at onetechtip@ap.org with your questions.

Source link

Continue Reading

Health

Pediatric group says doctors should regularly screen kids for reading difficulties

Published

 on

 

The Canadian Paediatric Society says doctors should regularly screen children for reading difficulties and dyslexia, calling low literacy a “serious public health concern” that can increase the risk of other problems including anxiety, low self-esteem and behavioural issues, with lifelong consequences.

New guidance issued Wednesday says family doctors, nurses, pediatricians and other medical professionals who care for school-aged kids are in a unique position to help struggling readers access educational and specialty supports, noting that identifying problems early couldhelp kids sooner — when it’s more effective — as well as reveal other possible learning or developmental issues.

The 10 recommendations include regular screening for kids aged four to seven, especially if they belong to groups at higher risk of low literacy, including newcomers to Canada, racialized Canadians and Indigenous Peoples. The society says this can be done in a two-to-three-minute office-based assessment.

Other tips encourage doctors to look for conditions often seen among poor readers such as attention-deficit hyperactivity disorder; to advocate for early literacy training for pediatric and family medicine residents; to liaise with schools on behalf of families seeking help; and to push provincial and territorial education ministries to integrate evidence-based phonics instruction into curriculums, starting in kindergarten.

Dr. Scott McLeod, one of the authors and chair of the society’s mental health and developmental disabilities committee, said a key goal is to catch kids who may be falling through the cracks and to better connect families to resources, including quicker targeted help from schools.

“Collaboration in this area is so key because we need to move away from the silos of: everything educational must exist within the educational portfolio,” McLeod said in an interview from Calgary, where he is a developmental pediatrician at Alberta Children’s Hospital.

“Reading, yes, it’s education, but it’s also health because we know that literacy impacts health. So I think that a statement like this opens the window to say: Yes, parents can come to their health-care provider to get advice, get recommendations, hopefully start a collaboration with school teachers.”

McLeod noted that pediatricians already look for signs of low literacy in young children by way of a commonly used tool known as the Rourke Baby Record, which offers a checklist of key topics, such as nutrition and developmental benchmarks, to cover in a well-child appointment.

But he said questions about reading could be “a standing item” in checkups and he hoped the society’s statement to medical professionals who care for children “enhances their confidence in being a strong advocate for the child” while spurring partnerships with others involved in a child’s life such as teachers and psychologists.

The guidance said pediatricians also play a key role in detecting and monitoring conditions that often coexist with difficulty reading such as attention-deficit hyperactivity disorder, but McLeod noted that getting such specific diagnoses typically involves a referral to a specialist, during which time a child continues to struggle.

He also acknowledged that some schools can be slow to act without a specific diagnosis from a specialist, and even then a child may end up on a wait list for school interventions.

“Evidence-based reading instruction shouldn’t have to wait for some of that access to specialized assessments to occur,” he said.

“My hope is that (by) having an existing statement or document written by the Canadian Paediatric Society … we’re able to skip a few steps or have some of the early interventions present,” he said.

McLeod added that obtaining specific assessments from medical specialists is “definitely beneficial and advantageous” to know where a child is at, “but having that sort of clear, thorough assessment shouldn’t be a barrier to intervention starting.”

McLeod said the society was partly spurred to act by 2022’s “Right to Read Inquiry Report” from the Ontario Human Rights Commission, which made 157 recommendations to address inequities related to reading instruction in that province.

He called the new guidelines “a big reminder” to pediatric providers, family doctors, school teachers and psychologists of the importance of literacy.

“Early identification of reading difficulty can truly change the trajectory of a child’s life.”

This report by The Canadian Press was first published Oct. 23, 2024.

Source link

Continue Reading

Trending

Exit mobile version