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Archive for the ‘Identify’ Category

Common cold, flu, or coronavirus?

Person lying in bed feeling unwell

 

In the early days of the outbreak, the novel coronavirus (COVID-19) was repeatedly compared to the flu (influenza) and even to the common cold (rhinoviruses, et al). This was due to an initial impression of shared symptoms.

The differences between these conditions are particularly important as we kick off National Influenza Vaccination Week (NIVW) and the ‘flu season’. So, how can we tell which of these diseases we are dealing with in a given patient?

 

Common cold, Influenza (flu), and COVID-19 (coronavirus) symptoms comparison table

 

Common cold

Let’s start with the common cold, a condition that can be caused by over 200 different strains of viruses.  On average, an adult will contract a cold two to three times yearly – making the total number of cases incalculable. Symptoms are almost always mild and may include a runny nose, fatigue, chills, coughing, sneezing, sore throat, and a headache.  Children – but not adults – often experience a low-grade fever.

Most cases clear without medication in less than one week, although the cough can persist for up to 18 days. Bottom line: symptoms are mild.  Your normal activity may diminish, and you might even spend a few days in bed, but you should not feel short of breath or unable to complete basic tasks.

 

Influenza (flu)

Influenza (flu) was once one of the most feared diseases, worldwide – and was responsible for the largest and most deadly outbreak in the 20th century (the ‘Spanish flu’),  In more recent years, the disease is largely manageable, thanks to advancements in medicine and technology.  Billions of doses of influenza vaccine may be administered in a given year, and several effective antiviral drugs are widely available. Nevertheless, the disease is still responsible for hundreds of thousands of deaths every year.

Influenza symptoms are similar to those of the common cold (fatigue, chills, coughing, etc) but much more acute, typically with high fever and pain in the back and muscles. Fatigue and even exhaustion may follow and pain medication is often required. The symptoms may persist for a few days to over a week.

Occasionally, influenza may be complicated by pneumonia due to bacteria, or to the influenza virus itself. A fatal outcome may ensue, particularly in the elderly or in patients with underlying chronic conditions. 

 

Coronavirus (COVID-19)

COVID-19 has evolved into the iconic disease of the 21st century, with tens of millions of cases reported worldwide in a period of only 10 months. The media inundate us all with a seemingly endless list of potential symptoms, signs, and complicating conditions, so here are some more common signs and symptoms which might differentiate the latest coronavirus from other respiratory diseases. 

In most cases, the illness will begin as if you do have a cold or the flu, with coughing, fever, and fatigue.  A common early symptom is the loss of the senses of smell or taste, which has been reported in the majority of cases in many reports. After a few days, you may feel short of breath and experience pain in the muscles. At this point, you should have already contacted your local doctor or clinic. Even if symptoms are relatively mild, you must seek medical attention if you are over the age of 65 or have a history of high blood pressure, diabetes, heart or lung disease, cancer, or other ongoing illness. 

Thankfully, effective and accurate tests for COVID-19 are widely available, and there is no need to “self-diagnose.”  A variety of drugs are already in use for the disease, and several promising vaccines are due to be released in the coming weeks.

 

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What is ME – Myalgic Encephalomyelitis?

Tired person with a wind up attached to the back

 

Myalgic Encephalomyelitis, also known as Chronic Fatigue Syndrome, is a little-understood, female-biased [1] illness. It is estimated that up to 90% of people with the condition go diagnosed [2] and about 25% of sufferers are severely ill [3]. In recognition of the profound physical and psychological impact this disease has on its victims, August 8th has been designated as a Severe ME Awareness Day.

What is Myalgic Encephalomyelitis (ME)?

The disease is best known for a state of extreme and unremitting fatigue. A range of additional symptoms may suggest the presence of an infectious disease: myalgia, nausea, cognitive disturbance, “flu-like” symptoms, sore throat, palpitations, headache, and insomnia [4]. In severe cases of ME, the patient may be bed-ridden and lose the ability to do the simplest of tasks, such as boil eggs for lunch [5] or feed themselves [6].

Diagnosing ME

Although outbreaks of possible ME have been recorded since 1955 [7], and several studies have suggested a viral or bacterial etiology, a lack of coherent understanding of etiology and pathogenesis makes the diagnosis of ME particularly difficult. Symptoms may persist for years [8] and patients in general practice settings may be sent from one specialist to another until all other potential disorders (notably Lyme disease [9] [10]) are discounted. Since most patients with ME are ultimately referred to Infectious Diseases specialists, GIDEON lists the condition in its database, allowing clinicians to run a side-by-side comparison with similar diseases.

Myalgic encephalomyelitis and Lyme Disease comparison table

 

Treatment to improve the quality of life of ME patients demands significant changes in lifestyle, such as creating a quiet, environment to help reduce the effects of hypersensitivity [11, 12].

There is currently no known cure for this condition. A variety of drugs are currently under review, including Metformin and Momordica charantia extract [13]. Newer diagnostic techniques include a nanoelectronics-blood-based diagnostic biomarker [14].

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References:

  1. McGrath, S. (2018). Analysis of data from 500,000 individuals in UK Biobank demonstrates an inherited component to ME/CFS. ME/CFS Research Review. Retrieved 7 August 2020, from https://mecfsresearchreview.me/2018/06/11/analysis-of-data-from-500000-individuals-in-uk-biobank-demonstrates-an-inherited-component-to-me-cfs/.
  2. What is ME/CFS? | Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) | CDC. Cdc.gov. (2018). Retrieved 7 August 2020, from https://www.cdc.gov/me-cfs/about/index.html.
  3. What is Myalgic Encephalomyelitis (ME)?. #MEAction. (2020). Retrieved 7 August 2020, from https://www.meaction.net/about/what-is-me/.
  4. Myalgic encephalomyelitis. gideononline.com. (2020). Retrieved 7 August 2020, from https://app.gideononline.com/explore/diseases/10405.
  5. Foggy Friends Where ME/CFS Sufferers Unite Forums – Anna – The M.E Years. Foggyfriends.org. Retrieved 7 August 2020, from https://www.foggyfriends.org/forum/content.php/151-Anna-The-M-E-Years.
  6. Price, N. (2020). [Image]. Retrieved 7 August 2020, from https://25megroup.org/wp-content/uploads/2020/05/N-Price-.jpg.
  7. Royal Free Hospital. (1957). An Outbreak of Encephalomyelitis in the Royal Free Hospital Group, London, in 1955. PubMed Central (PMC). Retrieved 7 August 2020, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1962472/.
  8. Foggy Friends Where ME/CFS Sufferers Unite Forums – Members Stories. Foggyfriends.org. Retrieved 7 August 2020, from https://www.foggyfriends.org/forum/content.php/9-Member-Stories.
  9. Cottle, L., Mekonnen, E., Beadsworth, M., Miller, A., & Beeching, N. (2012). Lyme disease in a British referral clinic. QJM105(6), 537-543. https://doi.org/10.1093/qjmed/hcs003
  10. Patrick, D., Miller, R., Gardy, J., Parker, S., Morshed, M., & Steiner, T. et al. (2015). Lyme Disease Diagnosed by Alternative Methods: A Phenotype Similar to That of Chronic Fatigue Syndrome. Clinical Infectious Diseases61(7), 1084-1091. https://doi.org/10.1093/cid/civ470
  11. Comhaire, F., & Deslypere, J. (2020). News and views in myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS): The role of co-morbidity and novel treatments. Medical Hypotheses134, 109444. https://doi.org/10.1016/j.mehy.2019.109444
  12. Chronic fatigue syndrome (CFS/ME) – Treatment. nhs.uk. (2017). Retrieved 7 August 2020, from https://www.nhs.uk/conditions/chronic-fatigue-syndrome-cfs/treatment/#medication.
  13. Severely Affected Patients | Clinical Care of Patients | Healthcare Providers | Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) | CDC. Cdc.gov. (2019). Retrieved 7 August 2020, from https://www.cdc.gov/me-cfs/healthcare-providers/clinical-care-patients-mecfs/severely-affected-patients.html.
  14. Esfandyarpour, R., Kashi, A., Nemat-Gorgani, M., Wilhelmy, J., & Davis, R. (2019). A nanoelectronics-blood-based diagnostic biomarker for myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS). Proceedings Of The National Academy Of Sciences116(21), 10250-10257. https://doi.org/10.1073/pnas.1901274116

Updated Microbiology module

GIDEON’s redesigned Microbiology module has been launched (screenshot). Following the update of the GIDEON Diagnosis module, we’ve implemented many of the new features in Microbiology, including

  • New tabs
  • Suggestions
  • Dynamic identification
  • Usability improvements

New tabs

The new tabs in Microbiology replace the older radio buttons and make it easier to reach each function. For each category: Bacteria, Mycobacteria and Yeasts there is easy access to Identify or Lists.

Suggestions

GIDEON’s Microbiology Compare function, until now, has ranked phenotypic tests which are most likely to impact the Identification list. Now, the top four tests which are most likely to focus and shorten the list of possible organisms are displayed and dynamically updated as each new test result is entered. Clickable boxes which allow the user to enter a “yes”, “no” or “unknown”, appear and enlarge each time the mouse passes near a test.

Dynamic identification

The Identify button has been eliminated! Now, the Identification list is automatically updated as test results are entered. This feature demonstrates the effects of each new test result as it is entered.

Diagnosis results buttonsThe familiar buttons: Compare, Why Not, Open case, Save case, Remove All, Print, Email are all in the Identification list area.

Usability improvements

Updated lists

The organism lists have been updated to extend the length of the screen. The organisms can be selected by clicking the check boxes to their left and then Compared. Clicking on expands the list of synonyms.

Collapsible windows

Windows in Identify, such as Suggestions and Phenotypic Tests can be minimized and hidden. For example to not see suggestions, click on the minimize button Minimize button to the left title.

Mouse overs
More mouse-overs have been added: Clickable boxes expand as you mouse over them, and display clear symbols to select “yes” or “no.”

Phenotype
You can now click on the tests  in the Phenotype window.

Quick sorting
Probability sort arrowIdentification results can be sorted alphabetically or by probability easily by clicking the column title.

Window resizing
Changing vertical window size expands size of Phenotypic tests and Identification list sub-windows in Identify and Organism list. This is a great feature for larger monitors.

Previous version
Click “Original Microbiology” to use the older interface.

Update: See video demonstration

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