Physicochemical Characterization of Exudate Gum from Neltuma flexuosa (ex Prosopis flexuosa).

The COVID-19 pandemic meant a major challenge for healthcare services worldwide, requiring them to adapt their services to the urgent needs of these patients. COVID-19 has a highly variable course, ranging from asymptomatic to extremely severe and often fatal. Many nearly asymptomatic or mildly symptomatic patients developed after 5–8 days viral pneumonia with hypoxemia and pulmonary infiltrates that led to hospitalization in 14% of the patients and acute respiratory distress syndrome in 12% of hospitalised patients. Early in the outbreak, studies suggested that lung ultrasound (LUS) could be a valuable tool for predicting the probability of clinical worsening of COVID-19, defined as the deterioration of several disease severity markers or other outcomes, such as hospitalization, intensive inpatient care, or death. The results of these studies demonstrate consistency in supporting the use of LUS as a predictive tool for patients with COVID-19, despite the diversity of the population and the variability in LUS measurements and scores. Most of these studies have been conducted in hospital wards or emergency departments. However, very few studies have assessed the value of lung point-of-care ultrasound (POCUS) in patients with suspected or confirmed COVID-19 in primary care settings. In the last decade, Spain has adopted POCUS as an imaging tool at the patient’s bedside with the goal of improving primary care’s resolution capability. Additionally, primary care physicians’ (PCPs) training in lung POCUS had a significant boost with the COVID-19 pandemic. In this context, it is necessary to get evidence to support the use of lung POCUS by PCPs to follow up patients with mild to moderate symptoms of SARS-CoV-2 infection in the community. Such evidence might lessen treatment uncertainty for patients, aid in the early detection of lung involvement, and prevent referring patients with minimal potential benefit, thereby alleviating stress on hospital emergency departments. The most common approach for diagnosing pneumonia involves a combination of plain chest X-rays, clinical findings, and symptomatology. Nonetheless, chest X-rays have demonstrated limited sensitivity for this purpose. Although chest CT scans are more sensitive, they have drawbacks in terms of cost, accessibility, and radiation exposure. Furthermore, the requirement to transport the patient to a radiology centre for an imaging test was an additional restriction on its use in the context of COVID-19, given the uncertainty and lack of knowledge surrounding the situation, which encouraged limiting visits to hospitals and health centres as much as possible to avoid contagion. Prior to the COVID-19 pandemic, several studies found LUS to be more sensitive than chest X-rays in diagnosing pneumonia. LUS was already considered for the diagnosis of pneumonia in emergency medicine and paediatrics. LUS offers good repeatability across operators with varying degrees of experience between them. Sonographic findings associated with COVID-19 pneumonia (anomalies in the pleural line thickness, focal, multifocal, and merging B-lines, and consolidations with sporadic mobile air bronchograms) are comparable to those reported in patients diagnosed with pneumonia prior to the COVID-19 pandemic. A recent systematic review and meta-analysis have indicated that LUS has a sensitivity of 87.2% and a specificity of 69.5% for the diagnosis of COVID-19 pneumonia in high-prevalence settings. LUS is more sensitive (97.6%) than chest X-ray (69.9%) in identifying COVID-19 pneumonia and has a diagnostic accuracy equivalent to chest CT for COVID-19 pneumonia.