Posts
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Techniques in Coloproctology
21 Apr, 2020The Italian Society of Colorectal Surgery (SICCR) published last week an article with some recommendations for good clinical practice in colorectal surgery during the novel coronavirus pandemic.
As a summary, they believe that the COVID-19 epidemic should not lead to approaches that impair oncologic results or expose patients to excessive morbidity. In COVID-19-negative patients, elective surgery should be performed following the current guidelines, using the least aggressive treatment po... -
ACS Guidelines for Triage and Management of Elective Cancer Surgery Cases
20 Apr, 2020The American College of Surgeons together with their Cancer programs published a list of statements for Elective surgery during the Acute and Recovery phases of the Covid-19 disease pandemic. There, they define the phases of the disease and how to manage all the oncologic surgery that must go forward depending on the infection stage.
It has been developed by the leaders within the ACS Cancer Programs (American Joint Committee on Cancer, AJCC, Clinical Research Program (CRP), Commissio... -
SARS-CoV-2 and viral sepsis: observations and hypotheses
20 Apr, 2020Since the outbreak of coronavirus disease 2019 (COVID-19), clinicians have tried every effort to understand the disease, and a brief portrait of its clinical features have been identified. In clinical practice, the clinicians noticed that many severe or critically ill COVID-19 patients developed typical clinical manifestations of shock, including cold extremities and weak peripheral pulses, even in the absence of overt hypotension. Understanding the mechanism of viral sepsis in COVID-19 is wa... -
Diagnostic Performance of CT and Reverse Transcriptase-Polymerase Chain Reaction for Coronavirus Disease 2019: A Meta-Analysis
20 Apr, 2020Recent studies have suggested that chest computed tomography (CT) scans could be used as a primary screening or diagnostic tool for coronavirus disease 2019 (COVID-19) in epidemic areas. To study that, some scientifics have created a project to perform a meta-analysis to evaluate diagnostic performance measures, including predictive values, of chest CT and initial reverse transcriptase-polymerase chain reaction (RT-PCR).
For the meta-analysis, MEDLINE and Embase articles were searched fro... -
Endoscopy in inflammatory bowel diseases during the COVID-19 pandemic and post-pandemic period
20 Apr, 2020The coronavirus disease 2019 (COVID-19) pandemic is changing the management of many chronic diseases, including that of patients with inflammatory bowel diseases (IBD). In particular, the performance of routine endoscopy is temporarily suspended, and only emergency endoscopy is allowed in many countries where severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has spread. We highlight different scenarios in which endoscopy should still be performed urgently in patients with IBD, as w... -
Impact assessment of non-pharmaceutical interventions against coronavirus disease 2019 and influenza in Hong Kong: an observational study
20 Apr, 2020
Background
A range of public health measures have been implemented to suppress local transmission of coronavirus disease 2019 (COVID-19) in Hong Kong. We examined the effect of these interventions and behavioural changes of the public on the incidence of COVID-19, as well as on influenza virus infections, which might share some aspects of transmission dynamics with COVID-19.
Methods
We analysed data on laboratory-confirmed COVID-19 cases, influenza surveillance data in outpat... -
ST-Segment Elevation in Patients with Covid-19 — A Case Series
19 Apr, 2020
Myocardial injury with ST-segment elevation has been observed in patients with coronavirus disease 2019 (Covid-19). Here, we describe our experience in the initial month of the Covid-19 outbreak in New York City.
Patients with confirmed Covid-19 who had ST-segment elevation on electrocardiography were included in the study from six New York hospitals. Patients with Covid-19 who had nonobstructive disease on coronary angiography or had normal wall motion on echocardiogra... -
Hydroxychloroquine in the management of critically ill patients with COVID-19: the need for an evidence base
19 Apr, 2020With the rapid spread of the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), critical care physicians are seeing increasing numbers of patients with acute respiratory failure secondary to coronavirus disease 2019 (COVID-19) and reporting mortality rates of 40–65% for those requiring mechanical ventilation1 —strikingly higher than the mortality rates reported for the more typical acute respiratory distress syndrome associated with other diseases. The focus of ther... -
Temporal dynamics in viral shedding and transmissibility of COVID-19
19 Apr, 2020AbstractWe report temporal patterns of viral shedding in 94 patients with laboratory-confirmed COVID-19 and modeled COVID-19 infectiousness profiles from a separate sample of 77 infector–infectee transmission pairs. We observed the highest viral load in throat swabs at the time of symptom onset, and inferred that infectiousness peaked on or before symptom onset. We estimated that 44% (95% confidence interval, 25–69%) of secondary cases were infected during the index cases’ presymptomatic stag... -
Remdesivir is a direct-acting antiviral that inhibits RNA-dependent RNA polymerase from severe acute respiratory syndrome coronavirus 2 with high potency
18 Apr, 2020Effective treatments for coronavirus disease 2019 (COVID-19) are urgently needed to control this current pandemic, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Replication of SARS-CoV-2 depends on the viral RNA-dependent RNA polymerase (RdRp), which is the likely target of the investigational nucleotide analogue remdesivir (RDV). RDV shows broad-spectrum antiviral activity against RNA viruses, and previous studies with RdRps from Ebola virus (EBOV) and Middle East r... -
Rates of Co-infection Between SARS-CoV-2 and Other Respiratory Pathogens
18 Apr, 2020Last April 15th, the Journal of the American Medical Association (JAMA) published a research letter relating the Covid-19 infections with other respiratory diseases.
As of April 3, 2020, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) had caused 972 303 cases of coronavirus disease 2019 (COVID-19) and 50 322 deaths worldwide. Early reports from China suggested that co-infection with other respiratory pathogens was rare. If this were the case, patients positive for other patho... -
How does coronavirus kill? Clinicians trace a ferocious rampage through the body, from brain to toes
18 Apr, 2020How does coronavirus kill? Clinicians trace a ferocious rampage through the body, from brain to toes
On rounds in a 20-bed intensive care unit (ICU) one recent day, physician Joshua Denson assessed two patients with seizures, many with respiratory failure and others whose kidneys were on a dangerous downhill slide. Days earlier, his rounds had been interrupted as his team tried, and failed, to resuscitate a young woman whose heart had stopped. All shared one thing, says Denson,...