Mid‐facial degloving for Juvenile Angiofibroma: A Case‐Series of 21 Adult Males

2020 ◽  
Author(s):  
Daniel Scholfield ◽  
Peter Clarke

2020 ◽  
Vol 12 (3) ◽  
pp. 61-69
Author(s):  
Beatriz Prista-Leão ◽  
Isabel Abreu ◽  
Raquel Duro ◽  
André Silva-Pinto ◽  
Filipa Ceia ◽  
...  

Panton-Valentine leukocidin-producing Staphylococcus aureus (PVL-SA) is associated with relapsing multifocal skin and soft tissue infections (SSTI), necrotizing pneumonia (NP) and severe musculoskeletal infections. Epidemiology is underknown and underdiagnosis is likely. Recent travel abroad, case clustering and relapsing disease are often reported. We reviewed all cases of PVL-SA infection diagnosed at our center, and found 21 cases over a 43-month period. Most patients were adult males, had relevant travel history, reported recurrent disease and presented with SSTI. Etiologic diagnosis took up to five years; meanwhile, 42% of patients had antibiotic treatments. Draining procedures were required in 43% of patients and intensive care support in 19%. All patients recovered. Methicillin-resistance prevalence was 24%. Only 2/13 decolonized patients had posterior relapsing SSTI, both with likely infected contacts. PVL-SA infection’s severity and impact are clear, even in small case series as ours. Physician awareness and active PVL-gene search are crucial for an adequate management.



1992 ◽  
Vol 102 (8) ◽  
pp. 928-933 ◽  
Author(s):  
Patrick J. Gullane ◽  
Jean Davidson ◽  
Tadgh O??Dwyer ◽  
Vito Forte


Author(s):  
Mina Kelleni

Introduction: COVID-19 management still lacks a protocol of proven efficacy and we present a novel COVID-19 immunomodulatory protocol basing on our early pioneering article that justified repurposing nitazoxanide/azithromycin combination for early COVID-19 which was followed by two articles to justify addition of non-steroidal anti-inflammatory drugs to nitazoxanide/azithromycin as well as by our recent article that illustrates the potential immunomodulatory mechanisms by which all the drugs used in this manuscript might benefit COVID-19 patients. Methods: We present a case series of 38 confirmed and highly suspected COVID-19 consented native Arabic speaking patients, including 12 confirmed by PCR, and the others diagnosed by other measures who were managed by telemedicine. The patients included 15 adult males including an immunocompromised patient, 16 adult females including one lactating, 3 pregnant patients including one confirmed by PCR as well as 4 children. All patients have received a short 5-day-regimen of NSAIDs / nitazoxanide/ azithromycin +/- cefoperazone either in full or in part. The primary endpoint of this protocol was a full relief of all serious COVID-19 clinical manifestations. Results: The primary endpoint was fully achieved within two weeks. Most of the patients who were treated early, have fully recovered during its described five days; the leucocytic/lymphocytic count was significantly improved for those with prior leucopenia or leucocytosis/lymphopenia. Neither significant adverse effects, nor post/para COVID syndrome was reported. Conclusions: a novel 5-day-protocol to safely and effectively cure COVID-19 using repurposed immunomodulatory safe and inexpensive FDA approved drugs is illustrated and we recommend performing sufficiently powered double-blind randomized clinical trials.



Author(s):  
Mina Kelleni

No treatment protocol of proven efficacy was approved to manage COVID-19 and we present a novel COVID-19 immunomodulatory protocol basing on our early pioneering article that justified repurposing nitazoxanide/azithromycin combination for early cases of COVID-19 which was followed by two articles to justify addition of non-steroidal anti-inflammatory drugs to nitazoxanide/azithromycin and recently an article that illustrates the potential immunomodulatory mechanisms by which all the drugs used might benefit COVID-19 patients has been published. We have managed more than 50 confirmed and highly suspected COVID-19 patients, mostly via telemedicine, while fully presenting a case series of 37 COVID-19 Arab patients including 12 confirmed by PCR and 23 diagnosed by other measures. The patients included 14 adult males including an immunocompromised patient, 16 adult females including one lactating, 3 pregnant patients including one confirmed by PCR as well as 4 children. All patients have received a short 5-day-regimen of NSAIDs (diclofenac potassium in most of cases, ibuprofen, lornoxicam, meloxicam, celecoxib, naproxen, ketoprofen or ketorolac)/nitazoxanide/azithromycin +/- cefoperazone either in full or in part as illustrated in the manuscript. The primary endpoint of this protocol was full relief of all serious COVID-19 clinical manifestations, and it was fully achieved in all patients within two weeks. Most of the patients treated early have fully recovered during its described five days; the leucocytic/lymphocytic count was significantly improved for those with prior leucopenia or leucocytosis/lymphopenia. No significant adverse effects were reported. In conclusion, a novel 5-day-protocol to safely and effectively cure COVID-19 using repurposed immunomodulatory safe and inexpensive FDA approved drugs is illustrated and we recommend performing sufficiently powered double blind randomized clinical trials against any current standard protocol.





Author(s):  
Mina Kelleni

Introduction: No treatment protocol of proven efficacy was approved to manage COVID-19 and we present a novel COVID-19 immunomodulatory protocol basing on our early pioneering article that justified repurposing nitazoxanide/azithromycin combination for early cases of COVID-19 which was followed by two articles to justify addition of non-steroidal anti-inflammatory drugs to nitazoxanide/azithromycin and recently an article that illustrates the potential immunomodulatory mechanisms by which all the drugs used might benefit COVID-19 patients has been published. Methods: We present a case series of 37 confirmed and highly suspected COVID-19 consented Arab patients including 12 confirmed by PCR and 23 diagnosed by other measures who were managed by telemedicine only to be noted that the same results were repeated with other patients when we resumed our classic medical examination. The patients included 14 adult males including an immunocompromised patient, 16 adult females including one lactating, 3 pregnant patients including one confirmed by PCR as well as 4 children. All patients have received a short 5-day-regimen of NSAIDs (diclofenac potassium in most of cases, ibuprofen, lornoxicam, meloxicam, celecoxib, naproxen, ketoprofen or ketorolac)/nitazoxanide/azithromycin +/- cefoperazone either in full or in part as illustrated in the manuscript. The primary endpoint of this protocol was full relief of all serious COVID-19 clinical manifestations. Results: The primary endpoint was fully achieved in all patients within two weeks. Most of the patients treated early have fully recovered during its described five days; the leucocytic/lymphocytic count was significantly improved for those with prior leucopenia or leucocytosis/lymphopenia. Neither significant adverse effects, nor post/para COVID syndrome were reported. In Conclusions: a novel 5-day-protocol to safely and effectively cure COVID-19 using repurposed immunomodulatory safe and inexpensive FDA approved drugs is illustrated and we recommend performing sufficiently powered double blind randomized clinical trials against any current standard protocol.



2021 ◽  

COVID-19 management still lacks a protocol of proven efficacy, and we present a novel COVID-19 immunomodulatory protocol based on our early pioneering article, re-purposing nitazoxanide/azithromycin combination for early COVID-19 diseases. Our findings were followed by two articles to justify the addition of non-steroidal anti-inflammatory drugs to nitazoxanide/azithromycin. Furthermore, another recent article of ours illustrated the potential immunomodulatory mechanisms by which all the drugs used in this manuscript might be beneficial for COVID-19 patients. We presented a case series of 34 confirmed and highly suspected COVID-19 patients. It is noteworthy that 13 PCR-confirmed COVID-19 patients were included while the others were diagnosed by other measures and all cases were managed by telemedicine. The patients included adult males and females as well as children. All patients have received a short 5-day-regimen of NSAIDs / nitazoxanide/ azithromycin +/- cefoperazone either in full or in part. The primary endpoint of this protocol was a full relief of all debilitating COVID-19 clinical manifestations, and it was fully achieved within two weeks. Most of the patients who were treated early have fully recovered during their described five days; the leucocytic/lymphocytic counts were significantly improved for those with prior abnormalities. Neither significant adverse effects nor post/para COVID-19 syndrome was reported. In conclusion, we present a pioneering 5-day protocol for the safe and effective treatment of COVID-19 using economic FDA-approved immunomodulatory drugs. We recommend conducting double-blind, randomized clinical trials with sufficient strength at the earliest opportunity.



2021 ◽  
Author(s):  
Mina Kelleni

Background: The current pandemic of coronavirus disease 2019 has necessitated trial of several drugs searching for a potential cure. We developed a novel protocol basing on our early pioneering article that recommended and justified repurposing of nitazoxanide/azithromycin combination for early cases of COVID-19 which was followed by two published articles to justify addition of non-steroidal anti-inflammatory drugs to nitazoxanide/azithromycin. Notably, nitazoxanide/azithromycin is currently being proven clinically beneficial by other researchers and NSAIDs are currently included to manage COVID-19 patients in some countries. Methods: The author is presenting his COVID-19 management protocol that evolved through a prospective telemedicine case series involving consented 30 patients including 10 confirmed by PCR and 20 highly suspected COVID-19 Egyptian patients. The patients included 14 adult males, 10 adult females, 2 pregnant patients as well as 4 children. All patients have received a 5-day-regimen of NSAIDs (mostly diclofenac potassium or ibuprofen)/nitazoxanide/azithromycin +/- cefoperazone either in full or in part as illustrated in the manuscript. The primary endpoint of this protocol was full relief of all serious COVID-19 symptoms and signs. Results: The primary endpoint was fully achieved in all patients within two weeks. Most of the patients treated early with the protocol have fully recovered during its described five days; the leucocytic/lymphocytic count was significantly improved for those with prior leucopenia/lymphopenia. No significant adverse effects were reported. Conclusion: A novel 5-day-protocol to safely and effectively manage COVID-19 repurposed inexpensive FDA approved drugs is illustrated providing a potential readily available COVID-19 cure.



Author(s):  
Mina Kelleni

To date no treatment protocol of proven efficacy was approved to manage COVID-19. We have developed a novel COVID-19 immunomodulatory protocol basing on our early pioneering article that justified repurposing of nitazoxanide/azithromycin combination for early cases of COVID-19 which was followed by two articles to justify addition of non-steroidal anti-inflammatory drugs to nitazoxanide/azithromycin. We are presenting a prospective telemedicine protocol that managed more than 50 documented COVID-19 patients while fully presenting a case series of 36 patients/legal guardians COVID-19 Arab patients including 12 confirmed by PCR and 23 diagnosed by other measures. The patients included 14 adult males including an immunocompromised patient, 15 adult females including one lactating, 3 pregnant patients including one confirmed by PCR as well as 4 children. All patients have received a short 5-day-regimen of NSAIDs (diclofenac potassium in most of cases, ibuprofen, lornoxicam, meloxicam, celecoxib, naproxen, ketoprofen or ketorolac)/nitazoxanide/azithromycin +/- cefoperazone either in full or in part as illustrated in the manuscript. The primary endpoint of this protocol was full relief of all serious COVID-19 clinical manifestations and it was fully achieved in all patients within two weeks. Most of the patients treated early have fully recovered during its described five days; the leucocytic/lymphocytic count was significantly improved for those with prior leucopenia/lymphopenia. No significant adverse effects were reported. A novel 5-day-protocol to safely and effectively cure COVID-19 using repurposed immunomodulatory safe and inexpensive FDA approved drugs is illustrated and we recommend performing sufficiently powered double blind randomized clinical trials against any current standard protocol.



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