scholarly journals Updated guidance on the management of COVID-19: from an American Thoracic Society/European Respiratory Society coordinated International Task Force (29 July 2020)

2020 ◽  
Vol 29 (157) ◽  
pp. 200287 ◽  
Author(s):  
Chunxue Bai ◽  
Sanjay H. Chotirmall ◽  
Jordi Rello ◽  
George A. Alba ◽  
Leo C. Ginns ◽  
...  

BackgroundCoronavirus disease 2019 (COVID-19) is a disease caused by severe acute respiratory syndrome-coronavirus-2. Consensus suggestions can standardise care, thereby improving outcomes and facilitating future research.MethodsAn International Task Force was composed and agreement regarding courses of action was measured using the Convergence of Opinion on Recommendations and Evidence (CORE) process. 70% agreement was necessary to make a consensus suggestion.ResultsThe Task Force made consensus suggestions to treat patients with acute COVID-19 pneumonia with remdesivir and dexamethasone but suggested against hydroxychloroquine except in the context of a clinical trial; these are revisions of prior suggestions resulting from the interim publication of several randomised trials. It also suggested that COVID-19 patients with a venous thromboembolic event be treated with therapeutic anticoagulant therapy for 3 months. The Task Force was unable to reach sufficient agreement to yield consensus suggestions for the post-hospital care of COVID-19 survivors. The Task Force fell one vote shy of suggesting routine screening for depression, anxiety and post-traumatic stress disorder.ConclusionsThe Task Force addressed questions related to pharmacotherapy in patients with COVID-19 and the post-hospital care of survivors, yielding several consensus suggestions. Management options for which there is insufficient agreement to formulate a suggestion represent research priorities.

2020 ◽  
pp. 1-3
Author(s):  
Johannes Knoch

<b>Background:</b> Coronavirus disease 2019 (COVID-19) is a disease caused by severe acute respiratory syndrome-coronavirus-2. Consensus suggestions can standardise care, thereby improving outcomes and facilitating future research. <b>Methods:</b> An International Task Force was composed and agreement regarding courses of action was measured using the Convergence of Opinion on Recommendations and Evidence (CORE) process. 70% agreement was necessary to make a consensus suggestion. <b>Results:</b> The Task Force made consensus suggestions to treat patients with acute COVID-19 pneumonia with remdesivir and dexamethasone but suggested against hydroxychloroquine except in the context of a clinical trial; these are revisions of prior suggestions resulting from the interim publication of several randomised trials. It also suggested that COVID-19 patients with a venous thromboembolic event be treated with therapeutic anticoagulant therapy for 3 months. The Task Force was unable to reach sufficient agreement to yield consensus suggestions for the post-hospital care of COVID-19 survivors. The Task Force fell one vote shy of suggesting routine screening for depression, anxiety and post-traumatic stress disorder. <b>Conclusions:</b> The Task Force addressed questions related to pharmacotherapy in patients with COVID-19 and the post-hospital care of survivors, yielding several consensus suggestions. Management options for which there is insufficient agreement to formulate a suggestion represent research priorities.


2017 ◽  
Vol 49 (4) ◽  
pp. 1600965 ◽  
Author(s):  
Ildiko Horváth ◽  
Peter J. Barnes ◽  
Stelios Loukides ◽  
Peter J. Sterk ◽  
Marieann Högman ◽  
...  

Breath tests cover the fraction of nitric oxide in expired gas (FENO), volatile organic compounds (VOCs), variables in exhaled breath condensate (EBC) and other measurements. For EBC and for FENO, official recommendations for standardised procedures are more than 10 years old and there is none for exhaled VOCs and particles. The aim of this document is to provide technical standards and recommendations for sample collection and analytic approaches and to highlight future research priorities in the field. For EBC and FENO, new developments and advances in technology have been evaluated in the current document. This report is not intended to provide clinical guidance on disease diagnosis and management.Clinicians and researchers with expertise in exhaled biomarkers were invited to participate. Published studies regarding methodology of breath tests were selected, discussed and evaluated in a consensus-based manner by the Task Force members.Recommendations for standardisation of sampling, analysing and reporting of data and suggestions for research to cover gaps in the evidence have been created and summarised.Application of breath biomarker measurement in a standardised manner will provide comparable results, thereby facilitating the potential use of these biomarkers in clinical practice.


2009 ◽  
Vol 2 (4) ◽  
pp. 243-255 ◽  
Author(s):  
Reginald D. V. Nixon ◽  
Leonard W. Kling

AbstractThe aim of this pilot study was to test whether a future-oriented expressive writing intervention is able to reduce post-traumatic stress disorder (PTSD) severity and associated symptoms such as depression and unhelpful trauma-related beliefs. In an uncontrolled pre-/ post-design participants attended 8 weeks of manualized therapy. Assessment was undertaken pre- and post-treatment, and participants also completed a 3-month follow-up assessment. Of the 17 participants who began therapy, 13 were treatment completers. Results indicated a significant decrease in PTSD severity, depression and unhelpful trauma-related cognitions from pre- to post-treatment and at 3-month follow-up. Clinically meaningful change was more modest; however, three participants reported PTSD remission at 3-month follow-up. It is concluded that expressive writing with a focus on achieving future goals and personal change may have some utility in reducing post-traumatic stress but future research will need to investigate this with greater methodological rigour before firm conclusions can be made.


Author(s):  
Allison Watters ◽  
Kevin Hamilton ◽  
J. Patrick Neary ◽  
Gregory Anderson

Previous studies on Post-Traumatic Stress (PTS) in fire-fighters have typically examined group responses to unusual and traumatic events. In this study, symptoms of PTS were observed in a group of urban Canadian firefighters during routine operations in the context of typical daily work. Participants completed a PTS questionnaire as well as a workplace health questionnaire which assessed environmental and contextual factors in addition to personal health. Elevated levels of PTS were observed in 18.1% of the 105 fire-fighters studied. Those who reported elevated symptoms also reported more concern for financial issues, more worries and more concern about needing physical exercise and support services. These results indicate that emergency response professionals such as fire-fighters can develop elevated levels of PTS in the context of routine work. The findings also suggest that the development of PTS involves a complex relationship between characteristics of stressors, work related variables and other contextual factors specific to the individuals affected. Complex models are needed to account for these types of interactions, particularly in chronically stressful occupational settings. Strategies for mitigating symptoms of PTS are discussed and suggestions for future research are offered


Author(s):  
Andrew J. Wawrzyniak ◽  
Samir Sabbag

The emerging field of sexual minority health has begun to highlight the differential impact of post-traumatic stress disorder (PTSD) on lesbian, gay, bisexual, and transgender (LGBT) persons. This chapter addresses the higher prevalence of PTSD among LGBT persons and examines the biological underpinnings of PTSD in this population. The chapter also presents risk factors for PTSD experienced by LGBT individuals. It concludes with treatment recommendations. Treatment for PTSD in LGBT populations, in addition to treatment as usual for any patient, should recognize and acknowledge the patient’s sexual identity in forming a treatment plan. Future research in this field should aim to incorporate heterosexual controls as a reference group for comparison, where applicable.


2015 ◽  
Vol 27 (5) ◽  
pp. 857-864 ◽  
Author(s):  
S. Eichhorn ◽  
N. Stammel ◽  
H. Glaesmer ◽  
T. Klauer ◽  
H. J. Freyberger ◽  
...  

ABSTRACTBackground:Sexual violence and wartime rapes are prevalent crimes in violent conflicts all over the world. Processes of reconciliation are growing challenges in post-conflict settings. Despite this, so far few studies have examined the psychological consequences and their mediating factors. Our study aimed at investigating the degree of longtime readiness to reconcile and its associations with post-traumatic distress within a sample of German women who experienced wartime rapes in 1945.Methods:A total of 23 wartime rape survivors were compared to age- and gender-matched controls with WWII-related non-sexual traumatic experiences. Readiness to reconcile was assessed with the Readiness to Reconcile Inventory (RRI-13). The German version of the Post-traumatic Diagnostic Scale (PDS) was used to assess post-traumatic stress disorder (PTSD) symptomatology.Results:Readiness to reconcile in wartime rape survivors was higher in those women who reported less post-traumatic distress, whereas the subscale “openness to interaction” showed the strongest association with post-traumatic symptomatology. Moreover, wartime rape survivors reported fewer feelings of revenge than women who experienced other traumatization in WWII.Conclusions:Our results are in line with previous research, indicating that readiness to reconcile impacts healing processes in the context of conflict-related traumatic experiences. Based on the long-lasting post-traumatic symptomatology we observed that our findings highlight the need for psychological treatment of wartime rape survivors worldwide, whereas future research should continue focusing on reconciliation within the therapeutic process.


2015 ◽  
Vol 46 (4) ◽  
pp. 976-987 ◽  
Author(s):  
Aryeh Fischer ◽  
Katerina M. Antoniou ◽  
Kevin K. Brown ◽  
Jacques Cadranel ◽  
Tamera J. Corte ◽  
...  

Many patients with an idiopathic interstitial pneumonia (IIP) have clinical features that suggest an underlying autoimmune process but do not meet established criteria for a connective tissue disease (CTD). Researchers have proposed differing criteria and terms to describe these patients, and lack of consensus over nomenclature and classification limits the ability to conduct prospective studies of a uniform cohort.The “European Respiratory Society/American Thoracic Society Task Force on Undifferentiated Forms of Connective Tissue Disease-associated Interstitial Lung Disease” was formed to create consensus regarding the nomenclature and classification criteria for patients with IIP and features of autoimmunity.The task force proposes the term “interstitial pneumonia with autoimmune features” (IPAF) and offers classification criteria organised around the presence of a combination of features from three domains: a clinical domain consisting of specific extra-thoracic features, a serologic domain consisting of specific autoantibodies, and a morphologic domain consisting of specific chest imaging, histopathologic or pulmonary physiologic features.A designation of IPAF should be used to identify individuals with IIP and features suggestive of, but not definitive for, a CTD. With IPAF, a sound platform has been provided from which to launch the requisite future research investigations of a more uniform cohort.


2005 ◽  
Vol 56 (4) ◽  
pp. 317 ◽  
Author(s):  
S. Pande ◽  
K. H. M. Siddique ◽  
G. K. Kishore ◽  
B. Bayaa ◽  
P. M. Gaur ◽  
...  

Ascochyta blight (AB), caused by Ascochyta rabiei is a major disease of chickpea (Cicer arietinum L.), especially in areas where cool, cloudy, and humid weather persists during the crop season. Several epidemics of AB causing complete yield loss have been reported. The fungus mainly survives between seasons through infected seed and in infected crop debris. Despite extensive pathological and molecular studies, the nature and extent of pathogenic variability in A. rabiei have not been clearly established. Accumulation of phenols, phytoalexins (medicarpin and maackiain), and hydrolytic enzymes has been associated with host-plant resistance (HPR). Seed treatment and foliar application of fungicides are commonly recommended for AB management, but further information on biology and survival of A. rabiei is needed to devise more effective management strategies. Recent studies on inheritance of AB resistance indicate that several quantitative trait loci (QTLs) control resistance. In this paper we review the biology of A. rabiei, HPR, and management options, with an emphasis on future research priorities.


Sign in / Sign up

Export Citation Format

Share Document