scholarly journals The Role of Bronchoscopy in the Diagnosis and Management of Patients with SARS-Cov-2 Infection

Diagnostics ◽  
2021 ◽  
Vol 11 (10) ◽  
pp. 1938
Author(s):  
Davide Biondini ◽  
Marco Damin ◽  
Martina Bonifazi ◽  
Elisabetta Cocconcelli ◽  
Umberto Semenzato ◽  
...  
Keyword(s):  
Healthcare Providers ◽  
Standard Of Care ◽  
Risk Exposure ◽  
Current Evidence ◽  
Risk Of Infection ◽  
Diagnosis And Management ◽  
Infectious Risk ◽  
Increased Risk ◽  
Diagnostic Management

Bronchoscopy has several major diagnostic and therapeutic indications in pulmonology. However, it is an aerosol-generating procedure that places healthcare providers at an increased risk of infection. Now more than ever, during the spread of the coronavirus disease 2019 (COVID-19) pandemic, the infectious risk during bronchoscopy is significantly raised, and for this reason its role in diagnostic management is debated. In this review, we summarized current evidence regarding the indications for bronchoscopy and the measures that should be applied to decrease risk exposure. Indeed, seeing the long-lasting period of the pandemic, resuming standard of care for all patients is required.

scholarly journals A novel box for aerosol and droplet guarding and evacuation in respiratory infection (BADGER) for COVID-19 and future outbreaks

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Hau D. Le ◽  
Gordon A. Novak ◽  
Kevin C. Janek ◽  
Jesse Wang ◽  
Khang N. Huynh ◽  
...  
Keyword(s):  
Respiratory Infection ◽  
Healthcare Providers ◽  
Airborne Particles ◽  
Risk Of Infection ◽  
Indirect Contact ◽  
Vacuum Suction ◽  
Qualitative And Quantitative ◽  
Additional Layer ◽  
Increased Risk ◽  
Design Construction

AbstractThe coronavirus disease 2019 (COVID-19) pandemic caused by the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) has infected millions and killed more than 1.7 million people worldwide as of December 2020. Healthcare providers are at increased risk of infection when caring for patients with COVID-19. The mechanism of transmission of SARS-CoV-2 is beginning to emerge as airborne spread in addition to direct droplet and indirect contact as main routes of transmission. Here, we report on the design, construction, and testing of the BADGER (Box for Aerosol and Droplet Guarding and Evacuation in Respiratory Infection), an affordable, scalable device that contains droplets and aerosol particles, thus minimizing the risk of infection to healthcare providers. A semi-sealed environment is created inside the BADGER, which is placed over the head of the patient and maintains at least 12-air changes per hour using in-wall vacuum suction. Multiple hand-ports enable healthcare providers to perform essential tasks on a patient’s airway and head. Overall, the BADGER has the potential to contain large droplets and small airborne particles as demonstrated by simulated qualitative and quantitative assessments to provide an additional layer of protection for healthcare providers treating COVID-19 and future respiratory contagions.

scholarly journals The role of telehealth during COVID-19 outbreak: A systematic review based on current evidence

2020 ◽  
Author(s):  
Elham Monaghesh ◽  
Alireza Hajizadeh
Keyword(s):  
Systematic Review ◽  
English Language ◽  
Healthcare Providers ◽  
Physical Contact ◽  
Current Evidence ◽  
Health Providers ◽  
Search Results ◽  
Effective Option ◽  
Critical Appraisal Skills

Abstract Purpose The outbreak of coronavirus disease-19 (COVID-19) is a public health emergency of international concern. Telehealth is effective option to fight COVID-19 outbreak. The aim of this systematic review was to identify the role of telehealth services during COVID-19 outbreak.Methods This systematic review was conducted through searching five databases including PubMed, Scopus, Embase, Web of Science and Science direct. Inclusion criteria included studies clearly defined role of telehealth services in COVID-19 outbreak, published from December 31, 2019, written in English language and published in peer reviewed. Two reviewers independently assessed search results, extracted data, and assessed quality of included studies. Quality assessment was based on the Critical Appraisal Skills Program (CASP) checklist. Narrative synthesis was undertaken to summarize and report the findings.Results Eight studies met the inclusion out of the 142 search results. Currently, healthcare providers and patients who are self-isolating, telehealth is certainly appropriate to minimizing the risk of COVID-19 transmission. This solution has the potential to avoidance of direct physical contact, provide continuous care to the community and finally reduce morbidity and mortality in COVID-19 outbreak.Conclusions The use of telehealth improves the provision of health services. Therefore, telehealth should be an important tool in caring services while keeping patients and health providers safe as the COVID-19 outbreak.

scholarly journals Role of Imaging in Diagnosis and Management of COVID-19: A Multiorgan Multimodality Imaging Review

2021 ◽  
Vol 8 ◽  
Author(s):  
Vinithra Varadarajan ◽  
Mahsima Shabani ◽  
Bharath Ambale Venkatesh ◽  
Joao A. C. Lima
Keyword(s):  
Multimodality Imaging ◽  
Imaging Techniques ◽  
Standard Of Care ◽  
Review Article ◽  
Health Centers ◽  
Imaging Modalities ◽  
Imaging Protocol ◽  
Diagnosis And Management ◽  
Radiologic Findings

In this pandemic of Coronavirus disease 2019 (COVID-19), a vast proportion of healthcare resources, including imaging tools, have been dedicated to the management of affected patients; yet, the frequent reports of unknown presentations and complications of disease over time have been changing the usual standard of care and resource allocation in health centers. As of now, we have witnessed multisystemic symptoms requiring the collaboration of different clinical teams in COVID-19 patients' care. Compared to previous viral pandemics, imaging modalities are now playing an essential role in the diagnosis and management of patients. This widespread utility of imaging modalities calls for a deeper understanding of potential radiologic findings in this disease and identifying the most compatible imaging protocol with safety precautions. Although initially used for respiratory tract evaluation, imaging modalities have also been used for cardiovascular, neurologic, and gastrointestinal evaluation of patients with COVID-19. In this narrative review article, we provide multimodality and multisystemic review of imaging techniques and features that can aid in the diagnosis and management of COVID-19 patients.

scholarly journals Role of Bacterial Overgrowth in the Stomach as an Additional Risk Factor for Gastritis

2003 ◽  
Vol 17 (suppl b) ◽  
pp. 13B-17B ◽  
Author(s):  
Gregory Naylor ◽  
Anthony Axon
Keyword(s):  
Gastric Cancer ◽  
Cell Mass ◽  
Bacterial Overgrowth ◽  
Nitroso Compounds ◽  
Current Evidence ◽  
Additional Risk Factor ◽  
Proximal Small Bowel ◽  
Increased Risk ◽  
H Pylori

Gastric bacteria can either be ingested or ascend from the distal bowel; however, their survival is usually limited by gastric acidity and motility. A reduction in gastric acid can result in bacterial overgrowth in the stomach and proximal small bowel, and the number of organisms rises as the intragastric pH rises.The increased risk of noncardia gastric cancer seen in patients with hypochlorhydria may be explained by an excess of nitrites and N-nitroso compounds (NOCs). These compounds are found in the diet of populations with a high gastric cancer risk, but can also be produced by the organisms that exist in the hypochlorhydria stomach. It has long been hypothsized that nitrites and NOCs act as one of the triggers in the atrophy-metaplasia-dysplasia-carcinoma path. However, although indirect data have linked the premalignant changes of metaplasia and dysplasia to NOCs, direct measurement of gastric nitrites and NOCs has not confirmed such a link.The role ofHelicobacter pyloriin bacterial overgrowth is mainly as a cause of hypochlorhydria resulting from atrophic gastritis, leading to a reduction in the parietal cell mass.Acid-suppressing drugs can result in bacterial overgrowth and increased nitrites and NOCs, although there is no current evidence for an increased risk of gastric cancer in patients taking them. One explanation is that the stomach appears to be colonized by different organisms than those in patients with hypochlorhydria for other reasons. There is some evidence that bacterial overgrowth per se can cause gastric inflammation in mice; however, although in humans the degree of gastric inflammation is greater when overgrowth is more prominant this may simply reflect the greater degree of hypochlorhydria in patients with a more severe H pylori-induced inflammation.

scholarly journals The role of combined fludarabine, cyclophosphamide and rituximab chemoimmunotherapy in chronic lymphocytic leukemia: current evidence and controversies

2016 ◽  
Vol 8 (3) ◽  
pp. 99-105 ◽  
Author(s):  
Alan P. Skarbnik ◽  
Stefan Faderl
Keyword(s):  
Chronic Lymphocytic Leukemia ◽  
Standard Of Care ◽  
Current Treatment ◽  
Lymphocytic Leukemia ◽  
Current Evidence ◽  
Treatment Paradigm

Chemoimmunotherapy (CIT) has become a cornerstone in the treatment of patients with chronic lymphocytic leukemia (CLL). The combination of fludarabine, cyclophosphamide and rituximab (FCR) has emerged as the standard of care for therapy of previously untreated patients with CLL who are younger than 65 years and have no significant comorbidities. In this article, we review the role of FCR in the current treatment paradigm for CLL.

scholarly journals Examining guidelines and new evidence in oncology nutrition: a position paper on gaps and opportunities in multimodal approaches to improve patient care

2021 ◽  
Author(s):  
Carla M. Prado ◽  
Alessandro Laviano ◽  
Chelsia Gillis ◽  
Anthony D. Sung ◽  
Maureen Gardner ◽  
...  
Keyword(s):  
Muscle Mass ◽  
Healthcare Providers ◽  
Improve Patient Care ◽  
Multidisciplinary Care ◽  
Standard Of Care ◽  
Nutrition Status ◽  
Care Process ◽  
Current Evidence ◽  
Patient Centered ◽  
Nutrition Screening

Abstract Malnutrition, muscle loss, and cachexia are prevalent in cancer and remain key challenges in oncology today. These conditions are frequently underrecognized and undertreated and have devastating consequences for patients. Early nutrition screening/assessment and intervention are associated with improved patient outcomes. As a multifaceted disease, cancer requires multimodal care that integrates supportive interventions, specifically nutrition and exercise, to improve nutrient intake, muscle mass, physical functioning, quality of life, and treatment outcomes. An integrated team of healthcare providers that incorporates societies’ recommendations into clinical practice can help achieve the best possible outcomes. A multidisciplinary panel of experts in oncology, nutrition, exercise, and medicine participated in a 2-day virtual roundtable in October 2020 to discuss gaps and opportunities in oncology nutrition, alone and in combination with exercise, relative to current evidence and international societies’ recommendations. The panel recommended five principles to optimize clinical oncology practice: (1) position oncology nutrition at the center of multidisciplinary care; (2) partner with colleagues and administrators to integrate a nutrition care process into the multidisciplinary cancer care approach; (3) screen all patients for malnutrition risk at diagnosis and regularly throughout treatment; (4) combine exercise and nutrition interventions before (e.g., prehabilitation), during, and after treatment as oncology standard of care to optimize nutrition status and muscle mass; and (5) incorporate a patient-centered approach into multidisciplinary care.

scholarly journals Role of Testosterone in the Treatment of Cardiovascular Disease

2017 ◽  
Vol 12 (02) ◽  
pp. 1 ◽  
Author(s):  
Carolyn M Webb ◽  
Peter Collins ◽  
◽  
Keyword(s):  
Risk Factors ◽  
Cardiovascular Disease ◽  
Cardiovascular System ◽  
Serum Testosterone ◽  
Current Evidence ◽  
Premature Coronary Artery Disease ◽  
Cvd Risk ◽  
Testosterone Levels ◽  
Increased Risk

Cardiovascular disease (CVD) is the most prevalent non-communicable cause of death worldwide. Testosterone is a sex hormone that is predominant in males but also occurs in lower concentrations in females. It has effects directly on the blood vessels of the cardiovascular system and on the heart, as well as effects on risk factors for CVD. Serum testosterone concentrations are known to decrease with age and reduced testosterone levels are linked to premature coronary artery disease, unfavourable effects on CVD risk factors and increased risk of cardiovascular mortality independent of age. A significant number of men with heart failure demonstrate reduced serum testosterone concentrations and there is early evidence suggesting that low testosterone levels affect cardiac repolarisation. Any association between endogenous testosterone concentrations and CVD in women has yet to be established. Testosterone replacement is used to treat men with hypogonadism but also has cardiovascular effects. This review will present the current evidence, expert opinion and controversies around the role of testosterone in the pathophysiology of CVD and surrounding the use of testosterone treatment and its effects on the cardiovascular system and CVD.

scholarly journals The role of telehealth during COVID-19 outbreak: A systematic review based on current evidence

2020 ◽  
Author(s):  
Elham Monaghesh ◽  
Alireza Hajizadeh
Keyword(s):  
Systematic Review ◽  
English Language ◽  
Healthcare Providers ◽  
Physical Contact ◽  
Current Evidence ◽  
Health Providers ◽  
Search Results ◽  
Effective Option ◽  
Critical Appraisal Skills

Abstract Purpose: The outbreak of coronavirus disease-19 (COVID-19) is a public health emergency of international concern. Telehealth is an effective option to fight the outbreak of COVID-19. The aim of this systematic review was to identify the role of telehealth services in preventing, diagnosing, treating, and controlling diseases during COVID-19 outbreak.Methods: This systematic review was conducted through searching five databases including PubMed, Scopus, Embase, Web of Science, and Science Direct. Inclusion criteria included studies clearly defining any use of telehealth services in all aspects of health care during COVID-19 outbreak, published from December 31, 2019, written in English language and published in peer reviewed journals. Two reviewers independently assessed search results, extracted data, and assessed the quality of the included studies. Quality assessment was based on the Critical Appraisal Skills Program (CASP) checklist. Narrative synthesis was undertaken to summarize and report the findings.Results: Eight studies met the inclusion out of the 142 search results. Currently, healthcare providers and patients who are self-isolating, telehealth is certainly appropriate in minimizing the risk of COVID-19 transmission. This solution has the potential to prevent any sort of direct physical contact, provide continuous care to the community, and finally reduce morbidity and mortality in COVID-19 outbreak.Conclusions: The use of telehealth improves the provision of health services. Therefore, telehealth should be an important tool in caring services while keeping patients and health providers safe during COVID-19 outbreak.

scholarly journals Wound care during the COVID-19 emergency in Padua Hospital (Italy)

2020 ◽  
pp. 1-12
Author(s):  
Giampiero Avruscio ◽  
Sonia Ragazzo ◽  
Chiara Tonello ◽  
Giuseppe Camporese ◽  
Fabiana Nalin ◽  
...  
Keyword(s):  
Social Impact ◽  
Wound Care ◽  
Healthcare Providers ◽  
High Standard ◽  
Standard Of Care ◽  
University Hospital ◽  
Current Evidence ◽  
Hospital Patients ◽  
Standard Of Practice ◽  
Difficult Challenge

Abstract Chronic vascular wounds have a significant economic and social impact on our society calling for allocation of a great deal of attention and resources. The COVID-19 outbreak has represented a difficult challenge to face for healthcare providers and fragile patients, such as for outpatients and Day-Hospital patients needing continuous care at the Angiology Unit of the University Hospital of Padova in Italy, one of the most crucial areas worldwide. The project consisted in a critical revision of all the procedures from the patient’s arrival to their discharge after completing the entire course of treatment. The previous standard of practice was modified according to the current evidence-based guidelines and the national and local Government’s indications.1 The new standard of practice allowed our Unit to protect every patient and staff member from the coronavirus infection, providing the same high standard of care as before the COVID-19 outbreak.

scholarly journals The Role of TEG Analysis in Patients with COVID-19-Associated Coagulopathy: A Systematic Review

Diagnostics ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. 172
Author(s):  
Jan Hartmann ◽  
Alexis Ergang ◽  
Dan Mason ◽  
Joao D. Dias
Keyword(s):  
Systematic Review ◽  
Whole Blood ◽  
Patient Population ◽  
Standard Of Care ◽  
Future Studies ◽  
Increased Risk ◽  
Coagulation Tests ◽  
Thrombotic Complications ◽  
Coagulation Status

Coronavirus disease 2019 (COVID-19)-associated coagulopathy (CAC), characterized by hypercoagulability and an increased risk of thrombotic complications, is an important consideration in the management of patients with COVID-19. As COVID-19 is a new disease, no standard of care for the diagnosis or management of its associated coagulopathy is yet established. Whole blood viscoelastic tests, such as thromboelastography (TEG® hemostasis analyzer), analyze whole blood to provide a complete overview of the coagulation status. We conducted a systematic review of thromboelastography for management of patients with COVID-19, using MEDLINE (PubMed) and Cochrane databases. TEG® parameter measurements and clinical outcomes data were extracted for analysis. Our review found 15 publications, with overall results showing thromboelastography can identify and assess a hypercoagulable state in patients with COVID-19. Furthermore, utilization of thromboelastography in this patient population was shown to predict thrombotic complications. The benefits of thromboelastography presented here, in addition to advantages compared with laboratory coagulation tests, position thromboelastography as an important opportunity for optimizing diagnosis of CAC and improving patient management in COVID-19. Given that the benefits of thromboelastography have already been demonstrated in several other clinical applications, we anticipate that clinical data from future studies in patients with COVID-19 will further elucidate the optimal use of thromboelastography in this patient population.

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