cord-000001-ug7v899j	2001	title: Clinical features of culture-proven Mycoplasma pneumoniae infections at King Abdulaziz University Hospital, Jeddah, Saudi Arabia OBJECTIVE: This retrospective chart review describes the epidemiology and clinical features of 40 patients with culture-proven Mycoplasma pneumoniae infections at King Abdulaziz University Hospital, Jeddah, Saudi Arabia. CONCLUSION: our results were similar to published data except for the finding that infections were more common in infants and preschool children and that the mortality rate of pneumonia in patients with comorbidities was high. Mycoplasma pneumoniae is a common cause of upper and lower respiratory tract infections. pneumoniae infections in Saudi Arabia is scarce, [8, 9, 10] we wished to study the epidemiology and clinical features of cultureproven infections caused by this organism at this hospital. pneumoniae culture were obtained from patients with upper or lower respiratory tract infections seen as inpatients or in the outpatient or emergency departments. Role of Mycoplasma pneumoniae in acute respiratory-tract infections in Saudi paediatric patients
cord-000083-3p81yr4n	2009	R. China Background: The objective of this study was to evaluate the early virologic response for prediction of achievement of HBeAg seroconversion and hepatitis B virus (HBV) DNA negativity after two years of lamivudine treatment in chronic hepatitis B (CHB) patients. Methods: A total of 620 patients who tested positive for hepatitis B surface antigen and were referred to Chiba University Hospital between February 1985 and March 2008 were included in the study, and their following characteristics were analyzed: age, gender, the status of HBeAg, ALT, HBV-DNA level, and PLT. Methods: A total of 60 patients with chronic hepatitis B, 32 (53.3%) were HBeAg positive (group A) while 28(46.7%) were HBeAg negative (group B) were included in this study after meeting the following criteria: age 18 to 60 years, HBsAg positive for more than 6 months, serum HBV-DNA was >5 log(10) copies/mL and ALT more than two times the upper normal limit.
cord-000161-hxjxczyr	2009	Primary influenza pneumonia has a high mortality rate during pandemics, not only in immunocompromised individuals and patients with underlying comorbid conditions, but also in young healthy adults. Pneumonia and the acute respiratory distress syndrome (ARDS) account for the majority of severe morbidity and mortality that accompany pandemic influenza infection [14] . A recent analysis of lung specimens from 77 fatal cases of pandemic H1N1v 2009 infection found a prevalence of concurrent bacterial pneumonia in 29% of these patients [31] . A recent World Health Organization treatment guideline for pharmacological management of 2009 pandemic H1N1v influenza A recommends the consideration of higher doses of oseltamivir (150 mg twice a day) and longer duration of treatment for patients with severe influenza pneumonia or clinical deterioration [44] . The rapid progression from initial typical influenza symptoms to extensive pulmonary involvement, with acute lung injury, can occur both in patients with underlying respiratory or cardiac morbidities and in young healthy adults, especially if obese or pregnant.
cord-000229-9fr0m92p	2010	However, six of 12 patients who underwent thin-section CT examinations showed abnormal findings for small ground-glass opacities (GGOs) in addition to poorly-defined nodules with upper lobe predominance. CONCLUSION: In a population of healthy young adults, elevated CRP with normal ESR and white blood cell levels combined with GGOs and nodules on thin-section CT scans may indicate early signs of infection by the pandemic H1N1 2009 influenza virus. In this article, we aim to describe detailed clinical characteristics and radiologic features of chest radiographs and thin-section CT findings of patients confirmed with the pandemic H1N1 2009 influenza virus infection occurring in a semi-closed setting. Most patients in our study did not show a severe hospital course, although one patient''s symptoms aggravated into ARDS and needed mechanical ventilation before laboratory tests revealed that he had the pandemic H1N1 2009 influenza virus infection.
cord-000268-480d3yfv	2010	title: Diagnostic value of triggering receptor expressed on myeloid cells-1 and C-reactive protein for patients with lung infiltrates: an observational study The aim of the present study was to define whether expression of TREM-1 on cell membranes of neutrophils (nTREM-1), of monocytes (mTREM-1) and serum sTREM-1 may help in the diagnosis of acute bacterial infections for patients admitted with a new pulmonary infiltrate or pleural effusion. In conclusion, the presented results indicate that serum sTREM-1 and expression of TREM-1 on neutrophils and monocytes may serve as markers of CAP in patients with pulmonary infiltrates. Increased levels of soluble triggering receptor expressed on myeloid cells-1 in patients with acute pancreatitis Prognosis of community acquired pneumonia(CAP): value of triggering receptor expressed on myeloid cells-1 (TREM-1) and other mediators of the inflammatory response Diagnostic implications of soluble triggering receptor expressed on myeloid cells-1 in BAL fluid of patients with pulmonary infiltrates in the ICU
cord-000284-00rk8fb5	2010	Conclusions: H1N1 viral infection in patients with cancer can cause severe illness, resulting in acute respiratory distress syndrome and death. However, patients with comorbidities as cancer and chronic diseases may show a serious clinical presentation, characterized by respiratory failure with variable severity [6, 7] . In this study, we describe the clinical and pathological findings in critically ill patients with cancer and respiratory failure related to novel H1N1 infection admitted to original article an oncologic intensive care unit (ICU) in a reference cancer center in Sao Paulo, Brazil. We report the clinical and pathological findings from eight patients with cancer and severe H1N1 infection who were admitted to an oncologic ICU during the winter period of the 2009 pandemic in Sao Paulo, Brazil. The serious clinical presentation of the novel Influenza A (H1N1) infection in some cancer patients should be expected.
cord-000308-cxr1ul7q	2011	BACKGROUND: Since the first outbreak of a respiratory illness caused by H1N1 virus in Mexico, several reports have described the need of intensive care or extracorporeal membrane oxygenation (ECMO) assistance in young and often healthy patients. Since the first outbreak of a respiratory illness caused by Influenza A (H1N1) virus in Mexico [1] , several reports have described the need of intensive care [2] [3] [4] or extracorporeal membrane oxygenation (ECMO) assistance [5] in young and often healthy patients. In the present investigation we report our experience, as an ECMO referral center, in H1N1-induced acute respiratory distress syndrome (ARDS) and we present the critical care service planning in response to the H1N1 pandemic. List of abbreviations ARDS: acute respiratory distress syndrome; BMI: body mass index; CVVH: continuous veno-venous hemofiltration; ECMO: extracorporeal membrane oxygenation; ICU: intensive care unit; LOS: length of stay; LUS: lung ultrasound; RT-PCR: real-time reverse transcriptase-polymerase-chain-reaction; SAPS: simplified acute physiology score.
cord-000457-e50a0suk	2011	METHODS: We evaluated the epidemiologic characteristics of all the subjects infected with the 2009 H1N1 influenza A virus (2,971 patients, ≤ 15 years of age), and the clinical and laboratory findings of the inpatients (217 patients, 80 had pneumonia) between 1 September 2009 and 31 January 2010 in a single hospital throughout the epidemic. In addition, during the study period we observed a dramatic effect of early treatment with corticosteroids and oseltamivir for patients with severe pneumonia including rapidly progressive pneumonia [9, 10] . We retrospectively evaluated all patients with 2009 H1N1 virus infection during the pandemic (2,971 patients) for epidemiologic characteristics, and for clinical characteristics, we reviewed the medical records and chest radiographic findings of 217 children admitted to The Catholic University of Korea, Daejeon St Mary''s Hospital between 1 September 2009 and 31 January 2010. In pandemic 2009 H1N1 virus infections, children of all ages were evenly affected, and males were predominant in pneumonia patients.
cord-000522-d498qj2b	2002	Five topics were selected that have been shown in randomized, controlled trials to reduce mortality: limiting the tidal volume in acute lung injury or acute respiratory distress syndrome, early goal-directed therapy, use of drotrecogin alfa (activated), use of moderate doses of steroids, and tight control of blood sugar. The present article provides guidelines from experts in the field on optimal patient selection and timing for each intervention, and provides advice on how to integrate new therapies into ICU practice, including protocol development, so that mortality rates from this disease process can be reduced. The interventions discussed encompassed low tidal volume in patients with acute lung injury (ALI)/acute respiratory distress syndrome (ARDS) (Edward Abraham), early goal-directed therapy (EGDT) (Emanuel Rivers), drotrecogin alfa (activated) (Gordon Bernard), moderate-dose corticosteroids (Djillali Annane), and tight control of blood sugar (Greet Van den Berghe).
cord-000716-fhm8abxp	2012	BACKGROUND: In the present study, the whole human genome oligo microarray was employed to investigate the gene expression profile in symptomatic pulmonary embolism (PE). Gene Ontology analysis showed the genes with down-regulated expressions mainly explain the compromised T cell immunity. However, mRNA expression of P-selectin (mainly distributed on the surface of ECs and platelets) and E-selection (mainly distributed on the surface of activated ECs) are not elevated in PE group which indicate venous endothelial cells are not impaired in patients with PE (Fig.2) . Gene ontology analysis exhibited compromised T cell mediated immune function, and t test indicated associated genes were significantly down-regulated in patients with PE than in control groups. Two genes with down-regulated expressions are closely related to the T cell mediated immunity according to GO analysis (with high value of Enrichment). Patient outcomes after deep vein thrombosis and pulmonary embolism: the Worcester Venous Thromboembolism Study
cord-000718-7whai7nr	2012	Method: We analyzed consecutive gastric cancer cases in terms of AMACR immunohistochemical expression and clinical/pathological characteristics and followed patients'' postoperative history. Results: Histological, immunohistochemical and molecular examination revealed non-neoplastic lymphadenopathy with atypical paracortical T-cell hyperplasia with immunoblastic reaction in the former and burnt-out histiocytic pattern in the latter, both falling into a broad spectrum of reactive lymph node changes associated with Still''s disease. Method: We have thus collected, from our two Institutions a large number (45 cases) of cancers showing the histological definition of adenosquamous carcinomas according to the WHO criteria and performed gene analysis for k-RAS (codons 12, 13) and EGFR (codons 18, 19 and 21) mutations. Objective: We previously identified amplified fibroblast growth factor 1 (FGFR1) as a therapeutic target for small molecule inhibitor (SMI) therapy in squamous cell lung cancer (L-SCC), resulting in currently running clinical trials treating patients with stage III disease.
cord-000831-zwfxnd7r	2011	The initial radiography obtained from the patients was reviewed regarding pattern (consolidation, ground glass, nodules and reticulation), distribution (focal, multifocal, and diffuse) and the lung zones involved. CONCLUSIONS: In patients with the novel swine flu infection, the most common radiographic abnormality observed was consolidation in the lower lung zones. In a study on 66 patients, the most common abnormal pattern was consolidation most commonly observed in the lower and central lung zones and patients admitted to the ICU were more likely to have three or more lung zones involved (4). In their study, patients with bilateral and peripheral involvement or four or more lung zone involvement were more likely to have severe outcome, which is in consistence with our findings in patients admitted to ICU. Another study reviewed the High Resolution Computed Tomography Scan (HRCT) findings of 18 patients with the new swine flu influenza.
cord-000843-e1bn79ui	2011	The role of radiology includes (a) characterisation of sonographically indeterminate adnexal masses, (b) staging as guidance for surgery and treatment planning (including identification of sites of non optimal resectabilty) in suspected ovarian cancer, (c) assessment of recurrent disease, and (d) in selected cases image-guided biopsy. The association of multiple markers of structural and functional imaging (MRI and PET) and the use of advanced computational analysis techniques will allow better management of AD but it needs a broader validation and know the most efficient combination of biomarkers at each stage of the disease, including the preclinical period. Although the basic techniques for DCE-CT have been available for decades, more recently a range of technological advances have contributed to the greater applicability of perfusion CT in the clinical environment including wider CT detectors, shorter gantry rotation times, ''table-toggling'', radiation dose reduction and software corrections for image mis-registration due to respiratory or other patient motion.
cord-000891-5r2in1gw	2012	Suspected and unsuspected cases were compared, and significant differences were found for age (53 versus 69 median years), severe respiratory failure (68.8% versus 20%), surgery (6.3% versus 60%), median days of ICU stay before diagnosis (1 versus 4), nosocomial infection (18.8% versus 66.7%), cough (93.8% versus 53.3%), localized infiltrate on chest radiograph (6.3% versus 40%), median days to antiviral treatment (2 versus 9), pneumonia (93.8% versus 53.3%), and acute respiratory distress syndrome (75% versus 26.7%). The variables recorded were age, sex, classification of the severity of underlying conditions according to the Charlson comorbidity index [6] , type of ICU, date and cause of ICU admission, APACHE II score [7] on admission to the ICU, date of onset of influenza symptoms, clinical manifestations and radiologic findings at diagnosis, date of TA sample collection, other samples tested for influenza and result, date of initiation of antiviral treatment, complications (septic shock, acute respiratory distress syndrome (ARDS)), outcome including mortality within 30 days after influenza diagnosis, and length of ICU and hospital stay.
cord-000904-g6ffaer1	2011	OBJECTIVE: To evaluate the efficacy and tolerability of sorafenib combined with cryoablation in treating unresectable hepatocellular carcinoma (HCC). METHODS: Patients with unresectable advanced HCC received cryoablation and sorafenib at a dose of 400 mg twice daily in 4-week cycles on the same day of the cryoablation. CONCLUSION: Cryoablation combined with sorafenib demonstrates good efficacy and acceptable tolerability in treating unresectable advanced HCC patients. Among patients with advanced disease who do not qualify for surgical or liver transplantation therapies, the only non-chemotherapeutic treatment that has been shown to increase survival is sorafenib [6] . In this paper, we report the results of our prospective study conducted to evaluate the efficacy and acceptable tolerability of sorafenib as adjuvant treatment after cryoablation in the treatment of unresectable HCC. However, all other patients and tumor characteristics, including age, sex, ECOG performance status, Child-Pugh class, ongoing antiviral therapy, BCLC stage, and prior systemic treatment had no effect on clinical benefits.
cord-000977-ka4261wc	2013	Methods and Materials: Mean attenuation, contrast-to-noise ratio (CNR) and signal-to-noise ratio (SNR) at abdominal aorta, right renal artery (RRA) and left renal artery (LRA) were measured in 24 kidney donors who had undergone CTA with tube current modulation, 120 kVp, filtered back projection reconstruction algorithm (Group A) and were compared with 24 BMI-matched kidney donors who had undergone CTA with automated kVp selection and SAFIRE (Group B Purpose: Cerebral small vessel disease (SVD) is a common cause of cognitive impairment. Overall average score of SSF reconstructed segments was significantly higher compared with STD reconstruction ( Purpose: To evaluate the feasibility and imaging quality of double prospectively ECG-triggered high-pitch spiral acquisition mode for coronary computed tomography angiography (CTCA) in patients with atrial fibrillation (AF).
cord-001078-5m29nugu	2013	title: Clinical Features and Factors Associated with Outcomes of Patients Infected with a Novel Influenza A (H7N9) Virus: A Preliminary Study OBJECTIVE: The present study aimed to analyze clinical features and factors associated with treatment outcomes of H7N9 influenza A virus infection. Factors analyzed for possible correlation with clinical features and treatment outcomes in patients included 1) baseline characteristics of patients, such as age, sex, occupation, underlying conditions, exposure to poultry and/or wild birds in the past seven days, date of symptom onset and hospital admission, date of specimen collection, and date of positive diagnosis; 2) results from laboratory tests and imaging examinations; 3) treatment regimen including basic supporting therapy, antibiotic therapy, antiviral therapy, traditional Chinese medicine (TCM) therapy, and other therapies if applicable; and 4) current condition of patients including the length of stay in the hospital.
cord-001154-7k59ogn0	2013	Evaluation of viral shedding, nasal and serum cytokines, clinical illness, and clinical outcomes were performed to compare severely immunocompromised individuals to nonimmunocompromised individuals with influenza infection. Immunocompromised patients with influenza had more severe disease/complications, longer viral shedding, and more antiviral resistance while demonstrating less clinical symptoms and signs on clinical assessment. Careful examination of symptoms and signs of infection, virological measurements, immunological studies, and clinical parameters were performed to investigate the natural pathogenesis of influenza in this group of severely immunocompromised hosts. The comparison of these individuals with nonimmunocompromised individuals during influenza infection demonstrated that the immunocompromised patients are at risk of more severe or complicated disease, which may be difficult to prevent with current vaccines and treat with current antivirals.
cord-001221-due9tloa	2014	
cord-001293-dfaxj3bv	2014	In response to the failure of therapies aiming to target either the up-stream microbial activators or the effector molecules of the inflammatory cascade, a new concept has emerged of boosting the immune system to counter immunosuppression that develops in patients who survive the initial, hyperinflammatory period of sepsis [1] . One can conjecture that systemic treatment with IL-7 may act in undesired places, as illustrated by the following: IL-7 worsens graft-versus-host-induced tissue inflammation [81] ; favors inflammation in colitis [82] , contributes to arthritis severity [83] ; upregulates chemokines, IFNγ, macrophage recruitment, and lung inflammation [84] ; and, finally, increases production of inflammatory cytokines by monocytes and T cells [85] . Not only are PD-1-deficient mice markedly protected from the lethality of sepsis, accompanied by a decreased bacterial burden and suppressed inflammatory cytokine response [98] , but also blockade of PD-1 or PD-L1 improves survival in a murine model of sepsis, reverses immune dysfunction, inhibits lymphocyte apoptosis, and attenuates organ dysfunction [99] [100] [101] .
cord-001313-f72hl6du	2014	Balkan endemic nephropathy (BEN) is a familial chronic tubulointerstitial disease with insidious onset and slow progression leading to terminal renal failure. Mutant genes (CELA1, HSPG2, and KCNK5) in BEN patients encode proteins involved in basement membrane/extracellular matrix and vascular tone, tightly connected to process of angiogenesis. Balkan endemic nephropathy (BEN) is a familial chronic tubulointerstitial disease with insidious onset and slow progression to terminal renal failure. In the present study we aimed to perform exome sequencing of 22 000 genes with the Illumina Nextera Exome Enrichment Kit using NGS technology in order to find specific mutations for BEN. have intensively studied the pathological changes in the kidneys of BEN patients and presented evidence that renal vascular changes occur early in Balkan nephropathy [30] . MDR1 haplotypes modify BEN disease risk: a study in Bulgarian patients with Balkan endemic nephropathy compared to healthy controls
cord-001322-7xmxcm35	2014	Phenotypic data was recorded using a robust clinical database allowing a contemporary analysis of the clinical characteristics, microbiology, outcomes and independent risk factors in patients with severe CAP admitted to ICUs across Europe. A number of more recent, larger studies have focussed on identifying patients with CAP at increased risk of severe sepsis and death, as well as those who may require ventilator or vasopressor support [3, [24] [25] [26] . The aim of the study reported here was to define the clinical characteristics, microbiological aetiology, outcomes and independent risk factors for mortality in a large, contemporary cohort of patients with severe CAP admitted to ICUs across Europe. The British Thoracic Society Research Committee and The Public HealthLaboratory Service: The aetiology, management and outcome of severe community-acquired pneumonia on the intensive care unit A five-year study of severe community-acquired pneumonia with emphasis on prognosis in patients admitted to an intensive care unit
cord-001421-6t5puo6p	2014	The serum proteomic profile and routine liver and renal function tests were initially analyzed in a training set of 10 HCV-RNA recurrent LT patients 6 months post LT that showed a fibrosis stage F$1 at 1 year after LT. HVPG was assessed in 53 of these patients and the average value was of 5.560.8 mm Hg. All the serum samples showed a quite similar expression pattern and coincidences included both the different peptide fragments detected and the signal intensity of these fragments (Data S4). All serum samples included in the test set showed an intensity m/z 5905 peak well below the values found in both healthy subjects and non recurrent HCV patients. In conclusion, we identified a 5.9 kDa C-terminal fragment of the fibrinogen a chain as a serum biomarker of early fibrogenic processes in patients with liver disease. In conclusion, we identified a 5.9 kDa C-terminal fragment of the fibrinogen a chain as a serum biomarker of early fibrogenic processes in patients with liver disease.
cord-001493-3yu2di1g	2014	Acute respiratory distress syndrome (ARDS) is defined as an acute-onset, progressive, hypoxic condition with radiographic bilateral lung infiltration, which develops after several diseases or injuries, and is not derived from hydrostatic pulmonary edema. In parallel with progress in understanding the pathophysiology of ARDS, various humoral factors induced by inflammation and molecules derived from activated cells or injured tissues have been shown as potential biomarkers that may be applied in clinical practice. Numerous proinflammatory cytokines play major roles in acute inflammation and the development of inflammatory lung diseases, including ARDS. Increased levels of soluble receptor for advanced glycation end products (sRAGE) and high mobility group box 1 (HMGB1) are associated with death in patients with acute respiratory distress syndrome Neutrophil elastase and systemic inflammatory response syndrome in the initiation and development of acute lung injury among critically ill patients Acute Respiratory Distress Syndrome Network: Plasma surfactant protein levels and clinical outcomes in patients with acute lung injury
cord-001536-ta1i0ata	2014	New studies have suggested strategies to identify patients at risk for resistant pathogen infection and therapies that optimize efficacy, without the overuse of broad-spectrum therapy in patients with healthcare-associated pneumonia. Infections, mostly nosocomial, are a major cause of mortality in hospitalized patients related to an increased risk of infection with multi-drug resistant (MDR) pathogens and the widespread use of indiscriminate broad-spectrum antibiotics. In a study including 519 patients with CAP and 419 with HCAP, the authors compared the performance of Pneumonia Severity Index (PSI) and CURB-65 risk scores for predicting 30-day mortality [20] . Maruyama and colleagues [23] , in a prospective study of 425 patients (CAP = 124, HCAP = 321), applied a therapeutic algorithm based on the presence of MDR risk factors (immunosuppression, hospitalization within the last 90 days, poor functional status indicated by a Barthel Index score <50, and antibiotic therapy within the past 6 months) and severity of illness (need for ICU admission or requiring MV) to determine its impact on outcomes.
cord-001617-ff3j7i7i	2015	BACKGROUND: The benign character formerly attributed to Plasmodium vivax infection has been dismantled by the increasing number of reports of severe disease associated with infection with this parasite, prompting the need for more thorough and comprehensive characterization of the spectrum of resulting clinical complications. We have used a common protocol in order to prospectively follow vivax malaria patients admitted to two distinct reference centers located in Brazil and India, aiming to comprehensively characterize and compare the clinical complications of P. The influence of these factors could already be observed by comparing the descriptions of clinical epidemiology of complications associated with this infection from different sites, showing that in areas of higher transmission intensities, children are the most frequently affected population [18, 19, 39, 40] , while in areas of moderate and low intensities, adults contribute more to the proportion of severe cases [7, 14, 41] .
cord-001661-dj9bxhwb	2015	title: Diffuse alveolar damage associated mortality in selected acute respiratory distress syndrome patients with open lung biopsy INTRODUCTION: Diffuse alveolar damage (DAD) is the pathological hallmark of acute respiratory distress syndrome (ARDS), however, the presence of DAD in the clinical criteria of ARDS patients by Berlin definition is little known. A pathological finding of DAD in ARDS patients is associated with hospital mortality and there are no clinical characteristics that could identify DAD patients before open lung biopsy. The following data were collected from the hospital chart of each patient and analyzed: age, sex, underlying diseases, acute physiology and chronic health evaluation (APACHE) II score on the day of ICU admission [28] , sequential organ failure assessment (SOFA) score on the day of ICU admission and the day of open lung biopsy [29] , lung injury score (LIS) [30] , PaO 2 /FiO 2 ratio, PEEP, tidal volume, diagnostic procedures before open lung biopsy (HRCT or BAL), complications related to surgery (i.e., postoperative air leak, pneumothorax, subcutaneous emphysema, bleeding, and wound infection), pathological diagnosis, hospital mortality, and therapeutic alterations.
cord-001879-bn7h0kcw	2015	In 2012 a randomized, double-blind, placebo-controlled trial based on an independent protocol reviewed by a committee appointed by the National Heart, Lung, and Blood Institute, and conducted in 25 clinical centers under the auspices of the Idiopathic Pulmonary Fibrosis Clinical Research Network (IPFnet) was terminated prematurely when the interim analysis demonstrated that IPF patients treated with combination therapy with prednisone, azathioprine and N-acetylcysteine not only had no evidence of physiological or clinical benefit but presented significantly increased rate of hospitalizations, exacerbations and deaths compared to the placebo arm [5] .
cord-002145-yq7iwp42	2016	title: Clinical profile and outcome of patients with acute kidney injury requiring dialysis—an experience from a haemodialysis unit in a developing country This study was conducted to describe the clinical profile and outcome of adult Acute Kidney Injury (AKI) patients treated with intermittent haemodialysis at the dialysis center of SPHMMC. The aim of this study is to describe the clinical profile and outcome of all adult AKI patients treated with intermittent haemodialysis at the unit in the first 18 months since its establishment. The medical record numbers of all patients dialyzed during the study period were identified from the dialysis unit log book and the clinical records retrieved from the hospital record office. Though difficult to accurately diagnose in our setup due to lack of availability of renal biopsy, AGN (diagnosed through clinical means) was found to be a common cause of AKI requiring dialysis.
cord-002240-38aabxh1	2016	The administration of intravenous immunoglobulins seems to reinforce the immune response to the infection in particular in patients with inadequate levels of antibodies and when an enriched IgM preparation has been used; however, more studies are needed to determinate their impact on outcome and to define the population that will receive more benefit. Despite the use of early and appropriate antibiotic treatment, mortality related to community-acquired pneumonia (CAP) is still high [1] , especially in patients with severe disease. In contrast, another meta-analysis [25] demonstrated a reduction in all causes of mortality in patients receiving corticosteroids (12 trials, 1974 In conclusion, all these studies confirm that the use of corticosteroids in CAP is associated with the following benefits: reduced length of hospital stay, reduced time to clinical stability, and prevention of ARDS. Effect of corticosteroids on treatment failure among hospitalized patients with severe community-acquired pneumonia and high inflammatory response: a randomized clinical trial
cord-002294-qa8e90qv	2016	title: Efficacy of recombinant human soluble thrombomodulin for the treatment of acute exacerbation of idiopathic pulmonary fibrosis: a single arm, non-randomized prospective clinical trial The administration of recombinant human soluble thrombomodulin (rhTM), which has both anti-inflammatory and anticoagulant activities, improves outcomes and respiratory function in patients with acute respiratory distress syndrome. Study data were compared with historical untreated comparison group, including 13 patients with AE-IPF who were treated without rhTM before the registration. Recombinant human soluble thrombomodulin (rhTM) demonstrates anticoagulation effects superior to heparin for the treatment of disseminated intravascular coagulation (DIC) [12] and improves the outcomes and respiratory functions in patients with sepsis-induced acute respiratory distress syndrome (ARDS) [13] . The patients who met any of the following conditions were excluded: 1) those with previous history of AE-IPF; 2) who was receiving corticosteroids or immunosuppressants; 3) who was receiving anti-coagulant therapy; 4) who had intracranial hemorrhage, pulmonary hemorrhage and/or gastrointestinal hemorrhage; 5) those with previous history of hypersensitivity against thrombomodulin; 6) those with active infectious disease; and 7) who was or possibly pregnant at the time of registration.
cord-002514-pp06m5xk	2017	title: Impact of Outpatient Neuraminidase Inhibitor Treatment in Patients Infected With Influenza A(H1N1)pdm09 at High Risk of Hospitalization: An Individual Participant Data Metaanalysis While evidence exists to support the effectiveness of neuraminidase inhibitors (NAIs) in reducing mortality when given to hospitalized patients with A(H1N1)pdm09 virus infection, the impact of outpatient treatment on hospitalization has not been clearly established. In patients with laboratory-confirmed or clinically diagnosed A(H1N1)pdm09 influenza, after adjustment for community-based antibiotic treatment and propensity score, the likelihood of hospital admission in patients with outpatient or community-based NAI treatment was 0.24 (95% CI, 0.20-0.30) when compared to no NAI treatment in the community (Table 2) . Our main findings ( Table 2) suggest that NAI treatment in the community for patients with severe pandemic influenza substantially reduced the likelihood of hospital admission due to influenza A(H1N1)pdm09. Effectiveness of neuraminidase inhibitors in reducing mortality in patients admitted to hospital with influenza A H1N1pdm09 virus infection: a meta-analysis of individual participant data
cord-002626-jzwwses4	2017	Clinical laboratories have thus had to develop new assays or modified the existing FDA-approved ones to detect high-risk HPV genotypes in head and neck cancer specimens. The vast majority of reporting laboratories utilized LDPs. 57 KRAS and RAS family gene mutation analysis is also critical in the management of patients with non-small-cell lung cancer (NSCLC) and other tumors, 58 for which FDA approval of kits has not occurred; LDPs or off-label use of kits is required. 74, 75 The FDA approval of anti-EGFR therapies based on clinical trial outcomes data resulted in the need for clinical laboratories to test tumor tissue for the EGFR-sensitizing mutations in order for patients to be eligible for treatment. During those ground-breaking first 15 years of the targeted cancer therapy era, if the laboratory community had been prohibited from providing high-quality, standardized LDP-based testing under existing CLIA guidelines, the negative consequences to patient care in the past and the future would have been substantial.
cord-002724-gtv9syzi	2017	
cord-002757-upwe0cpj	2017	The first section addresses general considerations, the second section profiles specific infections organized according to mechanism of transmission, and the third section focuses on unique phenotypes and unique susceptibilities in patients with PIDDs. This review does not address most parasitic diseases. In developing countries where polio is still endemic and oral polio vaccine is essential for eradicating the disease, it is of utmost importance that all PIDD patients and family members should not receive live oral polio (OPV) because of the reported prolonged excretion of the virus for months and even years [24] . As for host factors, although severe and fatal cases have been described in healthy immunocompetent hosts [129, 130] , there is evidence to suggest that children under the age of 10 [130] and immunocompromised hosts either secondary to hematologic malignancies, immunosuppressant treatment for organ transplantation, or HIV infection are at a greater risk to develop more severe disease with higher case fatality rates [131, 132] .
cord-002774-tpqsjjet	2017	Results: The CHIP Framework The CHIP framework aims to improve the health and wellness of the urban communities served by St. Josephs Health Centre through four intersecting pillars: • Raising Community Voices provides an infrastructure and process that supports community stakeholder input into health care service planning, decision-making, and delivery by the hospital and across the continuum of care; • Sharing Reciprocal Capacity promotes healthy communities through the sharing of our intellectual and physical capacity with our community partners; • Cultivating Integration Initiatives facilitates vertical, horizontal, and intersectoral integration initiatives in support of community-identified needs and gaps; and • Facilitating Healthy Exchange develops best practices in community integration through community-based research, and facilitates community voice in informing public policy.
cord-002782-mena480g	2017	Our findings suggest that pulmonary function and imaging findings improved during the first 6 months especially for those with ARDS, however long-term lung disability and psychological impairment in H7N9 survivors persisted at 2 years after discharge from the hospital. In survivors of H5N1 virus infection, radiologic abnormalities including ground-glass opacities with a reticular pattern remained evident at the 12-month follow-up visit 10 . A study of the long-term outcomes of survivors with ARDS reported a mild restrictive pattern on lung-function testing, with a mild-to-moderate reduction in carbon monoxide diffusion capacity at 3 months; The median DLCO improved by 9% of the predicted value from 3 to 12 months 13 . A meta-analysis showed that recovery in the HRQoL of ARDS survivors occurred during the first 6 months after discharge 20 , but no significant improvement was evident at the 2-year follow-up in our study. Follow-up study on pulmonary function and lung radiographic changes in rehabilitating severe acute respiratory syndrome patients after discharge
cord-002853-vj8t28hn	2018	BACKGROUND: We report a fatal case of disseminated adenovirus infection in a non-transplant haematology adult patient with chronic lymphocytic leukaemia who had completed combination chemoimmunotherapy a few months before developing respiratory symptoms. CASE PRESENTATION: This case started with an initial bacterial chest infection that responded to treatment, followed by an adenovirus pneumonitis that disseminated to his blood a week later with levels of up to 92 million adenovirus DNA copies/ml. We report here a case of adenovirus pneumonitis which led to a fatal disseminated adenovirus infection in an adult patient with chronic lymphocytic leukaemia (CLL) on chemotherapy. This patient''s chemotherapy regimen included fludarabine which has severe lymphopaenia as a recognised adverse effect, and which has been present in treatment regimens where various other viral reactivations have occurred, including hepatitis B [10] [11] [12] , BK virus [13] , herpes simplex and Epstein-Barr viruses [14] , cytomegalovirus [15] , as well as adenovirus [16] .
cord-002956-e5ihpe4i	2018	title: Ventilator Dependence Risk Score for the Prediction of Prolonged Mechanical Ventilation in Patients Who Survive Sepsis/Septic Shock with Respiratory Failure A total of 379 patients with sepsis or septic shock and acute respiratory failure requiring mechanical ventilation were admitted to the medical intensive care unit in the Kaohsiung Chang Gung Memorial Hospital from August 2013 to October 2015. We also tested and found that SOFA PaO 2 /FiO 2 subscore and GCS subscore on admission day 7 could help predict ventilator dependence on sepsis and septic shock patients with significant difference in univariate analysis ( Table 5 ). Ventilator dependence risk score, including a history of stroke and data from day 7 (thrombocytopenia, acidosis, and the higher fraction of inspired oxygen), can be applied to predict prolonged mechanical ventilation in patients who survive sepsis and septic shock.
cord-002977-o0dvwzxk	2018	Using CLL as a case study, we present a timeline and overview of the current treatment landscape for the radiologist, including an overview of clinical and radiological features of CLL, discussion of the targeted agents themselves, and the role of imaging in response and toxicity assessment. In this review, using CLL as a case study, we summarize the clinical and radiological features of this disease and discuss the various targeted therapies used to treat CLL and other indolent lymphomas, with emphasis on the role of imaging in toxicity assessment. Despite these potential toxicities, each of Fig. 9 a 78-year-old female patient with CLL on treatment with Idelalisib with pneumonitis, axial CT of the chest obtained in arterial phase demonstrates bilateral patchy areas of ground glass and consolidative opacities.
cord-003011-vclnb0eh	2018	title: Predictors of In-Hospital Mortality among Patients with Pulmonary Tuberculosis: A Systematic Review and Meta-analysis The aim of this systematic review and meta-analysis is to identify predictors of in-hospital mortality among patients with PTB. Methods: We searched MEDLINE, EMBASE, and Global Health, for cohort and case-control studies that reported risk factors for in-hospital mortality in PTB. We therefore conducted a systematic review and meta-analysis to establish predictors of in-hospital mortality among patients with pulmonary TB. Eligible trials met the following criteria 1 : cohort or case-control design 2 ; explored risk factors for in-hospital mortality among patients with pulmonary TB in an adjusted analysis. This systematic review and meta-analysis is expected to serve as a basis for evidence to reduce in-hospital mortality in TB patients, and as a guide for future research based on identified knowledge gaps. Predictors of in-hospital mortality among patients with pulmonary tuberculosis: a protocol of systematic review and meta-analysis of observational studies
cord-003198-1kw5v6rm	2018	The following data were collected on a standardized anonymized case record form: demographic characteristics (age, gender), severity scores upon ICU admission (Sequential Organ Failure Assessment [23] and Simplified Acute Physiology Score II [24] ), main comorbidities, delay between first respiratory sign and ICU admission, clinical examination (respiratory and extra-respiratory manifestations) and laboratory findings at the time of ICU admission (blood leukocytes and platelets counts, serum procalcitonine, C-reactive protein, creatine kinase and creatinine levels, PaO 2 /FiO 2 with FiO 2 calculated according to the following formula [25, 26] : FiO 2 = oxygen flow in liter per minute × 0.04 + 0.21 when standard oxygen was used), radiological findings on chest X-ray and CT scan, cytological and bacteriological analyses of broncho-alveolar lavage (BAL) fluid, type of positive autoantibodies (Jo-1, PL7, PL12, OJ, EJ, KS, Zo, YRS/Tyr/ Ha or aMDA-5), immunosuppressive treatments received (corticosteroids, cyclophosphamide, rituximab, basiliximab, tacrolimus, cyclosporine, methotrexate, intravenous immunoglobulins or plasma exchange), organ supports in the ICU (invasive mechanical ventilation, extra-corporeal membrane oxygenation (ECMO), renal replacement therapy, vasopressors), ICU and hospital length of stay, ICU and hospital mortality.
cord-003219-iryb3v0z	2018	title: Predictors of survival in patients with influenza pneumonia-related severe acute respiratory distress syndrome treated with prone positioning CONCLUSIONS: In the present study, in evaluating the effect of prone positioning in patients with influenza pneumonia-related ARDS, pneumonia severity index, renal replacement therapy and increase in dynamic driving pressure were associated with 60-day mortality in patients with influenza pneumonia-related ARDS receiving prone positioning. After multivariate Cox regression analysis, PSI, renal replacement therapy and increased dynamic driving pressure were associated with 60-day mortality in patients with influenza pneumonia-related ARDS receiving prone positioning. The present study in influenza pneumonia-related ARDS patients receiving prone positioning also found that increased dynamic driving pressure (hazard ratio 1.372, 95% confidence interval 1.095-1.718; p = 0.006) was identified as After multivariate Cox regression analysis, it was found that PSI, renal replacement therapy and increased dynamic driving pressure were associated with 60-day mortality in patients with influenza pneumoniarelated ARDS receiving prone positioning.
cord-003291-zuqx6ksy	2018	title: Characteristics and pregnancy outcomes of patients with severe pneumonia complicating pregnancy: a retrospective study of 12 cases and a literature review METHODS: A retrospective cohort study was conducted with 12 patients who were diagnosed with severe pneumonia complicating pregnancy at Peking Union Medical College Hospital between January 2010 and June 2017. High incidences of adverse fetal outcomes were observed; thus, termination of the pregnancy is recommended for patients in their third trimester when respiratory function deteriorates progressively. Several physiological and immunological changes that are experienced during pregnancy, such as altered T lymphocyte immunity, increased oxygen consumption, decreased functional residual capacity, decreased chest compliance, and increased risk of aspiration, may predispose pregnant women to a more severe course of pneumonia, which may result in greater maternal and fetal morbidity and mortality [1, 4] . The patients'' clinical data including symptoms at presentation, laboratory tests, and treatment strategies were reviewed carefully to screen for severe pneumonia.
cord-003376-2qi4aibx	2018	title: Effect of cytomegalovirus reactivation on the time course of systemic host response biomarkers in previously immunocompetent critically ill patients with sepsis: a matched cohort study Cytomegalovirus (CMV) reactivation is observed in 14-41% of intensive care unit (ICU) patients without known prior immune deficiency [1] [2] [3] and is associated with increased morbidity and mortality [4] [5] [6] . Therefore, this longitudinal study aimed to investigate whether the temporal course of seven host response biomarkers, including both pro-and anti-inflammatory cytokines, in previously immunocompetent ICU patients with sepsis differs between patients with and without CMV reactivation. Time trends of various markers within patients were described by symmetric percentage differences relative to their levels 2 days prior to CMV viremia onset (Fig. 2 for primary comparison, Additional file 1: Figure S1 for secondary comparison). We performed an explorative study to compare time trends of host response biomarkers in patients with reactivation that were matched to non-reactivating control patients who were either seropositive or seronegative for CMV.
cord-003404-eqgc8v7y	2019	We aimed to determine the association between G6PD deficiency and severity of dengue infection in paediatric patients in Myanmar. In vitro studies reported that monocytes from G6PD-deficient individuals had increased susceptibility to dengue virus serotype 2 infections along with higher viral replication [5, 6] . Herein, we investigated the association between G6PD deficiency and severity of dengue infection in paediatric patients in Myanmar. Out of 212 enrolled patients, 16 were excluded (2 did not have Glucose-6-phosphate dehydrogenase deficiency on dengue infection in children sufficient blood volume, 11 had a negative dengue result, and 3 lacked quantitative G6PD results). Severe dengue was not associated with a G6PD deficiency phenotype nor genotype variants whether we used a cut off of < 30% (i.e. only including hemizygous males and homozygous females) or a cut off of < 60%, corresponding to classes I to III of the WHO classification (Table 5) .
cord-003446-yp5d29fk	2017	A 79-year-old gentleman presented with spontaneous pneumomediastinum and subcutaneous emphysema with pneumonia but no pre-existing lung disease. After 4 days of intravenous antibiotics, the patient developed considerable subcutaneous emphysema and pneumomediastinum. Pneumomediastinum presents most commonly with chest pain, shortness of breath, and subcutaneous emphysema. Treatment of pneumomediastinum is typically conservative, and although options may be limited, aggressive management of any causative factor may be essential in selected cases. A case of spontaneous pneumomediastinum and subcutaneous emphysema in a 79-year-old gentleman with pneumonia but no pre-existing lung disease is presented. A 79-year-old gentleman presented with a 4-day history of increased shortness of breath, pleuritic chest pain, fevers, and non-productive cough. A repeat chest x-ray showed extensive subcutaneous emphysema and led to a diagnosis of suspected pneumomediastinum. Pneumomediastinum presents most commonly with chest pain, shortness of breath, and subcutaneous emphysema but rhinolalia, cough, neck pain, emesis, and dysphagia are also possible [4] .
cord-003520-f3jz59pt	2019	title: Free Fatty Acids'' Level and Nutrition in Critically Ill Patients and Association with Outcomes: A Prospective Sub-Study of PermiT Trial Objectives: The objectives of this study were to evaluate the clinical and nutritional correlates of high free fatty acids (FFAs) level in critically ill patients and the association with outcomes, and to study the effect of short-term caloric restriction (permissive underfeeding) on FFAs level during critical illness. Conclusion: We conclude that high FFAs level in critically ill patients is associated with features of metabolic syndrome and is not affected by short-term permissive underfeeding. The aims of this study were (1) to evaluate the clinical and nutritional correlates of high FFAs level in critically ill patients and the association with outcomes, and (2) study the effect of short-term caloric restriction (permissive underfeeding) on FFAs level during critical illness.
cord-003532-lcgeingz	2019	
cord-003533-8m0vyxq8	2019	We present a case series of severe leptospirosis with cardiac involvement observed during a period of one month at Colombo-North Teaching Hospital, Sri Lanka. CASE PRESENTATION: We report here five patients with severe leptospirosis complicated with cardiac involvement, admitted to a single medical ward, Colombo-North Teaching Hospital, Sri Lanka during a one-month period. In this case series, we describe a series of male patients with severe leptospirosis with cardiac involvement, presented to a single medical ward during a period of one month. By day eleven of illness he was completely recovered clinically and full blood count, liver function tests, renal function tests and ECG were normal. Patient was discharged from the ward on day 7 of illness with complete recovery and normal full blood count, renal and liver function tests. Despite adequate fluid resuscitation patient developed shock with low urine output on the same day of admission.
cord-003615-vpzzsdld	2019	Trauma leads to the dysregulation of both the innate and adaptive immune responses, which places the injured at risk for several late consequences, including delayed wound healing, late onset sepsis and infection, multi-organ dysfunction syndrome, and acute respiratory distress syndrome, which are significant for their association with the increased morbidity and mortality of wounded personnel. Patients with less severe trauma may develop late MODS due to new surgical stress, general anesthesia, transfusion of blood products, infection, or ischemia/reperfusion injury triggering the reactivation of the inflammatory response in a "two-hit" model of MODS [19, 58] . Among these consequences, delayed wound healing, late onset sepsis and infection, multi-organ dysfunction syndrome, acute respiratory distress syndrome, and persistent inflammation-immunosuppression and catabolic syndrome are significant in their association with the increased morbidity and mortality of wounded personnel.
cord-003686-1pfk4qve	2019	The majority of NOD-like receptors such as NLRP1, NLRP3, NLRC4, NLRP6, and NLRP12 can interact with apoptosis-associated speck-like protein containing a caspase-recruitment domain (ASC) and caspase-1, and the resulting complex is a sensor of cell injury called "inflammasome", an interleukin (IL)-1β-processing platform that plays a crucial role in IL-1β maturation and secretion from cells. NLRP3 inflammasomes have also been reported to be involved in low-grade subclinical inflammation induced by chronic exposure to high levels of free fatty acids and glucose, leading to increased apoptosis and impaired insulin secretion of β-cells in obese type 2 diabetes mellitus (T2D) patients [102] [103] [104] . Canakinumab and anakinra were also effective for patients with Schnitzler syndrome, an adult-onset autoinflammatory disease characterized by focal urticaria and systemic inflammation including fever with bone and muscle pain, in the first placebo-controlled study, and several clinical trials are currently ongoing [186] [187] [188] [189] .
cord-003701-i70ztypg	2019	Based upon observational data that suggest harms, adjunctive corticosteroid treatment is currently not recommended for children or adults hospitalized with influenza, including critically ill patients, unless clinically indicated for another reason, such as treatment of asthma or COPD exacerbation, or septic shock. No completed randomized, placebo-controlled trials of antiviral treatment have been conducted in hospitalized influenza patients to establish the efficacy of oseltamivir or other NAIs. A number of observational studies have reported clinical benefit of neuraminidase inhibitors in hospitalized patients, including reduction in duration of hospitalization and risk of death, including in ICU patients [67] [68] [69] [70] [71] [72] [73] [74] . A cohort study of early versus late oseltamivir treatment reported a significant reduction in mortality and median duration of ICU hospitalization in severely ill patients with influenza A(H3N2), but not A(H1N1pdm09) or B virus infection in Greece [78] .
cord-003798-nki2sasr	2019	BACKGROUND: Information on the clinical, epidemiological and molecular characterization of human metapneumovirus in critically ill adult patients with severe community-acquired pneumonia (CAP) and the role of biomarkers identifying bacterial coinfection is scarce. METHODS: This is a retrospective epidemiological study of adult patients with hMPV severe CAP admitted to ICU during a ten-year period with admission PSI score ≥ 3. The main objective of this study was to describe the clinical and epidemiological characteristics of adults with severe pneumonia caused by hMPV who required intensive care unit (ICU) admission, over a long period of time. Interestingly, three patients (10.7%) were young adult patients without comorbidities and without bacterial coinfection that developed ARDS pointing out a main role of hMPV in the etiology of severe respiratory infections requiring mechanical ventilation. Main characteristics of immunosuppressed adult patients admitted to the Intensive Care Unit due to a severe community-acquired pneumonia associated with human metapneumovirus infection (Guipuzcoa, Basque Country, Spain, 2007-2017).
cord-003828-bhfghcby	2019	In contrast to these case series, a case-control study (evidence class II) (48) including more than 440 patients with MS or optic neuritis and 950 controls without any underlying neuroimmunological disorder did not reveal an elevated risk for the development of MS or optic neuritis after immunization against hepatitis B, tetanus, influenza, measles/mumps/rubella, measles, or rubella (49) . While Hernan came to same results for immunization against influenza or tetanus in a case-control study (evidence class II), active immunization against hepatitis B was reported to pose a higher risk for MS (50) . A case-control study on vaccination against hepatitis B, influenza, polio, diphtheria, pertussis, tetanus, measles, mumps, rubella, Japanese encephalitis, meningitis, hepatitis A, varicella and rabies did not reveal an increased risk for the onset of ADEM in the time spans of 0-30 days and 61-180 days after vaccination, but between 31 and 60 days (78) .
cord-003832-q1422ydi	2019	title: Biomarker profiles of coagulopathy and alveolar epithelial injury in acute respiratory distress syndrome with idiopathic/immune-related disease or common direct risk factors This study aimed to investigate the biomarker profiles of coagulopathy and alveolar epithelial injury in two subtypes of ARDS: patients with direct common risk factors (dARDS) and those with idiopathic or immune-related diseases (iARDS), which are classified as "ARDS without common risk factors" based on the Berlin definition. Although no risk factors or causes are identified in this subgroup of ARDS, recent studies have shown that many patients with idiopathic interstitial pneumonia have clinical features that suggest an underlying immune process, indicating that the pathobiology of idiopathic and immunerelated diseases may partially overlap [9, 10] . The aim of this study was to examine the profiles of the plasma biomarkers that reflect coagulopathy and alveolar epithelial injury in patients with idiopathic/immune-related ARDS (iARDS) and in those with common direct risk factors (dARDS).
cord-004096-obrq7q57	2020	OCR: oculocephalic reflex BRASS is a clinical score that has been developed for scoring brainstem dysfunction in deeply sedated, non-brain-injured, mechanically ventilated, critically ill patients and ranges from 0 to 7 The BRASS has prognostic value, as 28-day mortality proportionally increases with the BRASS score applicable to ICU patients. The "brainstem dysfunction" hypothesis originates from our study on usefulness of neurological examination in non-brain-injured critically ill patients who required deep sedation. In deeply sedated non-brain-injured critically ill patients, the cessation of brainstem responses follows two distinct patterns. Middle latency BAEP responses and SSEP latencies were increased in 24% and 45% of deeply sedated non-brain-injured critically ill patients, respectively [34] , indicating an impairment of the brainstem conduction. Brainstem dysfunction can present with central sensory and motor deficits, cranial nerve palsies and abnormal brainstem reflexes, disorders of consciousness, respiratory failure, and dysautonomia.
cord-004147-9bcq3jnm	2020	title: New-onset atrial fibrillation and associated outcomes and resource use among critically ill adults—a multicenter retrospective cohort study CONCLUSIONS: While NOAF was not associated with death or requiring discharge to long-term care among critically ill patients, it was associated with increased length of stay in ICU and increased total costs. We primarily sought to evaluate the association between NOAF and outcomes, resource utilization, and costs among critically ill adult patients. However, NOAF was associated with higher hospital mortality among ICU patients with suspected infection (aOR 1.21 [95% CI 1.08-1.37]), sepsis (aOR 1.24 [95% CI 1.10-1.39]), and septic shock (aOR 1.28 [95% CI 1.14-1.44]). Among patients with NOAF, factors associated with increased risk of hospital mortality included increasing age, increased MODS score, history of CHF (as identified in the Data Warehouse), and sustained AF (Additional file 5: Table S5 ).
cord-004186-m817oudw	2020	title: Anesthetic management of a patient with a continuous-flow left ventricular assist device for video-assisted thoracoscopic surgery: a case report Here, we present the anesthetic management of a patient with a continuous-flow LVAD who underwent video-assisted thoracic surgery (VATS). In the present case, when the patient was set in a lateral decubitus position and progressive hypoxia was observed during OLV, transesophageal echocardiography demonstrated a dilated right ventricle and a temporally flattened interventricular septum, and the central venous pressure increased to approximately 20 mmHg. Because we anticipated deterioration of right heart function, dobutamine and milrinone were administered and/or respirator settings were changed to decrease PVR for maintaining LVAD performance. CONCLUSIONS: The anesthetic management of a patient with LVAD during VATS is challenging because the possible hemodynamic changes induced by hypoxia associated with OLV affect LVAD performance and right heart function. Anesthetic management of patients with continuous-flow left ventricular assist devices undergoing noncardiac surgery: an update for anesthesiologists
cord-004263-m1ujhhsc	2020	title: The effect of cisatracurium infusion on the energy expenditure of critically ill patients: an observational cohort study METHODS: We studied a cohort of adult critically ill patients requiring invasive mechanical ventilation and treatment with continuous infusion of cisatracurium for at least 12 h. CONCLUSIONS: Our data suggest that continuous infusion of cisatracurium in mechanically ventilated ICU patients is associated with a significant reduction in EE, although the magnitude of the effect is small. Our data suggest that continuous infusion of cisatracurium in mechanically ventilated ICU patients is associated with a significant reduction in EE as estimated by the VCO 2 method, although the magnitude of the effect is small. Validation of carbon dioxide production (VCO2) as a tool to calculate resting energy expenditure (REE) in mechanically ventilated critically ill patients: a retrospective observational study
cord-004310-hl7fa4af	2020	We recorded patient information, including age, sex, surgical procedure, and daily severity data (including severity of organ dysfunction and sedative/muscle relaxant dosages) during PICU stays for five days after the end of muscle relaxant usage. We found that, overall, the amount of MDZ administered was increased in DS versus controls after ending muscle relaxants and observed the reduced sedative effect of MDZ for DS patients while DEX was not different as estimated by Bayesian inference modeling. To adjust these biases, we used multivariate www.nature.com/scientificreports www.nature.com/scientificreports/ analysis with respect to these factors but we also "double checked" our results by using the demographic data propensity score for DS patients as a covariate in Bayesian inference modeling. To conclude, we conducted a retrospective study based on validated evaluative tools that indicated a need for higher doses of MDZ with higher doses of compensating sedatives for the 5-day period immediately after muscle relaxant usage following pediatric heart surgery.
cord-004314-gtwtakpr	2020	METHOD: A systematic search of papers published between 2002 and July 2019 was conducted in the Embase, AMED, PsycINFO, MEDLINE, CINAHL, and COCHRANE databases to identify studies reporting qualitative interviews addressing HCPs'' experiences working with adults with COPD, CKD or type 2 diabetes. A research group comprising 10 senior researchers (the authors), with a professional background in either nursing or physiotherapy and qualified in realist and interpretive qualitative research methods, conducted a systematic literature review of qualitative papers concerning HCPs'' experiences working with patients with type 2 diabetes, CKD, and COPD. Based on our analysis of the results chapters of the included studies, three main themes were identified and developed, each addressing our overall aim to describe HCPs'' experiences working with patients with long-term chronic diseases: individualizing the professional approach within the clinical encounter; managing one''s emotions over time; and working to maintain professionalism (Table 4 ).
cord-004339-7nwpic3d	2020	Secondly, consent to have the discussion about the NAIROS trial with the investigator audio-recorded and their details passed onto • Any prior septal surgery • Systemic inflammatory disease or the use of any current oral steroid treatment within the past 2 weeks • Granulomatosis with polyangiitis • Nasendoscopic evidence of unrelated associated pathology, e.g. adenoid pad, septal perforation, chronic rhinosinusitis indicated by the presence of polyposis or pus • Any history of intranasal recreational drug use within the past 6 months • Breast-feeding, pregnancy or intended pregnancy for the duration of involvement in the trial • Bleeding diathesis • Therapeutic anticoagulation (warfarin/novel oral anti-coagulant (NOAC) therapy) • Clinically significant contraindication to general anaesthesia • Patients known to be immuno-compromised • Those in whom an external bony deformity substantially contributes to the nasal obstruction a member of the qualitative team for a telephone interview.
cord-004342-9uok77wb	2020	title: Elderly versus non-elderly patients undergoing surgery for left-sided native valve infective endocarditis: A 10-year institutional experience This retrospective study aimed to clarify the shortand mid-term outcomes of elderly patients who underwent surgery to treat left-sided native valve infective endocarditis (LSNIE). The elderly group had a higher predicted mortality rate and a lower incidence of preoperative septic emboli-related complications. In this single-centre study, a comparative cohort of patients who underwent surgical treatment for active LSNIE is presented, which includes 38 elderly patients aged >65 years. Due to the increase in average life expectancy and the higher incidence of cardiovascular disease with advancing age, more elderly patients nowadays present for cardiac surgery 22 . Therefore, we suggest that a guideline-directed surgical strategy according to the presence of complications, which include embolism events, large vegetation, heart failure, or uncontrolled infection, would be beneficial to improve the mid-term outcomes of elderly patients with LSNIE.
cord-004379-91a7sgir	2020	The aim of this study was to evaluate age-related clinical manifestations of adverse events (AEs) related to NAIs. FAERS and WebMD data were downloaded. A disproportionality analysis showed that signals for vomiting and hallucinations were detected in younger patients given oseltamivir, while an abnormal hepatic function, cardiac failure, shock, and cardio-respiratory arrest were detected in older patients given peramivir. However, there is still concern regarding the adverse effects of NAIs. This study analyzed the age-related AEs associated with NAIs using data from FAERS and WebMD. Oseltamivir was the NAI most commonly showing AEs in the FAERS data, and the most common AEs for this drug were psychiatric and gastrointestinal disorders, similar to the findings of previous studies 8, [13] [14] [15] [16] . However, in the WebMD data, we could not detect signals by these disproportionality analyses due to the small number of AE cases, although psychiatric and gastrointestinal disorders were the most common AEs reported.
cord-004404-s6udpwxq	2020	METHODS: This is a prospective, single-center, double-blind, parallel randomized controlled trial with the aim to evaluate the effects of synbiotic supplementation on energy and macronutrient homeostasis and muscle wasting in critically ill patients. DISCUSSION: Gut microbiota modulation through synbiotics is proposed to improve clinical prognosis and reduce infectious complications, ventilator dependency, and length of ICU stay by improving energy and macronutrient homeostasis and reducing muscle protein catabolism. Previous studies suggest that modulating gut microbiota by novel therapeutics, such as prebiotics, probiotics, or synbiotics, can have an effect on gastrointestinal tolerance and complications of enteral nutrition, which eventually lead to the regulation of energy intake. Considering the extreme dysbiosis in critically ill patients and related energy and macronutrients homeostasis disturbance and muscle wasting, prompted us to evaluate the effect of synbiotic supplementation on the elimination of this condition. The primary objective is to evaluate the effects of synbiotic supplementation on energy and macronutrient homeostasis and muscle wasting in patients under critical care.
cord-004450-daxz9yhp	2020	Several preclinical studies have revealed a beneficial effect of iloprost on the control of pulmonary inflammation, and in a small number of patients with ARDS, iloprost treatment resulted in improved oxygenation. For safety reasons, after treatment of 100 patients (day 28 after last dose investigational medicinal product [IMP] Patient 100) within the study, an interim analysis for an increased risk for pulmonary hemorrhage ≥ grade III according to Common Terminology (Toxicity) Criteria for Adverse Events (CTCAE) Version 5.0 in the treatment (iloprost) arm will be performed and the results discussed with the Data and Safety Monitoring Board (DSMB). When possible, however, the patient or his legal representative is to be informed both in writing and verbally by the investigator before any study-specific procedure is Iloprost or NaCl 0.9% (control) X X X X X Clinical assessment including outcome X X X X X X X X X Laboratory testing X X X X X X X X Adverse/serious adverse event monitoring X X X X X X X Plasma biomarkers X X X X X X Barthel Index X X X X SOFA score X X X X X X X X Health-related questionnaire X VES X performed.
cord-004464-nml9kqiu	2020	title: Predicting the microbial cause of community-acquired pneumonia: can physicians or a data-driven method differentiate viral from bacterial pneumonia at patient presentation? Whether the etiology of CAP is viral or bacterial should be determined based on the patient interview, clinical symptoms and signs, biological findings and radiological data from the very first hours of the patient''s presentation (a time when microbiological findings are typically not yet available). The aim of our study was to evaluate and compare the abilities of experienced physicians and a data-driven approach to answer this simple question within the first hours of a patient''s admission to the ICU for CAP: is it a viral or a bacterial pneumonia? Step 2: clinician and data-driven predictions of microbial etiology Clinicians and a mathematical algorithm were tasked with predicting the microbial etiology of pneumonia cases based on all clinical (43 items), and biological or radiological (17 items) information available in the first 3-h period after admission except for any microbiological findings (Supplementary Table 1 ).
cord-004515-x22q1f21	2020	
cord-004532-flo9139j	2004	The authors concluded that their findings are important for trial design because of the observed differences in outcome, and proposed the use of standardized ventilator settings for patient enrollment. As indicated by Yu and Singh [46] , "over 300 studies have been published in peer-review journals in the past 8 years dealing with management of ventilator-associated pneumonia (VAP)." However, no consensus exists to date on the best way for identifying patients with true lung infection, for selecting early appropriate antimicrobial therapy, or for avoiding unnecessary use of antibiotics. [52] designed a study in 108 patients with 171 VAPs to assess the impact on the duration of MV and the use of antibiotic treatment of the results of a diagnostic technique: the percentage of infected cells in liquid obtained with BAL, i.e., the value of direct examination.
cord-004636-t6qldq3s	2020	In the original data set, 8.8% of the intraoperative MAP measurements were > 100 mmHg and 4.3% were < 55 mmHg. After automated and manual correction 7.3% (automated) or 7.3% (manual) of MAP measurements were > 100 mmHg and 2.0% (automated) or 2.1% (manual) were < 55 mmHg. The authors discuss potential limitations of the proposed algorithm during episodes with high blood pressure variability as it may be difficult to distinguish real variation from artifacts. The authors included 2273 cases with intra-arterial blood pressure measurements and analyzed changes in intraoperative SAP in four different age groups. In a pilot study, Pybus [38] investigated the feasibility of performing real-time spectral analyses of the respiratory and arterial pressure waveform in 60 cardiac surgical patients and assessed the clinical utility of this technique to predict fluid responsiveness.
cord-004643-uu4uipfy	2020	Here, we present a fatal case of HLH secondary to cytomegalovirus (CMV) infection complicated by both anti-viral drug resistance and sepsis from multiple MDROs including pandrug-resistant superbug bacteria. Whole genome sequencing (WGS) of the MDR bacteria and metagenomic analysis of his blood sample revealed an unusual accumulation of a wide range of antimicrobial resistance mechanisms in a single patient, including antiviral resistance to ganciclovir, and resistance mechanisms to all currently available antibiotics. Ganciclovir resistance was confirmed by the presence of the A594V mutation in UL97 [6] What was unique in our patient compared to other reported CMV-associated HLH cases was the overwhelming infection with MDROs. On hospital admission, the patient was found to be colonized with multiple MDROs including VRE, and carbapenamase-producing Enterobacteriaceae, which may have been acquired during his previous hospital course in India.
cord-004646-zhessjqh	2020	title: Adjunct low-dose ketamine infusion vs standard of care in mechanically ventilated critically ill patients at a Tertiary Saudi Hospital (ATTAINMENT Trial): study protocol for a randomized, prospective, pilot, feasibility trial The 2018 Pain, Agitation/sedation, Delirium, Immobility, and Sleep disruption guideline suggested low-dose ketamine infusion as an adjunct to opioid therapy to reduce opioid requirements in post-surgical patients in the intensive care unit (ICU). Therefore, we propose a prospective, randomized, active controlled, open-label, pilot, feasibility study to assess the effect and safety of Analgo-sedative ad-juncT keTAmine Infusion iN Mechanically vENTilated ICU patients (the ATTAINMENT trial) compared to standard of care alone. Physician decline after randomization Ketamine will be discontinued Subject will be included in the data analysis a In cases of death (either within the first 48 h, until ICU or hospital discharge, or 28 days after randomization, whichever comes first), detailed documentation will be carried out in the medical record for the cause of death, group allocation, and relation to study protocol allocation and initiation of the trial intervention.
cord-004675-n8mlxe7p	2019	
cord-004894-75w35fkd	2006	
cord-004949-icsey27p	2014	The objective of this study was to compare systemic and local cytokine profiles and neutrophil responses in patients with severe versus non-severe community-acquired pneumonia (CAP). Compared to non-severe CAP patients, the severe CAP group showed higher plasma levels of proand anti-inflammatory cytokines but in contrast, lower sputum concentrations of pro-inflammatory cytokines. The objectives of this study were to characterize and contrast the lung and systemic cytokine profiles as well as blood neutrophil responses in patients with severe versus non-severe CAP at the time of hospital admission. In order to compare results of the plasma cytokines and neutrophil functional assays from CAP patients with those of healthy individuals, blood samples were also obtained from a control group (n=12) of healthy adult donors (approved by the University of Louisville′s IRB #191.06). Generally, patients in the severe CAP group showed a pattern with median plasma concentrations of both pro-and anti-inflammatory cytokines that were higher in comparison with the non-severe CAP group and the healthy control group.
cord-004986-en7taikk	2002	Dans 44 h 68 % des patients sida prEsentant une entEropathie due ~un ou plusieurs agents pathogEnes concomitant, des symptEmes gastro-intestinaux sont retrouvEs. Le diagnostic d''infections opportunistes est en gEnEral base sur une combinaison de culture de selles, examen direct des selles ~ la recherche d''ceufs ou de larves, et d''une biopsie endoscopique. L''infection herpEtique semble 6tre plus frEquente chez le patient HIV que chez les autres patients immunodEprimEs. Dans une importante Etude prospective r6alisEe sur 100 patients HIV pr6sentant une cesophagite her-pEtique, le virus HSV n''a 6tE identifi6 que darts 5 % des cas alors que la prevalence du virus CMV atteignait 50 % [4] . Les infections ~ Campylobacter ont 6t6 identifi6es dans approximativement 11% des coprocultures des patients sida, qu''ils souffrent ou non de diarrh6es ; ces patients, pr6sentant une incidence d''infection, sont 39 fois plus importants que dans la population g6n6rale. Cependant une colonisation m6me par des agents non pathog6nes peut 8tre responsable d''affections s6vhres chez les patients immunocompromis [6] .
cord-005105-twsy61oq	2015	Th e present study is based on a retrospective analysis of a database of over 600 patients (age range 17-57 years) who met the consensus criteria for bacterial prostatitis, 75% of whom had dysuria, 35% perineal discomfort, 60% had obstructive luts, 37% infertility of unknown etiology, 10% erectile dysfunction and 25% recurrent infection of the partner. Further research is needed to determine to assess whether localization of small volume disease on 68Ga-PSMA PET/CT can improve diagnostic algorithms and outcomes in patients with recurrent PCa. Introduction and Objective: To assess long-term results of salvage pelvic lymph node dissection (PLND) in prostate cancer (PC) patients (pts) with biochemical recurrence aft er primary local treatment and confi rmed solitary lymph node (LN) metastases.
cord-005147-mvoq9vln	2017	Using whole-exome sequencing and trio-based de novo analysis, we identified a novel heterozygous de novo frameshift variant in the leukemia inhibitory factor receptor (LIFR) gene causing instability of the mRNA in a patient presenting with bilateral CAKUT and requiring kidney transplantation at one year of age. Loss of cdkl5 associated with deficient mammalian target of rapamycin (mTOR) signaling in mice and human cells We and other groups have shown that mutations in the X-linked cyclin-dependent kinase-like 5 (CDKL5) gene cause a severe neurodevelopmental disorder with clinical features including intellectual disability, early-onset intractable seizures and autism, that are closely related to those present in Rett syndrome (RTT) patients. Functional characterization of novel GNB1 mutations as a rare cause of global developmental delay Over the past years, prioritization strategies that combined the molecular predictors of sequence variants from exomes and genomes of patients with rare Mendelian disorders with computer-readable phenotype information became a highly effective method for detecting disease-causing mutations.
cord-005420-60ie0pfd	1998	title: Bacteraemia during the aplastic phase after allogeneic bone marrow transplantation is associated with early death from invasive fungal infection Episodes of bacteraemia during the aplastic phase were studied in 500 allogeneic bone marrow (BMT) recipients, regarding incidence, microbial aetiology, risk factors, mortality and causes of death. Among patients with negative blood cultures during the aplastic phase, 6/25 died of invasive fungal infection (three candida, one saccaromyces and two aspergillus). Invasive candida infection was defined as either candidaemia, and/or positive cultures from at least two organs, except the gastrointestinal tract when obtained at autopsy, in patients who died within 60 days after BMT. Risk factors analysed were recipient age and gender, donor age and gender, pretransplant diagnosis, disease stage (low risk for transplantation-related mortality (TRM): acute leukaemia in 1st complete remission, CML 1st chronic phase, aplastic anaemia, metabolic disorders; high risk for TRM: others), pretransplant serology for cytomegalovirus (CMV) and herpes simplex virus (HSV) in the recipient, HLAmatch, related and unrelated donors, conditioning regimen (TBI or not), splenectomy, type of GVHD prophylaxis and bone marrow cell dose.
cord-005425-0hxow3sj	2006	title: Phase II study of unrelated cord blood transplantation for adults with high-risk hematologic malignancies In order to overcome this barrier, we investigated a strategy by which patients without higher priority donors were to be transplanted with an unrelated CB unit that should contain at least 2 Â 10 7 total nucleated cells (TNCs)/kg of recipient weight. Here, we report the results of a phase II trial that enrolled heavily pretreated patients with high-risk hematologic malignancies that was prematurely interrupted owing to high rates of engraftment failure and excessive mortality. Transplants of umbilical cord blood or bone marrow from unrelated donors in adults with Acute Leukemia Outcomes after transplantation of cord blood or bone marrow from unrelated donors in adults with leukemia Hematopoietic engraftment and survival in adults recipients of umbilical-cord blood from unrelated donors Successful engraftment after reduced-intensity umbilical cord blood transplantation for adult patients with advanced hematological diseases
cord-005452-ouookpd8	1999	title: Successful non-invasive ventilatory support in a patient with regimen-related toxicity during allogeneic bone marrow transplantation A 13-year-old patient with transfusion-dependent β thalassemia major developed acute regimen-related lung toxicity after the conditioning regimen but before allogeneic bone marrow transplantation. Advances in non-invasive ventilatory support may drastically improve the outlook of this subset of patients who otherwise have a grim prognosis Rabitsch et al 1 reported successful management of adult respiratory distress syndrome by non-invasive ventilatory support. On this intermittent CPAP the patient steadily improved, received his allogeneic marrow graft from his brother engrafting by day +9. It has also been suggested that this modality of management should be severely restricted 3 in allogeneic BMT patients, particularly during their first +100 days. Successful management of adult respiratory distress syndrome (ARDS) after high dose chemotherapy and peripheral blood progenitor cell rescue by non-invasive ventilatory support Non-invasive pressure support ventilation in patients with acute respiratory failure.
cord-005453-4057qib7	2019	To compare the safety and efficacy of prophylactic DLI for prevention of relapse after allogeneic peripheral blood stem cell transplantation from haploidentical donors (HID-SCT) and matched-sibling donors (MSD-SCT) in patients with very high-risk acute myeloid leukemia (AML), we performed a retrospective, observational cohort study enrolled in 21 HID-SCT and 13 MSD-SCT recipients. The aim of this study is to identify the prognostic impact of pre-transplant TIM3 levels on early and late transplant related complications as well as post-transplant relapse and survival Methods: A total of 177 hematopoietic stem cell transplantation (HSCT) recipients with an initial diagnosis of acute leukemia [median age: 36(16-66) years; male/ female: 111/66] were included in the study.
cord-005460-ezrn8cva	2017	Still the optimal combination of immunosuppressive agents with PTCy should be elucidated for different types of SCTs. We report the 2-year update of the prospective NCT02294552 single-center trial that evaluated risk-adapted graft-versushost disease (GVHD) prophylaxis with PTCy in related, unrelated and haploidentical SCTs. 200 adult patients (median age 32 y.o., range: 18-62) with hematologic malignancies, including AML (47.5%), ALL (26.5%), CML (10.5%), MDS (4%), and lymphomas (11.5%), were enrolled in the study. Long-term follow-up from the prospective randomized phase III multicenter trial comparing a standard GvHD prophylaxis with cyclosporine A and methotrexate with or without additional pretransplant ATLG (Grafalon, previously ATG-FRESENIUS S) (given 20 mg/kg/day, days − 3 to − 1) in unrelated donor hematopoietic cell transplantation after myeloablative conditioning resulted in a significant reduction of acute and chronic GvHD without compromising relapse rate and survival [1, 2, 3] .
cord-005478-5iu38pr6	2019	There were some differences among groups: patients in group-1 were younger (median age 46 years, p< 0.02) were transplanted in more recent year (2015, p< 0.001), received more frequently a regimen based on TBF (thiotepa, fludarabine and busulfan) (83%, p< 0.001) and bone marrow (BM) as source of stem cells (77%, p< 0.001), with no ATG (100%, p< 0.001). Clinical Trial Registry: NCT01217723 Disclosure: None of the Authors have any conflicts of interest to declare O105 Immune reconstitution -based score at diagnosis of CGVHD predicts GVHD severity and overall-survival: A novel prognostication tool for GVHD treatment tailoring Background: Allogeneic stem cell transplantation (HSCT) survivors are at a relevant risk of developing chronic GvHD (cGvHD), which importantly affects quality of life and increases morbidity and mortality.
cord-005480-yg7salqt	2008	Standard NIH or Eurolupus cyclophosphamide (CY) protocols and mycophenolate Mofetil (MMF) as induction therapy in severe BILAG A SLE is still associated with 20 % failure, 50% relapse and 10% to 15 % death at 10 years In the absence of a single standard treatment worldwide for refractory SLE, phase I-II studies analysed the use of: a) rituximab (anti CD20 mAb) in more than 1 000 patients showing complete to partial early response around 100% with relapse in 50 to 60% of the cases; b) autologous Hematopoietic Stem Cell Transplantation (HSCT) since 1997 under the auspices of the joined EBMT-EULAR working party, reporting durable remission with reduced or no immunosuppressive drug requirement in 66%, one-third of whom later relapsed to some degree with a 74 ± 7% (n= 62/79) overall survival at 5 years for SLE among the 863 HSCT procedures registered: in 2007 in the EBMT data base.
cord-005481-00rezmqj	2001	[21] [22] [23] Tumor-selective viral replication and necrosis were demonstrated, and the treatment was well-tolerated without dose-limiting toxicities; flu-like symptoms and injection site pain were frequently noted. [24] [25] [26] [27] While all recurrent head and neck cancer patients on the combination viral and chemo-therapy clinical trial received intravenous chemotherapy (cisplatin and 5-fluorouracil), the response rate of tumors injected with ONYX-015 was significantly higher than in tumors that were not injected. Therefore, based on the favorable clinical toxicity and efficacy profile with intratumoral injection, and preclinical efficacy following intravascular administration, we performed a phase I/II dose escalation trial of ONYX-015 administered via the hepatic artery to patients with metastatic gastrointestinal carcinomas (primarily colorectal) to the liver. We performed a phase I dose-escalation trial of the replication-selective adenovirus ONYX-015 administered by hepatic arterial infusion, alone and in combination with intravenous 5-FU and LV, in patients with liver metastases from gastrointestinal carcinomas.
cord-005482-v5iayczy	2016	Material (or patients) and methods: Case Report 23-year-old male patient who underwent allogeneic hematopoietic stem cell tranplantation sixteen months ago, admitted to bone marrow transplantation clinic for shortness of breath. Material (or patients) and methods: Data sets of 436 consecutive patients who underwent allogeneic HSCT at a single center (University of Rostock) from 1998 to 10/2015 were analysed regarding their early mortality rates (d+30, d+60 Introduction: Mobilization and collection of CD34-positive stem cells for subsequent high-dose chemotherapy constitutes a standard approach in myeloma patients achieving a good remission after induction chemotherapy. Outcomes of high grade gastrointestinal gvhd post-hsct in children Material (or patients) and methods: This is a retrospective analysis of 28 pediatric patients presented with a clinical diagnosis of stage 3 and 4 acute GVHD of the GIS who were selected from allogeneic hematopoetic stem cell transplantation (HSCT) performed.
cord-005487-vac061r8	2010	We retrospectively analyzed 1257 patients (pts), 755 children (age≤18) and 502 adults, receiving fi rst single (n = 1080) or double UCBT (n = 177) in EBMT centers, between 1995 and 2009 , for malignant and non-malignant diseases, who survived at least 100 days from transplantation with neutrophils recovery and without relapse or autologous reconstitution. Prochymal® improves response rates in patients with steroid-refractory acute graft-versus-host disease involving the liver and gut: results of a randomized, placebo-controlled, multicentre phase III trial in GvHD P.J. Martin (1) , J.P. Uberti (2) Background and methods: Steroid-refractory acute GVHD (SR-GVHD) remains a signifi cant and life-threatening complication of allogeneic hematopoietic cell transplantation (HCT). A. Nagler (1) Background: Allogeneic transplantation of hematopoietic stem cells (allo-SCT) from an HLA-matched related (MRD) or unrelated donor (URD) is a curative option for patients (pts) with high-risk hematological disease (HRHD).
cord-005496-cnwg4dnn	2020	Whereas humans develop generalized concepts on the basis of just a few examples, training a machine learning algorithm requires large quantities of data. Other studies have been published describing the use of machine learning models in generating patient-specific risk scores for pulmonary emboli [30] , risk stratification of ARDS [31] , prediction of acute kidney injury in severely burned patients [32] and in general ICU populations [33] , prediction of volume responsiveness after fluid administration [34] and identification of patients likely to develop complicated Clostridium difficile infection [35] . evaluated several types of machine learning algorithms, including random forest, naïve Bayes, and AdaBoost on data recorded from 62 mechanically ventilated patients with or at risk of ARDS. Machine learning algorithms have been used to analyze data stored in electronic medical records to predict ICU mortality and length of stay.
cord-005497-w81ysjf9	2020	The positive NC group had more plasma transfusion (p-value 0.03) and a lower median hematocrit at 24 hrs (p-value 0.013), but similar hospital length of stay (p=0.17) and mortality rate (p=0.80) Conclusions: NC at ICU admission identifies subclinical AKI in TBI patients and it maight be used to predictclinical AKI. In patients with pneumonia requiring intensive care (ICU) admission, we hypothesise that abnormal right ventricular (RV) function is associated with an increased 90-day mortality. The objective of this study was to describe the incidence of each AKI stages as defined by KDIGO definition (with evaluation of urine output, serum creatinine and initiation of renal replacement therapy (RRT)), in a mixed medical and surgical population of patients hospitalized in ICU and PCU over a 10-year period (2008-2018). This study aimed at investigating the relationship of goal-directed energy and protein adequacy on clinical outcomes which includes mortality, intensive care unit(ICU) and hospital length of stay (LOS), and length of mechanical ventilation (LOMV).
cord-005503-hm8tvkt3	2020	Recently, automated infrared pupillometry has been introduced into clinical practice, quickly gaining popularity due to its quantitative precision, low cost, noninvasiveness, bedside applicability, and easy-to-use technology, contributing to a modern precision-oriented approach to medicine. reported that power mode transcranial Doppler had high sensitivity and specificity for diagnosis of brain death, respectively 100% and 98% (flow velocity was assessed in the middle cerebral artery using a transtemporal approach) [32] (Fig. 9 ). Processed EEG was originally intended for the management of the anesthetic state during surgery to avoid accidental awareness and to titrate sedation in critically ill patients where clinical scales represent the gold standard. In addition, clinical scale assessment is performed by disturbing sedated or sleeping patients (processed EEG does not require modification of the sedation state) and can never identify phases of burst suppression or isoelectric traces (total suppression) [39] , which are associated with negative outcomes (e.g., delirium occurrence, prolonged mechanical ventilation, mortality).
cord-005569-9d51l6bn	2008	Key recommendations, listed by category, include: early goal-directed resuscitation of the septic patient during the first 6 h after recognition (1C); blood cultures prior to antibiotic therapy (1C); imaging studies performed promptly to confirm potential source of infection (1C); administration of broad-spectrum antibiotic therapy within 1 h of diagnosis of septic shock (1B) and severe sepsis without septic shock (1D); reassessment of antibiotic therapy with microbiology and clinical data to narrow coverage, when appropriate (1C); a usual 7-10 days of antibiotic therapy guided by clinical response (1D); source control with attention to the balance of risks and benefits of the chosen method (1C); administration of either crystalloid or colloid fluid resuscitation (1B); fluid challenge to restore mean circulating filling pressure (1C); reduction in rate of fluid administration with rising filling pressures and no improvement in tissue perfusion (1D); vasopressor preference for norepinephrine or dopamine to maintain an initial target of mean arterial pressure [ or =65 mm Hg (1C); dobutamine inotropic therapy when cardiac output remains low despite fluid resuscitation and combined inotropic/vasopressor therapy (1C); stress-dose steroid therapy given only in septic shock after blood pressure is identified to be poorly responsive to fluid and vasopressor therapy (2C); recombinant activated protein C in patients with severe sepsis and clinical assessment of high risk for death (2B except 2C for post-operative patients).
cord-005587-8iwsvku9	2000	
cord-005606-c8c2rfzi	2004	
cord-005646-xhx9pzhj	1996	Aims and methods The aim of both a prospective and retrospective survey conducted in German pediatric intensive care units in 1993 was to accumulate data on the epidemiology, risk factors, natural history and treatment strategies in a large group of pediatric ARDS patients who were treated in the tt~ee year period from 1991 to 1993.All patients had acute bilateral alveolar infiltration of noncardiogenic origin and a pO2~iO2 ratio < 150mmHg. The influence of sex, underlying disease and single organ failure was analyzed using the Fischer''s exact test, the influence of additional organ failure on mortality was tested with the Cochran-Mantel-Haenszet statistics.
cord-005692-n4vxazst	2020	Empirical treatment takes into account the underlying disease and its severity, the presence of risk factors for multiple-drug-resistant pathogens (antibiotic therapy in the previous 90 days, hospital stay > 5 days, septic shock at VAP onset, ARDS prior to VAP onset, acute renal replacement therapy prior to VAP onset, previous colonization with MDR pathogen) and local pattern of antimicrobial susceptibility. While lower respiratory tract surveillance cultures may help to predict the involvement of MDR microorganisms in patients that develop VAP and thus decrease unnecessary broad-spectrum antibiotics use, there are no clear data that this strategy improves clinical outcomes or lowers costs [89, 90] . Subglottic secretion drainage has repeatedly been associated with lower VAP rates in both individual randomized trials and meta-analyses but does not appear to shorten the time to extubation, ICU length-of-stay, prevent ventilator-associated events, or lower mortality rates [94] . Effect of oropharyngeal povidone-iodine preventive oral care on ventilator-associated pneumonia in severely brain-injured or cerebral hemorrhage patients: a multicenter, randomized controlled trial
cord-005697-l1zmrq4p	2015	A subset of septic patients infected with highly virulent pathogens may die rapidly from refractory shock, disseminated intravascular coagulation, and intractable multiple organ failure as a result of hyper-cytokinemia and uncontrolled inflammatory response. However, with improvements in acute care and resuscitation therapies, this classical exuberant presentation is relatively rare nowadays, and the physician is more often challenged by a blunted clinical response to infection, with subtle findings including lethargy or depressed mental status, glucose intolerance and hyperglycemia, hypothermia, and/or a change in the white blood cell count or cell differential. In addition to overt immunosuppressive conditions (e.g., cancer and hematological malignancies, solid organ transplant, autoimmune and systemic diseases, HIV, use of immunosuppressive drugs), many septic patients commonly exhibit additional risk factors affecting immune status [3] . Regardless of underlying comorbidities and primary injuries responsible for ICU admission, a significant proportion of critically ill patients can reasonably be considered to be immunocompromised and at risk for ICU-acquired infections, especially if they develop overt signs of immunosuppression.
cord-005705-j765ruj1	2004	Another contention of the present paper is this [14] : critical care physicians may still believe that RCTs remain the best tool for improving knowledge and care, and in this case they must accept to use the means needed to achieve the end and therefore to insist on mandatory informed consent from the patient or proxy; or they may realize that the game is not worth the candle and they must then turn to other forms of research that are ranked less highly in the pyramid of evidence-based medicine [15] . Before discussing the problem of informed consent to research a critical appraisal of the scientific and ethical validity of RCTs in critical care medicine is in order.
cord-005717-x7gsqlwp	2008	RESULTS: Preoperative management focuses on optimization of organ function, minimizing ventilator-induced lung injury, preventing excessive edema yet maintaining adequate organ perfusion, preventing and controlling sepsis and bleeding from varices at enterocutaneous interfaces, and optimizing nutritional support. Critical care immediately after intestinal transplantation (Table 2) is influenced by the overall state of health of the patient at the time of surgery, specific organs included in the composite graft, hemodynamic stability in the operating room, and immediate graft function. Patients with multivisceral transplants usually remain intubated for several days, particularly when large graft size mandates delayed abdominal closure (Table 3) , however, the priority must be early extubation to reduce the risk of ventilator-associated pneumonia. When the primary indication for transplantation is declining central vein access, patients that are managed by a competent intestinal failure team usually present with appropriate nutritional status. Pre-transplant nutritional management of patients who are in both liver and intestinal failure is more challenging [40] .
cord-005727-li8pwigg	2010	Since, continuous epidural analgesia provides the required level of analgesia to support early mobilization and significant reduction in pulmonary and cardiovascular morbidity in the early postoperative period, we postulated that the use of low dose of continuous epidural morphine might improve postoperative analgesia and reduce undesirable side effects in elderly patientsTherefore, the present study was designed to evaluate the effects of morphine administered via epidural patients controlled analgesia and intravenous tramadol + metamizol on postoperative pain control and side effects in elderly patients after major abdominal surgery. For each ventilated patient the following data was registered:Age, APACHE II, the reason of admission, risk factors, use NIV, MV duration, timing of tracheostomy, time of diagnosis of VAP, microbiological data, length of stay and mortality in ICU. 23rd ESICM ANNUAL CONGRESS -BARCELONA, SPAIN -9-13 OCTOBER 2010 S131 Evaluated factors: patient characteristics, signs, symptoms, abscess location, time between symptoms and hospital admission and surgery, lab results, microbiology, antibiotic therapy, APACHE2, SAPS2, SOFA, length of ICU stay, surgical re-intervention, duration of mechanical ventilation, infectious complications, critical illness myopathy (CIM), renal replacement therapy (RRT), re-intubation, tracheotomy, mortality.
cord-005750-54hul2lw	2009	In their paper, the authors present a detailed description of sequential analysis methodologies and describe their potential prospective use as tools for monitoring the performance of intensive care units. [2] undertook a study to determine whether outcomes were influenced by time of admission to an Australian tertiary paediatric intensive care unit without 24 h per day in-house intensivist cover. [6] who reported a prospective observational study across 15 Italian paediatric intensive care units conducted over a period of 1 year. In this randomised controlled trial, there was a significant difference in mortality rate with use of ACCM/ PALS haemodynamic support guidelines for septic shock between patients with or without ScvO 2 guided therapy. The authors concluded that their results support the finding that the clinical scales do not evaluate the level of sedation accurately in critically ill children with neuromuscular relaxation, leading to a higher risk of over or undersedation.
cord-005777-6rvfsx4p	2007	We prospectively recorded data of all patients who were newly diagnosed with AF and all those with a septic shock on a surgical ICU (no cardiac surgery) during a one year period according to the requirements of the local ethical committee. Our aim was to evaluate the predictive role of admission APACHE II, admission and total maximum SOFA score, hypoalbuminemia, increased serum creatinine, C-reactive protein, lactate, and serum blood glucose for the 30-day mortality of septic patients admitted to medical ICU. The aim of this study was to analyze the clinical presentation and to evaluate mortality associated factors (timing and accurancy of diagnosis, timing of surgery, severity score and organ failure, surgical and medical treatments). Data were extracted independently to assess intention to treat intensive care unit (ICU) and hospital mortality, days of mechanical ventilation, length of stay, incidence of ventilator-associated pneumonia and pneumothorax, and associated complications of the implemented intervention.
cord-005795-sgi54hq8	2001	Patients in the intensive care unit (ICU) are at very high risk for the development of delirium due to factors such as multi-system illnesses and comorbidities, the use of psychoactive medications, and age. While recent studies have selected delirium and pharmacologic issues (which are inter-related) as two of the top three most important target areas for quality of care improvement in vulnerable older adults [13] , nearly all delirium investigations have excluded medical ICU patients who are often receiving prolonged sedation on mechanical ventilators [1, 2, 14, 15, 16, 17] . Two study nurses enrolled patients each morning and recorded baseline demographics, severity of illness data using the Acute Physiology and Chronic Health Evaluation (APACHE) II score [21] , activities of daily living [22] , and risk factors for delirium derived from data in the literature [2, 3, 14, 15, 23, 24, 25, 26, 27] .
cord-005808-w0763esk	2018	CONCLUSION: Administration of corticosteroids in patients with severe influenza pneumonia is associated with increased ICU mortality, and these agents should not be used as co-adjuvant therapy. Therefore, the aim of the present study was to identify the factors associated with corticosteroid use and its impact on intensive care unit (ICU) mortality using propensity score (PS) matching analysis in ICU patients with influenza pneumonia. Our results strongly suggest that administration of corticosteroids as co-adjuvant therapy to standard antiviral treatment in critically ill patients with severe influenza pneumonia is associated with increased ICU mortality. Three recent systematic reviews and meta-analyses [41] [42] [43] concluded that corticosteroid therapy is significantly associated with mortality, even in the subgroup of patients with influenza hospitalized in or outside the ICU. In a homogeneous group of critically ill patients with severe influenza pneumonia, after adequate adjustment by PS matching and competing risks, co-adjuvant corticosteroid therapy was significantly associated with increased ICU mortality.
cord-005814-ak5pq312	1995	Results: In 5 patients with treated SS, 16 tests were performed (VL n=8; Dobu n=4; NA n=4 Method: Septic shock was defined as severe sepsis with either persistent hypotension (mean arterial pressure; MAP<70 mmHg) or the requirement for a noradrenaline (NA) infusion ~> 0.1 ~g/kg/min with a MAP _< 90mmHg. Cardiovascular support was limited to NA + dobutamine (DB), 546C88 was administered for up to 8 h at a fixed dose-rate of either i, 2.5, 5, 10 or 20 mg/kg/h iv. Methods: Fourteen cases were s~udied,their gestational age ranged from(27-32)ws.Continnous positive air way pressure was applied to six cases at Peep level from (3-6)cm H2o through nasal pronge,(group I),the other 8 cases were managed as routine,(group II).Blood gases, TcPO2,TcCo2,resp.rate,depth and pattern were monitored for assessment of tissue Oxygenation and ventilation, Results: Our rasults showed that early application of CPAP improve ventilation among (83.3%)of cases,while (16.7%)of cases need IMV.The cases of group II need IMV among (75%)of the studied cases during the second or the third day of life.
cord-005816-i54q5gsu	2009	Several factors such as the initial lack of symptoms, a low diagnostic sensitivity of the CT (34% false negatives), and the nonoperative management of solid organ injuries, have contributed to a delayed diagnosis in one of every five patients in our series, but this has not led to a significant increase in septic complications in this group. Method: The demographic features, the treatments, the intensity of the illness and mortality rate of the 155 patients in Afyon Kocatepe University General Surgery clinic between the years 2006 Background: Enterocutaneous fistula continues to be a serious surgical problem. Introduction: In our previous study, we examined the treatment results of burn patients older than 45 years, and found a significant increase in mortality with increasing age groups. Methods: Data on emergency surgical cases and admissions to the surgical service over a 3-month period were collected and analyzed; this included patient demographics, referral sources, diagnosis, operation, and length of stay (LOS Conclusion: Emergency workload represents a significant part of the work for the general surgeons.
cord-005819-fp5khzd5	1991	title: Gram-negative bacterial pneumonia with secondary aspergillosis in an AIDS patient After the initial success of therapy and a symptom-free period, she developed pneumonia with septic shock and adult respiratory distress syndrome (ARDS). The largest study of invasive aspergillosis so far, with 13 HIV-infected patients, documents the diagnostic difficulties, as positive diagnosis mostly required bronchoalveolar lavage or transthoracic aspiration of pulmonary lesions. The cases of AIDS patients with invasive aspergillosis described in the literature therefore had neutropenia related to zidovudine or to ganciclovir therapy, increased exposure to aspergillus by marijuana smoking, underlying pulmonary disease, or corticosteroid use as predisposing factors. It also indicates the possibility of increasing confrontation with disseminated fungal infections like invasive aspergillosis as secondary neutropenia due to drugs such as zidovudine and ganciclovir becomes more common. Bacterial pneumonia in patients with human immunodeficiency virus infection Aspergillus endocarditis and myocarditis in a patient with the acquired immunodeficiency syndrome (AIDS) Bacterial infections in AIDS patients
cord-005861-3k8h3euj	2014	Efforts to enhance safety in anesthesia must include adherence to explicit and implicit safety standards, must make use of equipment that offers modern safety features, must seek to detect and correct developing safety threats as early as possible and must have a structured system to analyze problems and to institute remedies to prevent their recurrence. The health care system in which these fatal and non-fatal errors occur covers a spectrum that stretches from the manufacturers of equipment and drugs to the cleaning crew in the operating room and it involves many different clinical and supportive departments and their personnel.Anesthesia is an important component of this health care system comprising many interdependent parts that can affect the quality of anesthesia care. The Institute of Medicine [5] includes in its definitions the terms "accidental injury" and, interestingly, makes reference to a process:"Ensuring patient safety involves the establishment of operational systems and processes that minimize the likelihood of errors and maximize the likelihood of intercepting them when they occur."
cord-005881-oswgjaxz	2010	Prospective case series with historical control group.(Level III) Results: Preliminary data indicate: *a shorter time on ventilator than anticipated (based on comparisson to historical data) * a shorter time on ICU * less pneumoniae * no intra-operative complications * good healing results of the rib fractures * no implant failures * acceptable pain scores * good overal satisfaction * acceptable cosmetic results Conclusion: Internal fixation of rib fractures (flair chest or multiple sequential fractures with pulmonary function compromise) results in a earlier recuperation of pulmonary function with shortened ICU stay. (Regional Association Sanitary Emergencies) Material and Methods: The ARES, whose members are about 600, all over the nation, is configured as an extraordinary health resource, activated by the National Civil Defence operations centre, in according with the Regional centre of Marche, in disater situations Results: The main objectives of ARES are training and organization of medical staff and structures and its growth crosses several missions including: AE Earthquake in Molise, 2002 Introduction: Cephalomedullary nails rely on a large lag screw that provides fixation into the femoral head.
cord-005953-5z89yeb6	2008	Die anderen beiden Gruppen zeigten zwar in Hinblick auf die Wandstärken einen positiven Effekt, hinsichtlich der Herzfunktion konnten sie jedoch bei bereits deutlich erniedrigten Funktionswerten zum Baseline-Zeitpunkt lediglich stabilisiert werden (Reduktion der Wandstärke nach 3 Jahren ERT: Gruppe wenig Fibrose= 10 mm; Gruppe viel Fibrose= 12 mm) Schlussfolgerung: Die Enzymersatztherapie ist eine effektive Langzeitbehandlung bei Patienten mit Fabry Kardiomyopathie. Der Einfluss der sauren Sphingomyelinase auf die Expression von Matrix-Metalloproteinase-1 in intestinalen Epithelzellen und Fibroblasten Background: The calcineurin (Cn)/NF-AT signaling cascade takes a crucial role during T-cell activation and the development of myocardial hypertrophy. Effective and safe reduction of blood pressue by the combination of amlodipine 5/valsartan 160 mg in patients with hypertension and metabolic risk factors not controlled by amlodipine 5 mg or felodipine 5 mga subanalysis of the express-m trial Introduction: Atrial fibrillation (AF) is the most common cardiac arrhythmia and frequently occurs in patients with coronary heart disease.
cord-005992-mu917isy	2011	Es bleiben aber eine Reihe von IH übrig, welche an weniger auffälligen Lokalisationen sind, bei sehr jungen Säuglingen gerade im Entstehen, und solche bei denen die Relation zu einer systemischen Therapie grenzwertig ist. Auf Grund einer initial als Mutation beschrieben Veränderung des HNF1a Gens wurde die Diagnose MODY 3 gestellt und die Therapie von Insulin auf Sulfonylharnstoff umgestellt. SSW Der Patient zeigt ein sehr auffälliges Trinkverhalten (beim Trinken kommt es zum Zurückfließen von Milch aus dem Mund) sowie einen in-und exspiratorischen Stridor, die durchgeführten Untersuchungen bleiben jedoch ohne pathologischen Befund. Wir konnten auch zeigen, dass insbesondere bei Kindern mit B-Zellvorläufer ALL die Kombination von beiden MRD-Zeitpunkten prognostisch bedeutsam ist, da zum Beispiel Patienten mit einer MRD von ≥10 −3 am Tag 33 und jeglichem positivem Signal am Tag 78 ein schlechtes Ergebnis vorwiesen. In einer Pilotstudie konnten wir zeigen, dass durch Modifikation der Probenaufbereitung ein Einsatz des Roche Septifast-Systems bei Frühgeborenen mit einem geringen Blutvolumen von minimal 100 µl möglich ist.
cord-006000-ekwpkzqv	1999	We analyzed 25 BAL samples and clinical data of 4 patients who underwent lung transplantation and presented with recurrent episodes of eosinophilic alveolitis in BAL. We analyzed 25 BAL samples and clinical data of 4 patients who underwent lung transplantation and presented with recurrent episodes of eosinophilic alveolitis in BAL. All patients demonstrated a deterioration of clinical condition, lung function, and blood gas analysis during times of eosinophilia in BAL, compared to previous examinations. In conclusion, eosinophilic alveolitis may indicate acute rejection in patients after lung transplantation, if other causes of eosinophilia are excluded. In conclusion, eosinophilic alveolitis may indicate acute rejection in patients after lung transplantation, if other causes of eosinophilia are excluded. In this retrospective study, clinical data and differential cell counts from BAL samples of 37 lung transplant recipients, who had been treated at the University of Kiel until December 1996 and were available for follow-up investigation, were analyzed.
cord-006179-7uv4yfv2	2007	Autologous hematopoietic stem cell transplant (AHSCT) has been advocated as a form of salvage therapy for children with high-risk or relapsed brain tumors but only limited data are available currently. Over the past decade, high-dose chemotherapy with autologous hematopoietic stem cell transplant (AHSCT) has been tried in patients with high-risk brain tumors in an attempt to eradicate residual neoplastic cells and improve cure rate. In conclusion, AHSCT can result in long-term survival with satisfactory functional status in children with recurrent brain tumors, especially for those who can achieve complete remission before transplant. High-dose busulfan and thiotepa with autologous bone marrow transplantation in childhood malignant brain tumors: a phase II study High-dose melphalan and cyclophosphamide with autologous bone marrow rescue for recurrent/progressive malignant brain tumors in children: a pilot pediatric oncology group study High-dose chemotherapy with autologous stem-cell rescue in patients with recurrent and high-risk pediatric brain tumors
cord-006181-fkh2fzbr	2015	This report describes the clinical course of four consecutive patients with blastomycosis-related ARDS treated with venovenous extracorporeal membrane oxygenation (ECMO) during 2009-2014. 3 Venovenous extracorporeal membrane oxygenation (ECMO) has been utilized for the management of severe ARDS to facilitate gas exchange, allow lung rest by deescalation of ventilatory support, and provide time for resolution of the underlying disease. 7 Extracorporeal membrane oxygenation is generally considered in ARDS patients with refractory hypoxemia or hypercapnia despite a lung protective ventilation strategy or in those where the maintenance of adequate gas exchange requires potentially injurious applied volumes or pressures. Extracorporeal membrane oxygenation may be an effective treatment modality for patients with blastomycosis-related ARDS and refractory hypoxemia despite optimal mechanical ventilation. Extracorporeal membrane oxygenation (ECMO) for severe acute respiratory distress syndrome (ARDS) in fulminant blastomycosis in Germany
cord-006182-kck5e1ry	2019	The primary objective of COGiTATE (CppOpt GuIded Therapy Assessment of Target Effectiveness) is to demonstrate feasibility of individualising CPP at CPPopt in TBI patients, expressed as the percentage of monitoring time for which CPP is within 5 mmHg of regularly updated CPPopt targets during the first 5 days of Intensive Care Unit (ICU) admission. Neurocritical care has become increasingly subspecialized.Yet, due to limited availability of dedicated Neurocritical Care units (NCCUs), often patients may need to be admitted to ICUs other than NCCUs. This survey based study was conducted to explore self-reported knowledge in recognizing and managing some common neurological emergencies such as stroke, status epilepticus, raised intracranial pressure etc among critical care nurses at a Comprehensive Stroke Center. Coagulation factor Xa (recombinant), inactivated-Xa inhibitor associated life--factor prothrombin complex concentrate (PCC) was utilized offRetrospective, single center, cohort study including adult intracranial hemorrhage patients who received discharge between efficacy (defined by International Society on Thrombosis and Haemostasis criteria), thrombotic events, ICU and hospital length of stay, and mortality.
cord-006226-fn7zlutj	1994	The following were analysed: heart rate (HR, bpm), pre-ejection time (PEP, ms), ejection time (VET, ms), HR-corrected electromechanical systole (QS2c, ms), impedance-cardiographic estimates of stroke volume (SV, ml), cardiac output (CO, I/min) and peripheral resistance (TPR, dyn.s.cm -5) calculated from CO and mean blood pressure (SBP and DBP according to auscultatory Korotkoff-I and -IV sounds This indicates that 1) about half the rise of HR and CO and half the shortening of PEP is 131-respectively 1~2-determined, 2) that predominant 132-adrenergic responses, whilst not affecting VET, take optimal benefit from the inodilatory enhancement of pump performance, 3) that an additional 131-adrenergic stimulation is proportionally less efficient, as VET is dramatically shortened, thus blunting the gain in SV so that the rise in CO relies substantially on the amplified increase of HR and 4), VET is more sensitive than QS2c in expressing additional 131-adrenoceptor agonism and 5) prime systolic time intervals provide a less speculative and physiologically more meaningful represenation of cardiac pump dynamics than HR-corrected ones.
cord-006236-2gpwf4z2	2004	Key words: Gene Expression, Ventricular Hypertrophy, and Congenital Heart Disease Background: Extracorporeal membrane oxygenation (ECMO) can be used to support children with severe graft failure after heart transplant (Tx). In the 2 pts with graft failure from acute rejection, ECMO duration was 5 and 6 days; both regained normal heart function and were successfully decannulated without complications. Key words: ECMO, Heart Transplant, Graft Failure, Acute Hemodynamic Rejection Background: Ventricular assist device (VAD) support is well established in treating adults with end-stage heart disease. Key words: Mechanical circulatory support, Pediatric, VAD, Congenital Heart Disease, and Cardiomyopathy Background: Measurement of whole blood B-type natriuretic peptide (BNP) levels has been shown to detect heart failure in adults presenting with dyspnea in the acute setting. Key words: levosimendan, heart failure, cardiomyopathy Methods: 20 children were studied, age range from 2 to 192 months (median 32.5 months).
cord-006302-pnnkfid0	2017	We studied the follow-up changes of circulating vasoactive peptides and cytokines until the improvement or the worsening of a patient and progression into specific organ dysfunctions. In a prospective study, concentrations of tumor necrosis factor-alpha (TNFα), interleukin (IL)-6, IL-8, IL-10, interferon-gamma (IFNγ), endocan and angiopoietin-2 (Ang-2) were measured in serum by an enzyme immunoassay in 175 patients at baseline; this was repeated within 24 h upon progression into new organ dysfunction (n = 141) or improvement (n = 34). Our aims were to monitor the changes of circulating levels of pro-inflammatory and antiinflammatory cytokines and of vasoactive peptides of critically ill patients at well-defined time-points of the clinical course and to understand how these changes mediate progression to organ dysfunction in an individualized way. When pair-wise comparisons between baseline and follow-up measurements were done within the subgroups of patients developing new organ dysfunctions, it was found that the only parameters significantly changing were endocan and Ang-2.
cord-006332-ikh45wuy	1996	Probiotic bacteria have several important functions in the colon: (1) production of nutrients for the mucosa: acetate, butyrate, propionate, other SCFAs, pyruvate, lactate, and amino acids (arginine, cysteine, glutamine); (2) production of micronutrients (␤ group and folic acid, antioxidants, and polyamines), histamine, 5-hydroxytryptamine, piperidine, tyramine, cadaverine, pyrrolidine, agmatine, putrescine; (3) prevention of overgrowth of PPMs; (4) stimulation of the immune system, especially the gut-associated lymphoid tissue (GALT) system: NO is produced by these bacteria in the mouth and GI tract; (5) elimination of toxins from the lumen; (6) participation in intestinal regulation, mucus utilization, nutrient absorption, GI motility, and blood flow through signaling substances such as NO. Studies of abilities of lactobacilli to ferment fiber in vitro, to survive the acidity of stomach and the bile acid contents of the small intestine, to adhere to the colonic mucosa, and to remain and function there after the supply stopped led us to identify a few human lactobacilli with great capability.
cord-006343-c0amee70	2016	Intestinal transplantation (IT) is the least common form of organ transplantation; however, it has shown exceptional growth and improvement in graft survival rates over the past two decades mainly due to better outcomes achieved during the first year of transplantation (76 % at 1 year), due to improvement in surgical techniques and the development of better immunosupressive therapies as we understand more about the relationship between the recipient and host immune system. It remains on the continuum of care for pediatric patients with intestinal failure, but bowel transplant rates have declined worldwide over the last 6 years, in large part due to the development of multidisciplinary intestinal rehabilitation programs and the control of progressive cholestatic liver disease with novel lipid-based management strategies. With improved clinical outcomes of pediatric patients with intestinal failure, there is increasing evidence that the current indications for bowel transplantation no longer apply and need revision.
cord-006344-de4dhv4b	2006	title: Corticosteroids combined with continuous veno-venous hemodiafiltration for treatment of hantavirus pulmonary syndrome caused by Puumala virus infection Reported here are two cases of hantavirus pulmonary syndrome caused by Puumala virus infection, which rapidly resolved after initiation of corticosteroid treatment combined with continuous veno-venous hemodiafiltration. We describe two cases of PUU-associated HPS, in which administration of intravenous corticosteroids combined with continuous veno-venous hemodiafiltration (CVVHDF) was followed by rapid clinical improvement. On day 5 POS the lung infiltrates had increased considerably (Fig. 3a,b) , and the patient required continuous ventilation with a positive airway pressure mask. We describe two cases of PUU-infected patients who presented with both renal and respiratory failure requiring renal replacement therapy and mechanical ventilation. High levels of cytokineproducing cells in the lung tissues of patients with fatal hantavirus pulmonary syndrome High levels of viremia in patients with the Hantavirus pulmonary syndrome
cord-006363-xov4xwpa	2016	OBJECTIVE: To analyze the clinical and imagenological characteristics of acute Exogenous lipoid pneumonia (ELP), explore its risk factors, and assess the potential role of multiple bronchoalveolar lavages (BALs) and steroid therapy in the treatment of children with acute ELP. Exogenous lipoid pneumonia (ELP) is a rare condition resulting from aspiration or inhalation of oil-based substances, with both acute and chronic forms. All patients satisfied the following diagnostic criteria: clinical presentation of acute respiratory or febrile illness combined with either radiological features diagnostic of lipoid pneumonia, or confirmation of the exogenous origin of the lipid through BAL. For each patient, the authors collected demographic data, clinical presentation, imagenological characteristics, categories of oil ingested, laboratory data, treatment, therapy response, BAL findings, and outcomes. The index study demonstrates that multiple BALs combined with steroid therapy result in significant improvement of clinical, radiologic and laboratory parameters in children with acute ELP.
cord-006391-esnsa4u5	1982	In our parallel tests using an excision-sample technique [2] which is considerably more sensitive than the DGHM procedure, we have observed the following mean reductions in the counts of accessible bacteria: iodine in ethanol, 96%; povidone-iodine, 89%; chlorhexidine in ethanol, 88%; iso-propanol, The purpose of this study was to compare radiation injury in Guinea Pig small bowel (1) devoid of contents (2) containing bile (3) containing pancreatic juice. Studies in vitro employing isolated perfused rat pancreas and stomach revealed following results: Mean basal pancreatic somatostatin release in normal, diabetic and transplanted rats were 12___3, 24-t-7, and 17__+4 pg/ml, respectively. As these changes appear closely correlated to the blood glucose levels which show a 30 % decrease at 4 h and progressive restoration towards normal values up to 24 h, attempts have been made to alter the insulin/glucagon ratio by glucose infusion after PH and study its relation to liver regeneration.
cord-006394-ucthbqvt	2003	Conclusions: Resection combined with RFA provides a surgical option to a group of patients with liver metastases who traditionally are unresectable, and may increase long-term survival. Surgical resection of primary and metastatic liver tumors is considered to be the optimal treatment modality with a curative effect, offering a 5-year survival rate between 20% and 35%. For purposes of this study, the following were collected for all patients: patient age and sex; tumor histology, number, location, and size; type of surgical resection; operative details; disease status; follow-up date; death date; and complication data. Those patients who had more than 10 tumors treated with combined hepatic resection and RFA were significantly more likely to have a shorter time to recurrence than those with less disease (HR Ï­ 1.63, CI Ï­ 1.12-2.36, P Ï­ .009). Our group of 172 patients treated with combined hepatic resection and RFA of malignant liver tumors is the largest series reported to date.
cord-006426-baf2d47y	2010	Suppression of cell-mediated immunity may be caused by multifaceted cytokine/inhibitor profiles in the circulation and other compartments of the host, excessive activation and dysregulated recruitment of polymorphonuclear neutrophils, induction of alternatively activated or regulatory macrophages that have anti-inflammatory properties, a shift in the T-helper (Th)1/Th2 balance toward Th2, appearance of regulatory T cells, which are potent suppressors of the innate and adaptive immune system, and lymphocyte apoptosis in patients with sepsis. 13, 14 In response to major tissue injury and/or bacterial infection, endothelial and epithelial cells, as well as neutrophils, macrophages, and lymphocytes, produce powerful proinfl ammatory cytokines, especially tumor necrosis factor-α (TNF-α), interleukin (IL)-1β, and IL-6.
cord-006444-eq56zhtd	1993	The results from ongoing preclinical studies continue to confirm the broad spectrum of biological activities possessed by rhiL-1 1 in vitro and suggest this cytokine may be an effective agent in the treatment of myelosuppression associated with cancer chemotherapy and bone marrow transplantation. We performed a phase H trial to assess the ability of G-CSF -mobilized PBPC to rapidly and completely restore hemopeiesis after high dose chemotherapy in the absence of bone marrow infusions, with selection for PBPC-only infusions based on yield of granulocyte -macrophage colony -forming cells (GM-CFC) after G-CSF treatment. Our approach for high-dose (HD) chemotherapy is to first treat patients eligible for dose intensification with a standard dose chemotherapy (VIP: VP26 = etoposide: 500 mg/m 2, ifosfamide: 4 g/m 2, cis-platinum: 50 mg/m 2) followed by the application of colony stimulating factors (G-CSF, GM-CSF or IL-3 + GM-CSF) in order to combine a regimen with broad anti-tumor activity with the recruitment of peripheral blood progenitor cells (PBPCs).
cord-006460-3ayc0hne	2000	Here, then, is an example of a Nobel Prize being awarded for the study of endothelial A.E. Baue ( ✉ ) cell-produced NO on the one hand, and the concept of excess vasodilatation in septic shock, the hypothesis that this was due to NO and a clinical trial blocking NO that increased mortality on the other. 3. We have tried to lump together and treat human abnormalities according to symptoms and signs rather than to the basic causes of their diseases -we have tried to treat inflammation, sepsis, systemic inflammatory response syndrome (SIRS), and multiple organ dysfunction syndrome (MODS) rather than what caused them; perforated diverticulitis is not acute pancreatitis and neither are ventilator-associated pneumonia and appendicitis. There has been significant improvement in survival of patients with persistent severe organ system failure." Thus, this report confirms again (1) that better intensive care is helping, and (2) my insistence that the secret to MOF is prevention.
cord-006464-s8rjoyse	2015	Our data for the first time show systematically that increased susceptibility to infections in MECP2 duplication syndrome is associated with IgA/IgG(2)-deficiency, low antibody titers against pneumococci and elevated acute-phase responses. The single patient who has to date not developed severe infections despite We further investigated whether patients with MECP2 duplication syndrome showed stronger acute phase responses, which we could confirm in 7/10 patients in terms of elevated CRP values above 200 mg/l during non-invasive infections, mainly pneumoniae. In summary we here show for the first time systematically that patients with MECP2 duplication syndrome are at increased risk for in particular non-invasive but also for invasive infections with potentially encapsulated bacteria, that this increased susceptibility to infections may be associated with IgG 2 -subclass deficiency/ low titers against pneumococci and elevated acute-phase responses, while the precise role of T-cell immunity and in particular the extent of impaired IFNγsecretion and its role for the observed infectious phenotype is still to be defined.
cord-006466-e1phpqes	2018	
cord-006508-rje9bnph	2012	Lack of understanding of the nature and pathophysiology of the pain associated with sickle cell anaemia hampered rational approaches of therapy and had an adverse effect on the quality of life of an already compromised health status of affected patients. Beneficial effects of hydroxyurea in patients with sickle cell anaemia Decreases the frequency of acute painful episodes Decreases the incidence of acute chest syndrome Decreases the blood transfusion requirement Decreases morbidity and mortality error where a change of one letter of a keyword of a manuscript (''punctuation mutation'') corrupts the meaning of the intended message. [48] These include: (i) the risk associated with the inhibiting effect of MAb 73E on platelet function with an unpredictable net clinical effect (i.e. thrombosis versus bleeding); and (ii) to be effective, these antibodies have to be administered before the RBC adhere to the vessel wall (i.e., pre-treatment before the onset of a vaso-occlusive event) a scenario that is unpredictable in patients with sickle cell anaemia.
cord-006517-845w9r6l	2017	The aim of the present study was to assess the frequency and clinical impact of hematological abnormalities in the range of those accepted by the Histyocite Society for the suspicion of HPS [19] in patients who were admitted to the hospital with a confirmed influenza virus infection. In Beutel''s study of 25 critically ill patients with influenza A (H1N1) pdm09 virus associated hemophagocytic syndrome, the absence of steroid therapy in the early phase of the infection might have contributed to the high incidence of HPS (9 out of 25 patients) and the rather poor outcomes [18] . Significant hematological abnormalities are frequently seen in patients with influenza virus infection who required hospital admission and are associated with a poor outcome.
cord-006518-al94gxjw	2004	More recent studies showed that EPA did not induce TNF-α, IL-1β, or IL-1α (68) or IL-6 (69) in osteoblasts, and even countered the upregulating effect of arachidonic acid (68) ; that EPA and DHA could totally abolish cytokine-induced up-regulation of TNF-α, IL-1α, and IL-1β in cultured bovine chondrocytes and in human osteoarthritic cartilage explants (93, 94) ; and that EPA or fish oil inhibited endotoxin-induced TNF-α production by monocytes (111) (112) (113) (114) . Animal feeding studies with fish oil support the observations made in cell culture with respect to the effects of long-chain n-3 FA on NFκB activation and inflammatory cytokine production. Several studies in humans involving supplementation of the diet with fish oil have demonstrated decreased production of TNF-α, IL-1β, and IL-6 by endotoxin-stimulated monocytes or mononuclear cells (a mixture of lymphocytes and monocytes) (80) (81) (82) 119) .
cord-006523-zxn4oqly	2001	The common nosocomial infections in PICU are bloodstream infections (20–30% of all infections), lower respiratory tract infections (20–35%), and urinary tract infections (15–20%); there may be some differences in their incidence in different PICUs. The risk of nosocomial infections depends on the host characteristics, the number of interventions, invasive procedures, asepsis of techniques, the duration of stay in the PICU and inappropriate use of antimicrobials. 3 In the same study, it was observed that 91% of all nosocomial bloodstream infections occurred in children with central venous lines, 95% of nosocomial pneumonias occurred in those on mechanical ventilation and 77% of UTIs in children with urinary catheters. Transtracheal aspiration in non-intubated patients, percutaneous thin needle lung aspirations, bronchoalveolar lavage (bronchoscopic or blind), and protected bronchoscopic samples of the lower airways have all been suggested as methods for diagnosis, where contamination of lower respiratory secretions with upper airway flora is prevent-ed29~~ In the absence of gold standard criteria for the diagnosis of ventilator-associated pneumonia, quantitative cultures and microscopic examination of the lower respiratory tract secretions are the diagnostic tests of choice.
cord-006544-yr4u61qv	2004	title: Recurrent life-threatening thromboembolism and catastrophic antiphospholipid syndrome in a patient despite sufficient oral anticoagulation Over the preceding 3 years the patient had presented a wide spectrum of manifestations of APS, including recurrent venous and arterial thromboses, cardiac, gynecological (HELLP syndrome), neurological involvements, livedo reticularis, a mild thrombocytopenia and the most feared manifestation of the catastrophic antiphospholipid syndrome (CAPS). The antiphospholipid syndrome (APS) is one of the most common causes of acquired thrombophilia and is characterized by arterial and/or venous thrombosis, recurrent pregnancy losses, and the laboratory evidence of antibodies against phospholipids or phospholipidbinding protein cofactors [1] . Retrospective studies suggest that patients with APS have an increased risk of recurrent thromboembolism [4, 5, 6] , and for this reason it is recommended that they receive oral vitamin K antagonists, such as warfarin, in order to achieve an international normalized ratio (INR) range within a therapeutic level (INR fi 3).
cord-006545-c12m75gq	2011	The aim of this study was to determine the radiologic findings associated with admission to the intensive care unit (ICU) and the development of acute respiratory distress syndrome (ARDS) in patients with pH1N1 infection. A higher number of lung zones involved and consolidation on the initial chest radiograph as well as a rapid progression of the radiological abnormalities were identified in patients requiring ICU admission and development of ARDS. Several reports describe the initial radiographic and CT findings in patients with H1N1 infection of both mild and severe cases including interstitial markings, nodules, ground-glass opacities (GGO), and consolidations with focal, multifocal, or diffuse distribution [8] [9] [10] [11] [12] [13] [14] [15] . The presence on the initial chest radiograph of lung consolidation, multifocal, diffuse, and bilateral involvement (Fig. 2 ) was associated with a statistically higher risk of requiring ICU admission (p<0.001).
cord-006563-qmigctkp	2017	This is the reason why in the last decades a lot of clinical studies have been performed with the aim of reducing the magnitude of the postoperative pain, all of them directed to those factors which might influence the pain after surgery, such as: presence of preoperative chronic pain, anesthesia technique, or the need for an acute pain service. The list of proposals to be taken into consideration includes: a careful psychological evaluation and preparation of the surgical patient, a good preoperative sedation and even the use of antidepressants before surgery in specific cases. Regional anesthesia and ambulatory surgery: the role of continuous infusion devices in postoperative pain management in pediatrics Ralph J Beltran Department of Anesthesiology and Pain Medicine, Nationwide Children''s Hospital, Columbus, Columbus, OH, USA Continuous infusions of local anesthetic delivered via peripheral nerve block catheters (PNB) for postoperative pain management in adult patients has become more prevalent.
cord-006595-brpngt14	2005	After sampling a loop easily accessible sonographically, axial and longitudinal US were views were scanned to evaluate the morphology, thickness, and echo structural features of the intestinal loops and color Doppler views of the superior mesenteric artery and wall arteriole of the sampled loop CT was performed with a multidetector scanner (General Electric Medical Systems) 2 to 4 weeks after surgery to evaluate the anatomy of the transplanted organs and arterial and venous anastomoses, complications previously identified with other methods or suspected, and periodically in the follow-up of patients who underwent transplantation due to Gardner syndrome. Traditional radiologic evaluation of the gastrointestinal tract with radiopaque contrast agent allowed anatomic and morphologic examinations of the graft, proximal and distal anastomoses, and tone and motility of transplanted loops in all patients (Fig. 1 ).
cord-006621-0fxpn7qf	2017	title: Leptospirosis-associated catastrophic respiratory failure supported by extracorporeal membrane oxygenation The clinical relevance of the case is the scared evidence of leptospirosis-associated severe respiratory failure treated with ECMO. A high index of suspicion is needed for an adequate diagnosis of leptospirosis to implement the correct treatment, particularly in the association of respiratory failure, pulmonary hemorrhage, and an epidemiological-related context. Leptospirosis can present with a wide range of symptoms, mimicking flu, hepatitis, dengue, hanta virus cardiopulmonary syndrome, meningitis, among others, and has a specific treatment; thus, clinical suspicion must remain high and serological diagnosis should be performed. The most severe clinical form of leptospirosis is known as Weil''s disease, which is uncommon (5-10% of cases), and is characterized by hepatic, renal, and pulmonary involvement [7] [8] [9] [10] [11] . In the case presented, profound septic shock, with MOF and catastrophic ARDS, made it impossible to ventilate the patient protectively and simultaneously supply adequate oxygenation and ventilation; thus, ECMO was initiated.
cord-006679-nhbofufv	1993	Early trials of allogeneic bone marrow transplantation (BMT) for homozygous beta-thalassemia and the analyses of results of transplantation in patients less then 16 years old have allowed us to identify three classes of risk using the criteria of degree of hepatomegaly, the degree of portal fibrosis and the quality of the chelation treatment given before the transplant. Allogeneic bone marrow transplantation has proved to be a radical form of cure in those patients with an HLA identical donor found within the family.2-3We report here our experience on 491 patients transplanted since January 1981 on the base of their categorization into three classes of risk) MATERIAL The best results in term of engraftment, toxicity and GvHD prophylaxis were obtained with the association of BU 14 rag/ kg, CY 200 mg/kg and CSA alone from day-2 as GvHD prophylaxis.
cord-006701-q8qh1kas	2019	We have used placenta-derived decidua stromal cells (DSCs) to treat graft-versus-host disease and found an immunomodulatory and anti-inflammatory effect. The second patient was a 34-year old woman who was admitted 8 months after allogeneic hematopoietic stem cell transplantation due to hemolysis, impaired sensorium below arcus, and difficulty in ambulation. We have used placenta-derived decidua stromal cells (DSCs) for acute and chronic GVHD, ARDS and hemorrhagic cystitis [8] [9] [10] [11] . Electrophysiological investigation following DSCs infusion showed some improvement with more frequent motor unit activity, especially in the right arm. The day after the DSC infusion, she had normal sensation on neurological examination and subjectively in the lower abdomen and legs. The patient was examined with TMS and SEPs every 3-5 months up to a year after the onset of neurological symptoms. Placenta-derived decidua stromal cells for treatment of severe acute graft-versus-host disease
cord-006702-ekf6mja9	2016	After correction using the optimal linear regression, the variability of the measurements was examined using Bland-Altman plots Results: We studied 29 patients (17 male, 12 female) with a median age (SD) of 14.0 (3.4) years and eGFR 111 (17) Objectives: Mutations of the Pkhd1 gene cause autosomal recessive polycystic kidney disease (ARPKD). Objectives: To examine the characteristics, follow up and availability of long term outcome data in a cohort of New Zealand children with acute kidney injury (AKI) requiring renal replacement therapy (RRT) following cardiac surgery at Starship Hospital over a six-year period. Methods: Cohort study conducted from 2008-2012 of 57 female patients age 9-21 years recruited from 2 pediatric nephrology clinics with CKD (n=25), on dialysis (n=9), or status post kidney transplantation (n=23) who received the standard 3-dose vaccine series of the HPV vaccine.
cord-006714-q7wy76e2	2012	Our study supports the hypothesis that combination short-term antibiotherapy with an aminoglycoside for ICU-acquired bacteraemias could increase survival. Meta-analysis failed to demonstrate improved outcomes in patients treated with antibiotic combinations over those receiving monotherapy [1] [2] [3] [4] and resulted in a decreased use of combination therapy. We performed a retrospective study to evaluate the impact of AGs in antimicrobial combination on ICU-acquired bacteraemia in our universityaffiliated ICU [8] [9] [10] [11] . The aim of the study was to evaluate the impact of AGs in antibiotic combination on the outcome of patients with ICU-acquired bacteraemia. We found a survival benefit with the use of combination therapy with AGs for ICU-acquired bacteraemias. In the ICU, inadequate empirical antibiotic therapy is associated with an increased mortality risk in patients with ventilator-associated pneumonia and bacteraemia. Our study suggests that short-term combination beta-lactams plus AGs therapy in intensive care unit (ICU)-acquired bacteraemia could reduce mortality.
cord-006750-cg2i2bae	2019	PURPOSE OF REVIEW: Diffuse alveolar hemorrhage (DAH) is a rare but devastating manifestation of antiphospholipid syndrome (APS) patients with or without other systemic autoimmune diseases. In our experience, two different presentations of aPL-positive patients with DAH exist: (a) acute-with moderate to severe pulmonary hemorrhage (with varying degrees of respiratory failure) requiring hospitalization and (b) chronic-with mild hemoptysis, dyspnea, and/or positive imaging findings, usually seen as an outpatient. Antiphospholipid antibodies as a cause of pulmonary capillaritis and diffuse alveolar hemorrhage: a case series and literature review Difficulties in the treatment of recurring diffuse alveolar hemorrhage accompanying primary antiphospholipid syndrome: a case report and literature review Pulmonary capillaritis, alveolar hemorrhage, and recurrent microvascular thrombosis in primary antiphospholipid syndrome Rituximab induces resolution of recurrent diffuse alveolar hemorrhage in a patient with primary antiphospholipid antibody syndrome Primary antiphospholipid syndrome associated with diffuse alveolar hemorrhage and pulmonary thromboembolism
cord-006768-r2pa9qw0	2018	Patients who fulfilled any two of the four criteria proposed by the American College of Rheumatology, and those with clinical features of GPA with ANCA positivity and histopathological confirmation, were included in the study. Though we have sufficient information on the initial clinical presentations, the variable manifestations due to its multisystem involvement often delay the early diagnosis and treatment of this potentially treatable vasculitis. Considering the morbidity and mortality of this progressive vasculitis, knowledge of the various modes of presentation in various geographic regions is the key to early diagnosis and treatment. Clinical presentation as RPGN (28/38-66%) of those with renal GPA was the most common manifestation with 45% of Upper and lower respiratory involvement was seen in 63% of the patients which was much lower than the series from western and Asian data [12, 14, 15] . Wegener''s granulomatosis in India: clinical features, treatment and outcome of twenty five patients
cord-006828-i88on326	2013	Comparing gene expression profiles of yellow fever immunized individuals and active SLE patients it was possible to identify a "common" and an "autoimmune-specific" IFN signature. The inflammatory and profibrotic effects upon Aab stimulation in vitro, and their associations with clinical findings suggest a role for autoantibody-mediated activation of immune cells mediated through the AT1R and ETAR in the pathogenesis or even the onset of the disease. This study was aimed to investigate the humoral and cellular immune response to VZV including assessment of IgG-anti-VZV avidity and VZV-specific reactivity of lymphocytes in RA (n=56) or JIA patients (n=75) on different treatments, including biologic agents, such as anti-tumor-necrosis-factor(TNF)-alpha or anti-interleukin-6 (IL-6) receptor inhibition (tocilizumab), compared to 37 healthy adults (HA) and 41 children (HC). Production of cytokines by B cells in response to TLR9 stimulation inversely correlates with disease activity in SLE-patients
cord-006841-3u56erru	2003	The number of stem cells in the graft and the type of GvHD prophylaxis are factors which determine the rate of hematopoeitic reconstitution and may therefore also influence incidence and severity of infections during the early post-transplantation period. Modification of empiric antimicrobial regimens in patients with neutropenic fever after allogeneic stem cell transplantation When the causative agent of an infection has been identified, antibacterial therapy should be adapted according to the resistance pattern of the pathogen. If fever occurs in a patient later than 100 days after allogeneic stem cell transplantation, the upper and lower respiratory tract (bronchitis, pneumonia, sinusitis), and bacteremias have to be considered as specific foci of infections. Clinical manifestations of adenovirus infections in patients after allogeneic stem cell transplantation that have been reported so far include pneumonia, hepatitis, cystitis, diarrhea, and also disseminated disease (for diagnostic procedures see Table 3 ).
cord-006849-vgjz74ts	2019	Methods: We are performing this procedures within a prospective randomized trial that is design to compare the long term results of LRYGB-B versus the standard laparoscopic Roux-en-Y gastric bypass.The video shows our technique in a case of a 46 years old female with a BMI of 46 Kg/m2. Material and methods: We present a video of the surgical intervention of a 32-year-old patient, with functional dyspepsia, with a casual diagnosis of a pseudocystic mass of the right colon after performing a CT scan: giant diverticulum of the hepatic colon angle with fecaloid content inside it under tension The patient goes to the emergency room for acute abdominal pain, pending colonoscopy, antibiotic treatment is established, and a laparoscopic approach is decided upon after the patient''s evolution. Method: We present the case of a 65-year-old patient with surgical antecedent of laparoscopic low anterior resection due to rectal cancer, presenting in postoperative period an anastomosis leakage with severe peritonitis was identified and a laparotomy with end colostomy was performed.
cord-006854-o2e5na78	2018	Totally Laparoscopic ALPPS Combined with the Microwave Ablation for a Patient with a Huge HCC Hua Zhang; Department of Hepatopancreatobiliary Surgery, West China Hospital, Sichuan University Introduction: Associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) is a novel technique for resecting hepatic tumors that were previously considered unresectable due to the insufficient future liver remnant (FLR) which may result in postoperative liver failure (PLF). Not only does this case show that a large epiphrenic diverticulm can be successfully resected via the trans-abdominal laparoscopic approach, this case makes the argument that patients undergoing any minimally-invasive epiphrenic diverticulectomy and myotomy, with or without fundoplication, may be successfully managed with early post-operative contrast studies and dietary advancement, thus decreasing their length of hospitalization and overall cost of treatment. Introduction: There are reports of increased operative duration, blood loss and postoperative morbidity, caused by difficulties in obtaining good visualization and in controlling bleeding when laparoscopic resection is performed in obese patients with colon cancer.
cord-006856-b1w25ob5	2005	Egr-1 and hypoxia-inducible factor-1 (HIF-1) gene expression was examined in left ventricular biopsies of explanted failing hearts in 28 ICM and 42 DCM patients, as well as in 12 donor grafts before reperfusion (control), at 10, 30, 60 minutes after reperfusion, and at 1, 2, 3, 4, 6, 12 posttransplant weeks, using real-time RT-PCR. The risk of transplant-related mortality (TRM) due to graft-versushost disease (GvHD) is higher in male recipients of female stem cells compared with female patients receiving a graft from a female donor. We therefore analyzed a single-center cohort of 72 high-risk patients transplanted with a related or unrelated stem cell graft after nonmyeloablative conditioning for outcome (acute and chronic GvHD, TRM, relapse, and survival). Four patients between the age of 34 and 44 years underwent allogeneic peripheral blood stem cell (PBSC) transplantation (SCT) from HLA-identical sibling or unrelated donors at our institution.
cord-006860-a3b8hyyr	1996	Dept of Pediatrics, University Hospitals Kiel and Mtinster, Germany Resistance to activated protein C (APCR), in the majority of cases associated with the Arg 506 Gin point mutation in the factor V gene is present in more than 50 % of patients < 60 years of age with unexplained thrombophilia. The regular APC resistance test is not applicable to plasma from Orally anticoagulated (OAC) or heparinized patients due to decreased levels of vitamin K-dependent clotting factors and to thrombin inhibition by antithrombin, respectively. On admission an extensive coagulation screen yielded the following results (n/normal, t/elevated, I/reduced, +/positive, -/negative): PT t, aPTT t, Tr n, factor II, V, VIII n, factor VII, IX, XI, XII /,, fibrinogan t, ATIII n, protein C, S *, activated protein C sensitivity ratio 1.92 ($), FV-Leidenmutation PCR -, fibrinolytic system n, TAT t, Ft÷2 t, lupus anticoagulant +, heparin induced platelet antibodies +; no diagnosis of a specific autoimmuna disorder could be made.
cord-006862-5va1yyit	2012	10 .45 % (n = 202) of attendances were for non-respiratory diseases as the clinic also provides follow-up for general medical patients post hospital admission. Higher levels of exercise participation were seen in the younger age groups (p = 0.585 Introduction: Respiratory diseases, largely represented by COPD, are the third most common cause of acute hospital admission.Our aim was to audit the prescribing habits of inhaled, nebulised medication and oxygen by doctors in a general hospital. Our study was designed to determine the baseline and post-treatment values of total lymphocyte count and its subsets in HIV-negative patients diagnosed with active pulmonary MTB. The results of this study indicate that AAT can inhibit LTB 4 signaling thereby reducing the proteolytic activity of neutrophils and propose AAT aerosolized augmentation therapy as an effective treatment for LTB 4 associated pulmonary diseases including cystic fibrosis and severe asthma.
cord-006864-t5qsjyfi	1995	28 patients with RA were studied prospectively by measuring disease activity and radiological articular destruction at entry and at review 6 (mean) (range 4-8) years later. We document its occurrence in the paediatric age group with 3 case reports of tinea unguium occurring in healthy children, ages ranging from 7 to 14 years from different families, presenting over a 6 month period. The first group (the study group, n=20) consisted of patients attending ophthalmic clinics with a diagnosis of early open angle glaucoma who are on medical treatment with good control of intraocular pressure, evidence of optic disc cupping and no field loss on KOWA fields. In this study, 12 outpatients having Dementia of the Alzheimer Type (Clinical Dementia Rating, Score ~ 1 ; mean age _+ SEM, 74 + 2 years) were continuously monitored using Finapress and their responses to the Valsalva manoeuvre and positional change were compared with 12 age matched (73 _+ 1 years) healthy elderly controls.
cord-006869-g2q1gpp0	2009	This was a pilot study to compare the cerebral neurochemical changes in patients with traumatic brain injury (TBI) who underwent conventional blood glucose level (BGL) control and intensive BGL control with continuous titrated insulin. We studied 14 comatose SAH patients who underwent multimodality neuromonitoring with intracranial pressure (ICP), cerebral microdialysis, and brain tissue oxygen (PbtO 2 ) as part of their clinical care. We studied 46 consecutive comatose patients with subarachnoid or intracerebral hemorrhage, traumatic brain injury, or cardiac arrest who underwent cerebral microdialysis and intracranial pressure monitoring.Continuous insulin infusion was used to maintain target serum glucose levels of 80-120 mg/dl. This suggests that risk of cerebral vasospasm following traumatic brain injury is increased not only in subarachnoid hemorrhage, but also intraparenchymal hemorrhage, and that Rotterdam CT score may be a useful metric for assessing risk of csPTV in severe TBI patients.
cord-006870-f5w6fw6q	2017	
cord-006876-v2m5l5wz	2016	
cord-006880-9dgmdtj8	2012	Patients initially comatose after cardiac arrest treated who awoke after therapeutic hypothermia (TH) were evaluated by a neuropsychologist prior to hospital discharge with the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS), a well-validated tool that assesses function in multiple domains compared to standardized normal values. Clinical data including the pre-admission-status, neuroradiological, initial presentation, treatment, and outcome were evaluated through institutional databases, patient''s medical charts and by mailed questionnaires. To determine the differences in hospital outcomes among adult mild traumatic brain injury (TBI) patients where the severity of TBI is defined by Glasgow Coma Scale (GCS) score. Retrospective chart analysis was performed on all adult patients arriving to emergency department with history of fall at a level one trauma center for parameters like vomiting, alteration of consciousness (AOC) & loss of consciousness (LOC) after TBI; post-traumatic amnesia (PTA) and history of seizures before or after injury, along with outcomes such as ICU admission & ICU length of stay.
cord-006882-t9w1cdr4	2012	Objective: The aim of this study was to develop a mathematical model to determine the TTO based on two or more DEXA scans with TTO defined as the age at which the patient will enter the osteoporotic T-score range. An Audit of Clinical Outcomes in Transcervical Resection of the Endometrium Compared to Outpatient Balloon Thermablation Anglim BC, Von Bunau G Department of Gynaecology, Adelaide and Meath Children''s Hospital, Tallaght, Dublin Thermablation was introduced to the Coombe in November 2009 and thus far it has provided a quick and effective means of treating women with menorrhagia refractive to medical treatment. This audit reviewed cases of ovarian cystectomy, oopherectomy and salpingooopherectomy using both a hospital online database and records of theatre procedures to identify these patients. A retrospective review of the case notes of patients aged greater than 80 years who underwent bronchoscopy between September 2009 and November 2011 was carried out.
cord-006888-qfnukav4	2008	2 This study explored anxiety, depression and QoL of a small group of patients (n = 5), predominantly male (66.7%), mean age 74 years, using the Marie Curie ''''breathing space'''' outpatient clinic over a four week period. Methods: CF patients attending CUH completed a questionnaire relating to personal smoking and second-hand smoke (SHS) exposure, correlated with pulmonary function and exacerbation-rate data. This ongoing study indicates that a clinical pharmacy led management programme can reduce the need for hospital care in patients with moderate-to-severe COPD and improve aspects of their health related quality of life. There is a need for wider availability of joint hospital/ community based initiatives such as COPD Outreach and PRPs. Pulmonary rehabilitation has established efficacy, but patients often require follow-up care or maintenance. Patient data (MDS/ISWT/endurance shuttle walking test(ESWT)) from our pulmonary rehabilitation programme were initially analysed (n = 214; median FEV 1 = 1.04 L; mean age = 69 yrs).
cord-006924-1i3kf01j	2020	Results: Patients'' characteristics of 77 cases were as following; median age was 60 years old (range 33-77); 67 male and ten female; 16/16/41/4 of clinical Stage I/II/II/VI; 21 chemotherapy, 52 chemoradiation and 4 radiotherapy; 52 adenocarcinomas, 18 squamous cell carcinomas and seven other types of histology. The aim of this study was to explore the expression of piR-796 piRNA, which was identified by small RNAseq, in resected nonsmall cell lung cancer (NSCLC) patients, and to analyze the correlation with the clinic-pathological features. Conclusions: Our data demonstrated that OTP expression was only rarely identified in non-pulmonary neuroendocrine tumors/carcinomas, which further validated the previous report of OTP to be a highly specific marker for diagnosing PCs. The diagnostic sensitivity for PCs in this study appears to be lower than the previous report, which is probably due to the small number of cases included.
cord-006975-u5ecibta	2020	The outcomes achieved by medical care of patients requiring mechanical ventilation have been incompletely characterized with regard to the likelihood of both weaning and survival, and even less so with regard to quality of life during the time these patients remain alive. To measure whether the creation of a dedicated weaning program altered the outcomes seen in this patient population, we performed a single-institution retrospective study of cancer patients requiring long-term mechanical ventilation who were cared for in a specialized intermediate care weaning unit. Design, setting, and eligibility criteria After a waiver of authorization (WA0023-13) was obtained from the Institutional Review Board at Memorial Sloan Kettering Cancer Center, we performed a retrospective review of a single institution''s experience with all patients treated with prolonged mechanical ventilation with weaning as a goal of care after ICU discharge, subject to intensivist discretion, between 2008 and 2012 and between January and December 2018.
cord-007009-4wbvdg1r	2014	Severe fever with thrombocytopenia syndrome (SFTS), an infectious disease with a high case-fatality rate, is caused by SFTS virus (SFTSV), a novel bunyavirus reported to be endemic to central and northeastern parts of China [1, 2] . Vero cells were inoculated with RT-PCR-positive patient sera for virus isolation, cultured for 4-7 days, and examined for SFTSV antigen detection by indirect immunofluorescence assay (IFA) with a polyclonal antibody raised against SFTSV recombinant NP (rNP; rabbit anti-SFTSV rNP serum), which was produced as follows. Physicians were asked to volunteer information if they had treated patients who satisfied the following case definition: (1) fever of >38°C; (2) gastrointestinal tract symptoms, such as nausea, vomiting, abdominal pain, diarrhea, and melena; (3) thrombocytopenia, with <100 × 10 9 platelets/L; (4) leukopenia, with <4 × 10 9 white blood cells/L; (5) elevated levels of aspartate aminotransferase, alanine aminotransferase, and lactate dehydrogenase; (6) absence of other causes; and (7) death or admission to an intensive care unit because of the severity symptoms. Detection of severe fever with thrombocytopenia syndrome virus (SFTSV) RNA in the right cervical lymph node by the in situ hybridization ATtailing method.
cord-007321-7gi6xrci	1992	These guidelines for the evaluation of drugs for the treatment of respiratory tract infections include acute streptococcal pharyngitis and tonsillitis, acute otitis media, acute and chronic sinusitis, acute exacerbations of chronic bronchitis, and acute infectious pneumonia (table 1). This is often the case in otitis media, sinusitis, and pneumonia, when the use of invasive procedures such as tympanocentesis, sinus puncture, or transtracheal aspiration to confirm microbial eradication in the patient who is improving clinically generally is considered unjustified. Patients eligible for study entrance are children or adults with symptomatic pharyngitis or tonsillitis of acute onset clinically consistent with infection with group A I3-hemolytic streptococci and from whom group A (3-hemolytic streptococci have been isolated in cultures of throat -swab specimen or for whom a rapid screening test has indicated the presence of streptococci.
cord-007444-c9vu8ako	2000	The three major bacterial pathogens isolated from patients with COPD during periods of both clinical stability and exacerbation are nontypeable Haemophilus influenzae, Streptococcus pneumoniae, and Moraxella cafar~halis.~~ When FEV, is severely reduced, Enterobacteriaceae and Pseudomonas aeruginosa are also commonly detected.42 These organisms possess a wide array of virulence factors that allow them to evade clearance from the lower airways. Two randomized controlled trials evaluating the vaccine''s efficacy among patients with COPD were unable to show statistically significant protective benefit.36, 69 A recent meta-analysis concluded that the vaccine provides partial protection against bacteremic pneumococcal pneumonia but not against other important outcomes, including bronchitis or mortality caused by pneumococcal infection. The dose of methylprednisolone was high (125 mg every 6 hours for 3 days) and resulted in significantly more hyperglycemia and, possibly, increased secondary infection rates.''06 In summary, the evidence from randomized, controlled trials supports the conclusion that among patients with acute exacerbations, oral or intravenous corticosteroids significantly increase the FEV, for up to 72 hours and likely reduce the risk for treatment failure.
cord-007563-33jxxp1b	2018	In the present study, we investigated titin-isoform expression, total-titin and site-specific N2Bus/PEVK phosphorylation, and the degree of fibrosis in endomyocardial biopsy samples from AS patients compared with nonfailing donor heart samples. In our patient group, we found a significant shift toward the more compliant N2BA titin isoform versus nonfailing donor heart samples ( Figure 2) . This GCH1-GFRP complex is operative in humans because oral challenge with L-phe leads to a 3-fold rise in plasma biopterin levels (a correlate of BH 4 )-an effect that is attenuated in patients with a loss-of-function GCH1 mutation (23 To support this hypothesis, it is known the GCH1-GFRP axis regulates BH 4 and NO in endothelial cells (25) . Some studies report that elevations in circulating biomarkers of oxidative stress (myeloperoxidase) precede clinically significant systolic dysfunction in anthracycline-treated patients (8, 15 CT images were used to localize the heart and confirm the epicardial surfaces for VOI edge placement.
cord-007564-ljqrxjvv	2006	Trentetrois examens directs et 46 Ces données montrent que l''examen direct et la culture de l''expectoration dès lors qu''ils sont correctement effectués chez un patient sans antibiothérapie sont fréquemment positifs au cours des PAC à pneumocoque les plus graves, c''est-à-dire bactériémiques. Ces données ne doivent pas toutefois faire perdre de vue, comme le souligne Pesola [37] que dans plus de 10 % des cas, les PAC ont une étiologie plurimicrobienne et qu''il n''est peut être pas raisonnable de focaliser l''antibiothérapie uniquement sur le pneumocoque en cas de test positif. À partir d''échantillons provenant du tractus respiratoire inférieur (expectoration, voire prélèvements endoscopiques) ou supérieur (prélèvement nasopharyngé), un certain nombre de techniques ont été mises au point pour le diagnostic des infections liées à des germes tels que Chlamydia pneumoniae, Mycoplasma pneumoniae ou Legionella spp.
cord-007567-vst954ef	2003	3 Epidemiologic evidence indicates that transmission of the illness occurs with close person-toperson contact (to household members, health care workers, or nearby patients who were not protected by contact or respiratory isolation precautions) and through droplet secretions. In an effort to deal with the transmission and onset of illness within health care and community settings, the province of Ontario designated a Provincial Operations Centre (POC), which was responsible for issuing directives to hospitals about patient care and infection control practices. Some had normal chest radiography with no infiltrates demonstrated (yet) but had symptoms of fever, headache, myalgia, and malaise, and 1 of 3 distinct exposures: they had either traveled to Vietnam, China, Hong Kong, Singapore, or Taiwan; they had been exposed to a person with SARS; or they had been a health care worker, patient, or visitor in a hospital in the GTA where there had been recorded cases of SARS transmission.
cord-007575-5ekgabx5	2016	Important trends and developments in the field include (1) the emergence of a Chlamydia psittaci strain (TWAR) that is passaged from human to human, causes a mycoplasma-like illness, and that is relatively resistant to erythromycin, (2) the recognition of respiratory syncytial virus as a pathogen in nursing home outbreaks and in immunosuppressed adults, (3) the continuing high lethality of fully developed influenza pneumonia, (4) the efficacy of acyclovir and adenine arabinoside in limiting the complications of varicella-zoster virus infections, and (5) the increasing frequency of pneumonia caused by cytomegalovirus and the severity of this disorder in highly immunosuppressed patients. Important trends and developments in the field include (1) the emergence of a Chlamydia psittaci strain (TWAR) that is passaged from human to human, causes a mycoplasma-like illness, and that is relatively resistant to erythromycin, (2) the recognition of respiratory syncytial virus as a pathogen in nursing home outbreaks and in immunosuppressed adults, (3) the continuing high lethality of fully developed influenza pneumonia, (4) the efficacy of acyclovir and adenine arabinoside in limiting the complications of varicella-zoster virus infections, and (5) the increasing frequency of pneumonia caused by cytomegalovirus and the severity of this disorder in highly immunosuppressed patients.
cord-007577-f1jzbtjj	2006	Frequency of HAA in acute hepatitis: After the initial suggestion in 1967 by Blumberg and co-workers [4] that Australia antigen might be related to the infectious agent of viral hepatitis, and the demonstration in 1968 by Okochi and Murakami [5] and Prince [6] that the antigen appeared in blood of patients during the incubation period of serum hepatitis, a number of investigators reported further evidence for existence of a hepatitis-associated antigen (Table II) . The antibodies used diagnostically to measure HAA by precipitin and complement fixation technics all come from patients who have received multiple transfusions and in whom high titer "hyperimmune" anti-HAA developed apparently as a result of repeated exposure to antigen in transfused blood. [29] tested serum obtained at weekly intervals from twenty-two patients with HAA-positive hepatitis during a one to two month period after onset of disease and found only one antibody detectable by agar gel precipitin technics and two antibodies of low titer detectable only by complement fixation.
cord-007580-qwh8ei60	2014	We had three major goals: to determine the rate of viral recovery from cases of nonepidemic acute or subacute follicular conjunc tivitis; to compare the accuracy of clinical diagnoses with that achieved by culture or serologic studies, or both; and to explore the possible role of serum antibody in the forma tion and maintenance of corneal subepithelial infiltrates. 4 VIRAL KERATOCONJUNCTIVITIS 663 antibody titers to vaccinia, herpes, coxsackievirus A-9, A-16, and A-21, and four strains of acute hemorrhagic conjunctivitis virus were similarly assayed by serum neutraliza tion tests in human diploid fibroblast tissue culture. Table 2* shows the difference between the number of positive isolates ob tained by culturing before or after the eighth * All of the data for the epidemic keratoconjunc tivitis group were published elsewhere, except for the corneal quantitative material in clinical studies.'' day of illness.
cord-007696-83v9yfa6	2005	Idiopathic pulmonary fibrosis (IPF) is a chronic fibrosing lung disease limited to the lungs and associated with the histologic appearance of usual interstitial pneumonia (UIP) on surgical lung biopsy. Factors that predict poor outcome include older age, male gender, severe dyspnea, history of cigarette smoking, severe loss of lung function, appearance and severity of fibrosis on radiological studies, lack of response to therapy, and prominent fibroblastic foci on histopathologic evaluation. With greater comprehension of the clinical relevance of the different histopathological subgroups that make up the idiopathic interstitial pneumonias, the term idiopathic pulmonary fibrosis (IPF) is now reserved to patients with idiopathic usual interstitial pneumonia (UIP) on surgical lung biopsy. Tang In a recent study, human T-lymphtropic virus type I (HTVL-I) positive IPF patients had more affected lung parenchyma, demonstrated traction bronchiectasis with honeycomb change, and exhibited increased levels of specific cytokines that correlated with activated T-cells in the bronchoalveolar lavage fluid (BALF).
cord-007786-cu831tl7	2019	We suggest that in patients with hypotensive shock, fluid bolus therapy (30 mL/kg) with isotonic crystalloids be commenced (ungraded) and, if available, early initiation of vasopressor medication (ungraded) Timing of enteral feeding in cerebral malaria We suggest not to use a strategy of permissive hypercapnia to achieve ventilation with low tidal volumes in patients with cerebral malaria, because of the high incidence of brain swelling in these patients (ungraded) Fluid management in severe dengue We recommend not to use prophylactic platelet transfusion for thrombocytopenia in the absence of active bleeding complications or other risk factors (uncontrolled arterial hypertension, recent stroke, head trauma or surgery, continuation of an anticoagulant treatment, existing hemorrhagic diathesis) (1B) acidosis [14, 15] , and transpulmonary thermodilution-guided rapid fluid resuscitation resulted in pulmonary edema in 8/28 (29%) patients [15] . There are several randomized clinical trials comparing crystalloid with colloid fluid management for the treatment of patients with severe dengue and compensated shock.
cord-007788-09t52zix	2017	Some other relatively rare complications are also covered here: haemorrhagic cystitis (HC), endothelial damage (ED) syndromes including engraftment syndrome (ES), idiopathic pneumonia syndrome (IPS), diffuse alveolar haemorrhage (DAH), transplant-associated microangiopathy (TAM) and sinusoidal obstruction syndrome/veno-occlusive disease (SOS/VOD). Oral damage may be a hallmark of graft versus host disease (GvHD) in patients following allogeneic stem cell transplantation, and the presence of lichenoid hyperkeratotic plaques (diagnostic sign), gingivitis, mucositis, erythema, pain, xerostomia and ulcers may indicate GvHD. The increased risk of infections in patients undergoing haematopoietic stem cell transplantation (HSCT) is well known, and infection is a leading cause of morbidity and mortality. Differential diagnoses will need to be excluded by assessing risk factors, symptoms and lab tests since liver dysfunction can also be seen in sepsis, viral infection, graft versus host disease (GvHD) and iron overload and as a side effect from many of the drugs used in the HSCT setting.
cord-007798-9ht7cqhu	2010	In the context of analgesic, anti-inflammatory, anticholinergic, anticonvulsant, antihyperglycemic, antimicrobial, antineoplastic, cardiovascular, opioid, or sedative-hypnotic agents overdose, N-acetylcysteine, physostigmine, l-carnitine, dextrose, octreotide, pyridoxine, dexrazoxane, leucovorin, glucarpidase, atropine, calcium, digoxin-specific antibody fragments, glucagon, high-dose insulin euglycemia therapy, lipid emulsion, magnesium, sodium bicarbonate, naloxone, and flumazenil are specifically reviewed. As might be anticipated from the fact that supportive care suffices for the majority of poisoned patients, a typical study of routine administration of charcoal following oral overdose of primarily benzodiazepines, acetaminophen, and selective serotonin reuptake inhibitors could not demonstrate benefit [16, 17, 23] . Patient characteristics suggesting extracorporeal therapy include signs or symptoms of significant end organ toxicity; impaired elimination secondary to baseline comorbidities or critical illness-induced hypoperfusion; inability to tolerate or refractory to antidotal strategies (such as bicarbonate or saline); inadequate response to supportive care measures; concurrent electrolyte derangements (e.g., metformin-associated lactic acidosis); or serum drug concentrations historically associated with severe outcome [127] .
cord-007818-jfp9uumb	2019	Finally, so-called telemedicine in ICUs in resource-rich settings, mainly to solve the problem of physician shortages during nighttime hours and in some ICUs with low-intensity staffing [21] , has been shown to improve early identification of patients who deteriorate [22] and increases the number of interventions [23] , but the effect on ICU outcomes remains controversial [24] and costs of required technological infrastructure are high [25] . Despite the availability of specialty training programs in selected countries, regional data and the experience of the authors suggest that intensive care specialists are unavailable in many ICUs in resource-limited settings [40] . Dedicated courses in trauma and intensive care-and emergency medicine-related procedures improve knowledge in "best clinical practice" of healthcare professionals working in ICUs in resource-limited settings [56, 57] .
cord-007833-wkv808ix	2015	In this article, the authors report an additional case of pomalidomide-induced pulmonary toxicity based on temporal relationship between drug administration and onset of symptoms as well as characteristic imaging findings. Lenalidomide and bortezomib were discontinued, and he was initiated on pomalidomide 4 mg/d, days 1 through 21 with dexamethasone 20 mg once weekly. Approximately 8 months after starting treatment with pomalidomide, the patient developed fever, progressive dyspnea, productive cough, and generalized weakness for 5 days duration before presenting to the hospital. The patient''s recurrence and resolution of symptoms in a temporal relationship to therapy with pomalidomide, along with ground glass opacities on CT, led to a strong suspicion of pomalidomide-induced pulmonary toxicity. 3, 4 Pulmonary toxicity is an uncommon but increasingly reported clinical complication of IMiD agents, particularly thalidomide and lenalidomide. Usual time interval between initiation of treatment to onset of symptoms is 8 to 120 days, but toxicity from pomalidomide may be delayed.
cord-007865-1oyl6clq	2008	title: Patients Would Prefer Ward to Emergency Department Boarding While Awaiting an Inpatient Bed Boarding of admitted patients in the Emergency Department (ED), rather than in inpatient care areas, is widespread. The practice of holding admitted patients in the Emergency Department (ED) until an inpatient bed becomes available (commonly called "boarding") is widespread (1, 2) . These were convenience samples (dependent on research assistant [RA] availability) of 1) patients waiting to be seen without a disposition, 2) visitors of patients, and 3) admitted patients who were being held in the ED while awaiting an inpatient bed. The purpose of sampling these three groups was to determine the opinion of members of the general public with an immediate interest in the subject (visitors), non-boarding patients, and those patients who were actually being boarded in the ED. Emergency department overcrowding: patient preference for boarding hallway location
cord-007890-bie1veti	2002	Effects of Interferon alpha plus ribavirine therapy on frequencies of HCV, HIV and CMV specific CD4-T-cell responses in peripheral blood of HIV/HCV coinfected patients after 6 months of treatment SoA9.5 Methods: Two groups of patients with chronic HCV infection were studied: 26 HIV coinfected progressors with antiretroviral therapy and 13 HIV-negative controls. In order to assess the local temporal trend of antibiotic sensitivity of the most common urinary tract bacterial pathogen, all urine-cultured Escherichia coli isolates were reviewed as to susceptibility profile, and specimen source (community-versus hospital-acquired infection). Methods: A total of 87 penicillin resistant clinical strains isolated from patients at Hacettepe Children''s Hospital, Ankara, Turkey between 1999 and 2001 were tested for their in vitro susceptibility to various antibiotics that are commonly used in the treatment of respiratory tract infections.
cord-008596-zhk82cor	2008	The questions are "what happened?" and "why review this topic now?" In inverse order, I believe after the present presidential campaign, we will see major efforts to revise the structure of the US health care system, and the changes advocated will have significant impacts on physicians and the way they practice [4] . Belatedly, physicians began organizing their practices around the group model to overcome these concerns; belatedly, because the managed care model they were fighting began to lose acceptance by the public as it did not hold down costs, and its proactive policies regarding physician decision making were offensive to patients [15] . These changes in the US health care system, which have restricted physician autonomy, have also adversely affected the public''s respect for the medical profession for one major reason.
cord-008672-luoxomif	2004	We undertook a prospective cross-sectional study of adult patients admitted to a government hospital in Nairobi, Kenya, to determine possible bacterial, mycobacterial, parasitic and viral causes of diarrhoca; to consider which may be treatable; and to relate microbiological findings to clinical outcome. METHODS: Stool specimens from 75 consecutive HIV-seropositive patients with chronic diarrhoca admitted to a Nairobi hospital were subjected to microbiological investigation and results were compared with clinical findings and outcome. CONCLUSIONS: HIV-infected patients with chronic diarrhoea in Nairobi have a poor outcome overall, and even with extensive investigation a putative pathogen was identified in only just over half the patients. We undertook a 4-month study in Nairobi, Kenya, to determine possible bacterial, viral and parasitological causes of chronic diarrhoea and wasting using a broad range of investigations and related findings to patient outcome.
cord-008695-y7il3hyb	2007	Children may be considered at increased risk of complications if they have cough and fever (or influenza-like illness) and temperature >38.5ºC, plus either chronic co-morbid disease or one of following features: breathing difficulties severe earache vomiting >24 hours drowsiness These patients should be offered an antibiotic as well as oseltamivir (in those >1 year of age) and advice on antipyretics and fluids. Children may be considered at increased risk of complications if they have: Cough and fever (or influenza-like illness) and temperature >38.5ºC and either (i) chronic co-morbid disease (see Appendix 2) or (ii) one of the following features • Breathing difficulties • Severe earache • Vomiting > 24 hours • Drowsiness These patients should be offered an antibiotic as well as oseltamivir (in those over one year of age) and advice on antipyretics and fluids.
cord-009278-98ebmd33	2020	Community-acquired pneumonia (CAP) is the leading cause of death among infectious diseases and an important health problem, having considerable implications for healthcare systems worldwide. Recently, Nature Medicine published the first use of phages to treat a multidrug-resistant (MDR) microorganism [3] and Lancet Infectious Diseases reported the first use of pneumolysin in severe CAP treatment added to standard of care in a phase II trial [4] . Incidence of community-acquired lower respiratory tract infections and pneumonia among older adults in the United Kingdom: a population-based study Incidence rate of community-acquired pneumonia in adults: a population-based prospective active surveillance study in three cities in South America Disease burden and etiologic distribution of community-acquired pneumonia in adults: evolving epidemiology in the era of pneumococcal conjugate vaccines Epidemiology and clinical outcomes of community-acquired pneumonia in adult patients in Asian countries: a prospective study by the Asian network for surveillance of resistant pathogens Effect of corticosteroids on treatment failure among hospitalized patients with severe community-acquired pneumonia and high inflammatory response: a randomized clinical trial
cord-009285-1ddfywfa	1993	By means of a monoclonal immunoradiometric assay for calcitonin precursors, we have measured serum concentrations of procalcitonin in patients with various bacterial and viral infections. Lancet 1993; 341: 518-21 Introduction About 3000 of the 30 000 people admitted to hospital in the UK each year for acute upper-gastrointestinal-tract bleeding will die.1 Prognostic indicators for outcome include: age, pulse rate, blood pressure, and haemoglobin at admission, and findings at endoscopy, such as presence, site, and nature of a bleeding lesion, and stigmata of recent bleeding.2-4 One factor that may promote continued bleeding and hence an adverse clinical outcome is the fibrinolytic activity of the upper gastrointestinal tract, because fibrinolysis may lead to digestion of haemostatic plugs.5 Consistent with this possibility, Poller and colleaguess demonstrated increased serum fibrin degradation products (FDP) in a small series of patients with acute upper-gastrointestinal-tract bleeding; however, the prognostic value of serum FDP concentrations has not been reported in a prospective study.
cord-009322-7l7slziv	1997	□ PATIENTS AND METHODS: Ten patients with adult onset of Still''s disease (AOSD) were examined one to nine years after the established diagnosis. 1 971 beschfieb Bywaters 14 erwachsene Patienten mit Symptomen ~ihnlich denen einer juvenilen chronischen Polyarthritis, die frª als ,,Still''s disease" bezeichnet wurde [3] . Rey Words: AOSD 9 Adult onset of Still''s disease 9 Prognostic critefia 9 Course of disease 9 Outcome 9 Review of the literature 9 Case reports Med. Klin Betroffen sind vor allem der Stamm und die proximalen Extremiditen (Abbildung 2, Patient Nr. 8), gelegentlich aber auch das Gesicht [18] . Eine schwere hepatische Beteili~mg trat bei unserem sp~iter verstorbenen Patienten ira P,.ahmen eines hffmophagozytischen Syndroms auf[28], auch dies schon als seltene und lebensbedrohliche Komplikation des AOSD bekannt. Eine Verschmfflerung des Gelenkspaltes in Karpometakarpaloder Interkarpalgelenken mit sp~iterer kn6cherner Ankylosierung gilt als eine ftir das AOSD charakteristische radiologische Verffnderung [1] , die in dieser Forro bei unseren Patienten nicht zu beobachten war.
cord-009360-rgwe2pkx	2019	Considering infection/inflammation to be an important risk factor in male infertility, the aim of this study was to make a comprehensive evaluation of the prevalence of urogenital tract infection/inflammation and its potential impact on sperm retrieval in azoospermic patients. Considering infection/inflammation to be an important risk factor in male infertility and the frequent presence of pathogens within the seminal tract, the aim of this prospective study was to make a comprehensive evaluation of the prevalence of urogenital tract infection/inflammation and its potential impact on sperm retrieval in azoospermic patients undergoing testicular biopsy/TESE. To the best of our knowledge, this is the first prospective study which set out to comprehensively evaluate infection and inflammation in patients presenting with azoospermia using a 2-glass test and analysis of semen, testicular fluid and testicular tissue by measuring inflammatory parameters and performing systematic microbiological investigations.
cord-009417-458rrhcm	2009	Benefi ts to the patient with more judicious use of platelet transfusion include decreased donor exposure, which lessens the risk of transfusion-transmitted disease; fewer febrile and allergic reactions that may complicate the hospital course; and the potential delay or prevention of alloimmunization to HLA and platelet antigens. If anti-IgA antibodies are determined to be the cause of this reaction, the patient must receive blood components donated by IgA-defi cient individuals or, if unavailable, specially prepared washed RBCs and platelet concentrates. These patients may have intensive red cell and platelet transfusion requirements and need specialized products such as CMV-negative and irradiated blood components. A blood bank problem uniquely encountered in BMT is the need to switch the patient''s ABO group because of an ABO-mismatched transplant, thus necessitating an exchange transfusion of red cells and plasma-containing products (i.e., platelet concentrates) of differing ABO type to avoid hemolysis of donor and recipient cells.
cord-009507-l74c9x0n	2008	To generate the appropriate differential diagnosis in this case, there are several key features of the patient''s history and physical examination that aid in the understanding of his pathologic process: 1) symptom development occurred soon after emigration from Indonesia, 2) the patient''s primary symptoms were pulmonary in origin, and 3) secondary cardiac involvement resulted in a large, initially asymptomatic pericardial effusion. 10 Acute infection begins with sudden onset of one or more of the following: high fevers (up to 104-1058F), severe headache, general malaise, myalgia, confusion, sore throat, chills, sweats, nonproductive cough, nausea, vomiting, diarrhea, abdominal pain, and chest pain. In our patient, the most likely cause of the pericardial effusion was infection with tuberculosis. To summarize, this patient''s recent immigration, symptoms of intermittent fever and of chronic cough that failed to respond to outpatient antibiotics, and development of large pericardial effusion all are consistent with a diagnosis of tuberculosis.
cord-009512-o4y9s8zf	2010	The authors in this study report the incidence and risk factors associated with the development of solid tumors in 4349 pediatric and adult patients who underwent allogeneic stem cell transplant (SCT) for acute myelogenous leukemia (AML) in CR1 or chronic myelogenous leukemia (CML) in first chronic phase. The lower hOCT1 mRNA expression level in LEU from IMA naïve de novo CML patients compared to healthy volunteers as well as its progressive increase after the start of IMA therapy could be explained by the initial presence and subsequent gradual disappearance of tumor cells from the measured cell population. To confirm this hypothesis, we performed an analysis on the relationship of hOCT1 expression with the percentage of immature myeloid cells in the LEU samples (as a marker of disease burden) obtained from IMA naïve de novo CML patients.
cord-009567-osstpum6	2008	Introduction: Previously, it has been demonstrated that FOXP3, a gene required for the development and function of regulatory T cells, was highly expressed in the graft during cardiac rejection, suggesting infiltration of regulatory T cells in the transplanted organ during an allogeneic response. Efficacy and safety parameters assessed at follow-up included: acute rejection; patient and graft survival; renal function, vital signs, basic lab results and immunosuppressive regimen for the patients 10 years after completion of the original study. We analyzed, for the first time, the expression of TLR4 in PBMC from kidney recipients with contrasted situations: operational tolerance and chronic immune-mediated rejection (Banff 2005), compared to patients with normal histology and stable graft function, non transplant patients with renal failure and healthy volunteers.
cord-009571-mygj2nd4	2005	Levels of Ty cells as well as total T lymphocytes were measured in 19 patients with systemic lupus erythematosus (SLE), 11 with active and 8 with inactive disease, and in 47 normal subjects. The diagnosis of GC arthritis were studied for the presence of GC antigen (AG) and anti-in all seven patients was made by typical clinical presentation, body (AB) in serum and synovial fluid by counter-positive local culture for Ngonorrhoeae (NG) , and response to treatment. A retrospective study was instituted on 10 patients in the UCLA lupus nephritis clinic in an attempt to determine the ability of three serologic indicators-specifically immune complexes (IC), anti-DNA antibodies (DNA-ab), and C3-to predict the activity of SLE renal disease as indicated by changes in 24 hour proteinuria, serum creatinine, and creatinine clearance.
cord-009575-bd67ph64	2009	ABSTRACT‐ A population‐based study of the prevalence and risk factors of multiple sclerosis (MS) was conducted in the Hautes‐Pyrénées, the southwestern region of France. The mumps antibody titer was significantly higher in the MS patients than in the controls. Patients and controls were asked whether they had ever contracted the following infectious diseases: rubella, measles, varicella, mumps, viral hepatitis, herpes simplex, zoster, pertussis, chronic sinusitis, and upper airways infections ( Table 2) . Age at the time of immunization was significantly higher for patients than controls (15.8 years versus 8.9 years, A history of familial MS was reported by 4 There was no association between antibody levels and clinical features, including sex, age at onset of MS, and the course of the disease. Nevertheless, MS patients tended to have higher measles antibody titers than controls. Risk factors in multiple sclerosis: tuberculin reactivity, age at measles infection, tonsillectomy and appendicectomy Viral infection in patients with multiple sclerosis and HLA-DR matched controls
cord-009664-kb9fnbgy	2014	
cord-009667-8r8j0h08	2017	13, 17 Recently, the results of 2 multicenter Community-Acquired Respiratory Tract Infection Pathogen Surveillance (CAR-TIPS) studies in adults conducted in urban tertiary hospitals in China showed that 88.1%-91.3% of S. Step 3: Predict the potential pathogens of CAP and risks of antibiotic resistance ( Table 2) : considering patient age, season of onset, underlying diseases and risk factors, symptoms or signs, characteristics of chest imaging (X-ray film or CT), laboratory tests, severity of CAP, prior antibacterial therapies and so on. After clinical diagnosis of CAP is established, and etiological test and sampling arranged appropriately, the most potential pathogens should be assessed in terms of patient age, underlying disease, clinical characteristics, results of laboratory and radiography tests, severity of disease, hepatic and renal functions, and history of medication and antimicrobial susceptibility profile, then evaluate the risk for antibiotic resistance, select the appropriate anti-infective agent (s) and dosing regimen ( Table 6 ).
cord-009697-dq4y89ab	2003	3 This multicentre, placebo-controlled, randomized, double-blind trial in 6213 patients with acute ST-elevation myocardial infarct (STEMI) found that magnesium sulphate, (2 g intravenous bolus over 15 min followed by a 17 g infusion over 24 h), administered within 6 hours of onset of symptoms did not have any effect on the primary end-point of 30 day all-cause mortality when compared with placebo (15.3% 30 day mortality in the magnesium group vs 15.2% in the placebo group; odds ratio 1.0; 95% CI 0.9-1.2; P = 0.96). As the investigators point out in the discussion of their paper, this means that 68 684 patients have been studied over the past 22 years in 14 randomized trials of magnesium in myocardial infarction. Second, a multicentre, placebo-controlled, randomized, double-blind trial of intravenous magnesium sulphate in 248 patients with acute severe asthma was recently reported.
cord-009713-sxd4t2tz	2020	Poster No. 010 Seizure, developmental and cognitive outcomes in children post hemispherotomy TT TAY 1 , DR REED 2 , VJ JOSAN 3 , SR RUST 4 , JT TAN 5 1 University of Manchester, Manchester, UK; 2 Neuropsychology Team, Paediatric Psychosocial Service, Royal Manchester Children''s Hospital, Manchester, UK; 3 Neurosurgery, Salford Royal NHS Foundation, Manchester, UK; 4 Paediatric Neuropsychology, Royal Manchester Children''s Hospital, Manchester, UK; 5 Paediatric Neurology, Royal Manchester Children''s Hospital, Manchester, UK Introduction: Patients with focal refractory epilepsy secondary to structural hemispheric changes have been shown in retrospective studies to have significantly improved seizure outcomes following hemispheric disconnection. In a univariate analysis of 682 cases with ≥12 months follow-up data, poor final outcome (defined as modified Rankin Scale [mRS] score 3-6) occurred in 30% and was associated with very young or elderly age at onset, movement disorder, decreased consciousness, autonomic dysfunction, mechanical ventilation, higher mRS score in the acute phase, longer hospital stay, extreme delta brush on EEG, abnormal MRI, CSF pleocytosis and elevated CSF protein (all p<0.05).
cord-009788-bc6sc2rc	2009	The Quality in Australian Health Care Study (QAHCS) 1 estimated that 5.5% of hospital admissions were affected by healthcare-associated infection (HAI), with an estimate at that time of 155 000 infections per annum across Australia. 11 MRSA infected or colonized patients admitted to hospital increase the risk of MRSA spread to healthcare staff and their families. 16 Healthcare staff and other patients must be protected from infectious fine particle (<5 mM) aerosols that are capable of transmitting infection at low doses †Active screening and isolation for methicillin-resistant Staphylococcus aureus-colonized patients/staff is not performed at some Australian sites as it is considered to be an ineffective measure. [22] [23] [24] A national initiative commenced in 2008 to improve hand hygiene, focusing on education, provision of alcohol-based hand rub at every bedside, reliable, regular audits of compliance with effective feedback to staff and management, and measurement of patient infection outcomes (healthcare-associated S.
cord-009891-gqrhbhbn	2003	The Centers for Disease Control and Prevention (CDC), USA, reports that ''transmission to health care workers appears to have occurred after close contact with symptomatic individuals (e.g. persons with fever or respiratory symptoms) before recommended infection control precautions for SARS were implemented (i.e. unprotected exposures).'' There is also a possibility that the causative agent can remain viable for extended periods of time after drying on environmental surfaces. Preliminary results of a large-scale trial of a candidate AIDS vaccine announced by the US-based biotechnology company VaxGen suggest that it is possible to protect some individuals from HIV infection. The result is that poor diagnosis of pain in cancer patients remains a significant problem, with many physicians finding it difficult to differentiate between the various pain types; and, many underestimating its severity. Poor diagnosis, poor assessment, the choice of less appropriate treatments, plus patients and physicians fears about controlled drugs such as morphine all contribute to under treatment of cancer pain.
cord-009967-fyqc5bat	2012	Recent studies have confirmed the efficacy and reduced expense of oral antibiotics prescribed for selected children with osteomyelitis and septic arthritis.1"22 In 1973, it was reported that favorable results ensued when oral antibiotic therapy was prescribed for hospitalized patients with serious infectionsz3 Fourteen patients with osteomyelitis were treated successfully with oral cephalexin after they had received a short course of parenteral cephaloridine. Adults with disseminated gonococcal infection can be effectively treated with a one week program consisting initially of 2 million units of penicillin G administered every 4 hours followed by oral ampicillin or amoxicillin prescribed as 500 mg four times daily.34,35 Hospitalization is usually recommended to establish the diagnosis of disseminated gonococcal disease since misdiagnosis occurs not infrequently with this disorder.33 Selected patients can complete the oral regimens in an outpatient setting or, alternatively, they can be treated entirely without ho~pitalization.~~ Acceptable oral regimens consist of giving amoxicillin (500 mg four times daily), tetracycline (500 mg four times daily), or erythromycin (500 mg four times daily) for at least 7 days.
cord-009982-zgbu46fo	2019	DESIGN: Retrospective electronic medical record review of prospectively collected data from critically ill children receiving peramivir for influenza A or B viral infections in the pediatric intensive care unit (PICU). CONCLUSION: The pharmacokinetics of PRV demonstrated in this PICU cohort differs in comparison to healthy pediatric and adult patients, and alterations to dosing regimens may be needed in PICU patients to achieve pharmacodynamic exposures. 20 The current FDA-approved pediatric dosing regimen is recommended based on pharmacokinetic data to approximate a total drug exposure or AUC similar to that achieved in adults that was associated with safety and efficacy. 3 The pharmacokinetic data from these 11 PICU patients suggest that dosing modifications would be needed for PRV to better achieve drug exposures similar to those described earlier 3 and in the PI.
cord-009997-oecpqf1j	2018	Completed cranial radiation and proceeded to allogeneic stem cell transplant with unrelated cord marrow donor and is disease free at approximately day +200.Case 2: 5 year-old female diagnosed with FLT3 and MLL negative AML and completed treatment per COG AAML1031 study on the low risk arm without Bortezomib. Design/Method: This study was a retrospective chart review that included patients 3 to 23 years old with sickle cell disease type SS and S 0 followed at St. Christopher''s Hospital for Children. Background: Hydroxyurea, chronic blood transfusion, and bone marrow transplantation can reduce complications, and improve survival in sickle cell disease (SCD), but are associated with a significant decisional dilemma because of the inherent risk-benefit tradeoffs, and the lack of comparative studies. Brown University -Hasbro Children''s Hospital, Providence, Rhode Island, United States Background: Despite clinical advances in the treatment of sickle cell disease (SCD) in pediatric and young adult patients, pain remains a significant source of disease-related morbidity.
cord-010027-r0tl01kq	2015	Further profiling of other T cell populations may help to further understand this expression which may act as a biomarker or provide a therapeutic target Biomarkers that are able to distinguish stage II and III colon cancer patients at high risk of developing disease recurrence, who may benefit from adjuvant chemotherapy, are still lacking. *AM supported by the NIHR and the Academy of Medical Sciences ABSTRACTS S·17 Assessment of HER2 Status on Needle Core Biopsy of Breast Cancer: Impact of Histopathological Concordance P M Pigera; AHS Lee; IO Ellis; EA Rakha; Z Hodi Nottingham City Hospital, Nottingham, UK One of the key recommendations introduced in the ASCO/CAP update guideline recommendation on HER2 testing is the novel concept of "histopathological concordance." It is proposed that certain tumour morphological features such as histologic type and grade should trigger repeating a molecular test in cases of "discordance".
cord-010036-6czkzek0	1990	title: Treatment of idiopathic spasmodic torticollis with botulinum‐A toxin: a pilot study of 19 patients Nineteen patients with spasmodic torticollis, unresponsive to standard therapy, were administered local injections of botulinum‐A toxin into the affected muscles. Botulinum toxin is a very effective and safe method of treatment for spasmodic torticollis, (Med J Aust 1990; 152: 528-530) T he term "dystonia" was coined by Oppenheim in 1911 1 in describing six patients with alterations in muscle tone, sustained posturing and involuntary movements. A 48-year-old male mechanic suffering from haemochromatosis, which was treated with weekly venesections, developed spasmodic torticollis 18 months before he was referred for botulinum toxin treatment. In up to 15% of patients with ST the symptoms may remit in the first five years of the illness, so some cases of improvement may be examples of a natural remission hastened by botulinum toxin injections. Controlled trial of botulinum toxin injections in the treatment of spasmodic torticollis
cord-010075-72jodunj	2011	Expression of MR, CD91 and CD31 were decreased in patients with NEA or COPD, but not signifi cantly changed in EA Conclusion Impaired sputum-macrophage phagocytosis of apoptotic cells in NEA is associated with reduced expression of key macrophage recognition molecules. Conclusions Subjects with severe persistent asthma have an eating pattern of lower diet quality with higher intakes of fat and lower intakes of fi bre than healthy controls, which is related to lower lung function and increased airway infl ammation. Support and Confl ict of Interest Nil. Methods We performed a retrospective chart review of all adult patients who had an ICC over a 24-month period within a tertiary hospital respiratory service. The objectives of our study were to (1) determine the point prevalence and identify viruses associated with exacerbations and (2) evaluate clinical and investigational differences between viral infection positive and negative exacerbations in children with non-CF bronchiectasis.
cord-010078-8lkkez3n	2010	Both modes of imaging discriminate early malignant lesions from non-specifi c infl ammation, aid in selecting appropriate sites for biopsy and better delineate tumor margins for more precise staging, but are of little value at present in clinical practice since most patients with malignant pleural effusions have extensive pleural involvement that is easy to diagnose with white light pleuroscopy For pleuroscopic guided pleural biopsies, specimens obtained with the rigid forceps are larger than those with the fl ex-rigid pleuroscope since they are limited by size of the fl exible forceps, which in turn depends on the diameter of the working channel. In the United Kingdom, a thrombosis group has been formed to promote awareness among parliamentarians about the risk and management of VTE; to increase knowledge of its causes, effects, and treatments; and to monitor the implementation of government initiatives and other researches being and this program has corrected the wrong perception that PTE is a rare disease in China Pulmonary hypertension (PH) is a common complication of chronic respiratory diseases, such as chronic obstructive pulmonary disease (COPD) or interstitial lung diseases (ILD).
cord-010088-s9tfvtao	2013	These include ''incorrect blood component transfused'' events, where the blood component was intended for another recipient (frequently due to errors in patient identification at the time of collection of the pre-transfusion sample, or at the time of bedside administration), or did not meet the patient''s special needs (such as a patient with a red cell antibody who did not receive the required antigen-negative unit). Methods: Eligibility criteria for inclusion in the study included the following: transfusion of Rh D positive platelets, no anti D detectable before transfusion, no previous exposure to Rh D positive blood components, and results of follow-up testing of anti-D in patients serum available. In addition, the allelic frequency of Hpdel was calculated to be 0.015 by a genetic study of a limited number of the Japanese individuals, suggesting that Hp deficiency might distribute among the Japanese population as a phenotype of serum Hp. Aims: In this report, we present the results obtained from a hemovigilance survey carried out between 1998 and 2012, in which Hp deficiency was identified among Japanese patients who had experienced nonhemolytic TRs (NHTRs), and those obtained from a screening of Hp-deficient Japanese healthy blood donors.
cord-010092-uftc8inx	2019	Prospective testing of blood donations in endemic areas of the U.S. revealed 0.38% of donors were positive for Babesia DNA or antibodies (Moritz, NEJM, 2016) Aims: -To report results of ongoing Babesia clinical trial -To explain significance of Babesia as a TT infection Methods: In cobas â Babesia for use on the cobas â 6800/8800 Systems, is a qualitative polymerase chain reaction nucleic acid amplification test, developed to detect in whole blood (WB) donor samples the 4 Babesia species that cause human disease: B. In sensitivity analyses, there were two discrepant results for HIV testing, three for HCV, and five for anti-HBc. Summary/Conclusions: Elecsys â infectious disease parameters on the cobas e 801 analyser demonstrate high specificity/sensitivity for screening first-time blood donor samples, with similar clinical performance to other commercially available assays.
cord-010116-hfzs16jh	2014	Other causes of pulmonary infiltrates include acute cellular rejection, chronic lung allograft dysfunction Abbreviations: AR, acute rejection; BAL, bronchoalveolar lavage; BOS, bronchiolitis obliterans syndrome; CFU, colony-forming units; CLAD, chronic lung allograft dysfunction; CMV, cytomegalovirus; CRP, C-reactive protein; FEV1, forced expiratory volume in the first second; IQR, interquartile range; ISHLT, International Society of Heart and Lung Transplantation; LTR, lung transplant recipients; LTx, lung transplantation; SOT, solid organ transplant; TBB, transbronchial biopsy (CLAD), and drug toxicity. Patients A retrospective analysis was performed of all LTR and heart-lung transplant recipients attending the outpatient clinic at our institution between September 1, 2006 and October 14, 2011. Pulmonary infiltrates on postoperative chest x-rays are common in lung vascular injury of the donor, re-implantation disease (24) , reperfusion edema (25), or primary graft dysfunction (26) , vascular obstruction, adult respiratory distress syndrome (27) , infection, atelectasis (26) , rejection, pharmacological toxicity, and post-transplantation lymphoproliferative disorders (28) .
cord-010119-t1x9gknd	2017	Conclusion: The wide distribution in the concentration of bioactive lipids among 405 stored RBC units suggests that lipid degradation is highly donor-Background/Case Studies: To ensure availability of biological products to hospitals, blood banks have developed and validated multiple storage conditions for each of their products to maximize shelf life and quality. 1 The Department of Blood Transfusion, The PLA General Hospital, 2 The Department of Blood Transfusion, Air Force General Hospital, PLA Background/Case Studies: Recently, multi researches have reported that longer term-stored red blood cells(RBCs) units were associated with increased risks of clinically adverse events, especially in critically ill patients. Weak D types 1, 2 and 3 express all the major RhD epitopes and these patients can be managed as RhD-positive, which may lead to a reduction in unnecessary Rh immunoglobulin (RhIG) administration and conservation of RhD-negative RBCs. Study Design/Method: RHD genotyping was performed on all patient samples with weaker than expected or discrepant RhD typing results, utilizing a commercially available genotyping kit manufactured by Immucor (RHD BeadChip).
cord-010141-955r29sd	2016	The purpose of this review is to assess the evidence related to corticosteroids and other nonantibiotic adjunctive therapies use and clinical outcomes in patients with CAP, with special interest in studies published in the last 10 years. These authors demonstrated a mortality reduction in the group treated with corticosteroids, a better modulation of systemic inflammatory response, and significant improvement in clinical endpoints, such as chest X-ray, multiple organ dysfunction syndrome severity scale, PaO 2 :FiO 2 ratio, and ICU and hospital stay. Our group demonstrated that acute administration of methylprednisolone (0.5 mg/kg/12 hours during 5 days) decrease treatment failure in a population of 120 patients with severe CAP who had high inflammatory response (defined as CRP greater than 150 mg/L on admission). Effect of corticosteroids on treatment failure among hospitalized patients with severe community-acquired pneumonia and high inflammatory response: a randomized clinical trial
cord-010261-sy7esszi	2006	Our observations suppol:t the presence of an early, reversible coagulopathy dependent on the serum iron concentration in poisoned patients. Its onset is usually delayed for at least 24 hours after iron ingestion, making the early coagulation abnormalities in patients 1 and 2 noteworthy. The coagulation measurements in patient 1 also improved coincident with a precipitous fall in serum iron concentration and prior to the onset of the hepatic coagulopathy. The initial ~hase, occurring within hours of overdose, appears to be a functional, reversible, and serum iron concentration-dependent impairment of coagulation. 6 If additional experience confirms the presence of an early coagulopathy in severe iron poisoning, the presence of early coagulation abnormalities could also suggest the need for deferoxamine therapy. Identification of respiratory virus antigens in middle ear fluids of children with acute otitis media
cord-010398-5wot7tix	2010	Also, these terms are consistent with the views held by practitioners who treat these patients and researchers who study them that CFS/ICF is a very heterogeneous disorder that, like many other chronic medical illnesses (eg, hypertension, diabetes), has a multiplicity of etiologic and pathogenic factors that contribute to the expression of the syndrome [12, 13] . There is now unanimity that at least a large subset of patients with CFS have a condition that is much broader than just CFS and has been labeled variously, including "functional somatic syndromes," "medically unexplained symptoms," "chronic multisymptom illnesses," "somatoform disorders," and perhaps most appropriately, "central sensitivity syndromes." Yunus [32] first showed FM to be associated with tension-type headache, migraine, and IBS; this author designed a Venn diagram in 1984 that emphasized the epidemiological and clinical overlaps between these syndromes and primary dysmenorrhea.
cord-010416-u0yo0lk6	2020	A systematic review of randomized controlled trials (RCTs) was conducted to evaluate the efficacy and safety of alternative neuraminidase inhibitor (NAI) regimens compared to standard of care in patients hospitalized for H1N1, H3N2, or B influenza. Thus, the study''s aim was to perform a systematic review (SR) of randomized controlled trials (RCT) to evaluate the efficacy and safety of alternative NAI regimens compared with 75 mg orally administered oseltamivir twice/daily or 600 mg intravenously administered peramivir once/daily in patients hospitalized for H1N1, H3N2, or B influenza. The evidence evaluated in this SR indicates that the alternative NAI regimens to orally administered oseltamivir 75 mg twice/daily or intravenously administered peramivir 600 mg once/daily to treat hospitalized patients with influenza infection are equally safe but do not modify meaningful clinical outcomes when compared with the standard dose.
cord-010460-pczs9alv	2020	Secondary objectives were to characterize the efficacy of VR in enhancing patient cooperation, describe the integration of VR into Child Life services, and identify interventions that accompanied VR. Secondary objectives of the study were to analyze VR efficacy in enhancing patient cooperation, describe the integration of VR into Child Life services throughout a pediatric hospital, and identify the frequency with which CCLS paired other interventions with VR. The Chariot Program and CCLS collaborated with the hospital information services (IS) department to develop customized child life intervention notes in the EMR. CCLS also documented which coping interventions the patient underwent, including family presence, comfort positioning, diaphragmatic breathing, environmental adaptions, imagery, pharmacologic assistance, tablet, bedside entertainment theater, 25 VR, augmented reality, interactive video game, and/or movie. In the exploratory VR analysis, patients were more likely to be cooperative after receiving a VR coping intervention (with or without accompanying interventions) (99.5%, n = 212, 95% CI 97.4%-100%) compared to preintervention (96.7%, n = 206, 95% CI 93.4%-98.4%, P = 0.041).
cord-010461-un9pls28	2020	METHODS: PediPlace introduced 3 interventions: improved patient tracking to measure timing on the electronic health record interface, elimination of script repetition between medical assistants and providers, and patient art kits. PediPlace implemented 3 interventions and measured the impact by tracking survey responses and total appointment length. PediPlace compared appointment lengths between July-December 2018 and January-June 2019, dividing the year into 2 parts before and after 2 of the QI interventions (revising MA and provider scripts and improving tracking). The clinic studied how different factors, such as patient age, patient ethnicity, provider, and time of year, impacted the total appointment length. PediPlace did not examine time spent during each part of the visit, such as "time with provider" or "time waiting for immunizations." This analysis is a potential area for future data collection because even a 5-minute difference in appointment length can alter patient perceptions of the healthcare experience.
cord-010477-g754gjvh	2020	Key process elements included (1) new Flow Nurse/EMT roles, (2) elimination of traditional registration and triage processes, (3) immediate "quick registration" and nurse assessment upon walk-in, (4) direct-bedding of patients, and (5) a novel "Intake" system staffed by a pediatric emergency medicine physician. CONCLUSIONS: Using quality improvement and Lean methodology, an inter-professional team decreased door-to-provider times and LWBS rates in a large pediatric ED by redesigning its front-end processes and implementing a novel pediatric emergency medicine-led Intake system. Strategies employed to improve the front-end processes include the abolishment of traditional nurse-led triage, "split-flow" models that create separate patient streams depending on each individual''s particular care needs, direct-bedding of patients, and placing providers in triage. Using QI and Lean methodology, an inter-professional team in a large, tertiary-care pediatric ED designed and implemented a novel front-end system and significantly improved patient flow by decreasing door-to-provider times 49% and LWBS rates by over 50%.
cord-010487-wncgecld	2020	Here, the ASK-1 inhibitor, selonsertib, was compared to placebo in ~1700 patients with NASH and bridging fibrosis (F3, STELLAR-3) or compensated cirrhosis (F4, STELLAR-4). In the absence of a placebo controlled phase 2b study, STELLAR 3 and 4 were substantially informed by a phase 2 study, [5] in which NASH patients with F2/F3 were recruited in a multicenter trial and randomized in a 2:2:1:1:1 ratio to receive 24 weeks of treatment with 6 mg or 18 mg of selonsertib alone; 6 mg or 18 mg of selonsertib with 125 mg of simtuzumab; or 125 mg of simtuzumab alone. The STELLAR studies did not meet their primary outcomes, and selonsertib was ineffective in reversing fibrosis in NASH patients with stage F3 and F4 fibrosis -those most in need of treatment. A randomized, placebo-controlled trial of emricasan in patients with NASH and F1-F3 fibrosis Selonsertib for Patients with Bridging Fibrosis or Compensated Cirrhosis Due to NASH: Results from Randomized Ph III STELLAR Trials
cord-010564-7c9h16bi	2019	Based on the clinical presentation of these patients and on the recurrent phenotype of the patients with pathogenic variants in the CDC45 gene (Table 1) , reported by Fenwick et al., 5 we further expanded the atypical findings spectrum, to include rare gastrointestinal anomalies, such as intestinal malrotation, imperforate/anteriorly displaced anus and congenital diaphragmatic hernia and short stature (in absence of any endocrine or metabolic cause) and patellar anomalies. 5 identified biallelic pathogenic variants in the CDC45 gene in patients with a recurrent phenotype ( Table 1 ) they reported to be consistent with Meier-Gorlin syndrome (MGS, MIM 224690), a rare autosomal recessive primordial dwarfism disorder, characterized by microtia, short stature, and absent or hypoplastic patellae. Importantly, we suggest that a pathogenic variant in CDC45 should now be considered in every patient with a 22q11.2 deletion who presents with the following findings: craniosynostosis, anorectal anomalies/intestinal malrotation, short stature, upper limb anomalies, and cleft lip and palate.
cord-010566-tciwtxud	1998	Determinants of outcome and the utility of the Child-Pugh score and the acute physiology and chronic health evaluation (APACHE) II score as predictors of outcome were prospectively assessed in 54 consecutive patients with cirrhosis requiring intensive care unit (ICU) management. 9,10 Acute physiology and chronic health evaluation (APACHE) scores were determined to be of prognostic significance in a study in ICU patients with cirrhosis; however, neither Child-Pugh scores nor etiology of liver disease were assessed in that study. 35 Mental status has been shown to be a significant predictor of outcome in ICU patients in a number of clinical settings, e.g., patients with acute renal failure requiring dialysis and transplant recipients. Although Child-Pugh scores, serum bilirubin, creatinine, or the incidence of gastrointestinal bleeding was not different, the patients with liver disease not caused by alcohol may have been more debilitated, as indicated by a significantly greater requirement for mechanical ventilation and a higher incidence of pulmonary infiltrates.
cord-010658-67k8pthy	2020	To expertly guide patients through this often devastating illness, palliative care professionals will need to keep abreast of the COVID-19 literature as the pandemic evolves and the longer-term outcomes come into sharper focus. Bottom Line: Early reports of COVID-19-associated pneumonia and ARDS provide insights into risk factors, short-term prognosis, and mortality that are important for palliative care professionals to be aware of when counselling patients and families. This article discussed a component of an appropriate response to the COVID-19 pandemic: ensuring that clinicians have discussions about advance care planning (especially with older patients with chronic illness) and goals of care with patients/families. This pandemic heightens the importance of implementing do-not-resuscitate (DNR) orders for appropriate patients: although unwanted/nonbeneficial CPR always risks increasing psychological distress for patients'' families, inappropriate CPR now is especially stressful and potentially dangerous for healthcare workers.
cord-010786-w3kjc6so	2019	title: Hospitalization following influenza infection and pandemic vaccination in multiple sclerosis patients: a nationwide population-based registry study from Norway We conducted a population-based registry study to investigate the risk of acute hospitalization of MS patients in relation to influenza infection or pandemic vaccination in Norway. We aim to examine risk of acute hospitalization among MS patients up to 3 months following influenza infection and pandemic vaccination in a large population-based cohort consisting of 6755 MS patients using nationwide populationbased Norwegian registries. We applied the self-controlled case series (SCCS) method to estimate incidence rate ratios (IRRs) of acute hospitalization with MS diagnosis in various risk periods following a diagnosis of influenza infection or vaccination, compared with a background period [22] . In model III, the IRR of acute hospitalization among patients was estimated following a diagnosis of seasonal influenza infection in the period from 1st of January, 2008 through 15st May, 2014, excluding the pandemic season (from September 2009-May 2010).
cord-010844-y26y5myb	2020	OBJECTIVES: In a cohort of patients with traumatic spine injury (TSI) in Tanzania who did not undergo surgery, we sought to: (1) describe this nonoperative population, (2) compare outcomes to operative patients, and (3) determine predictors of nonoperative treatment. Patients with AO type A0/1/2/3 fractures (p < 0.001), ASIA E exams (p = 0.016), cervical spine injuries (p = 0.005), and central cord syndrome (p = 0.016) were more commonly managed nonoperatively. Surgery for TSI is offered in a small number of tertiary centers throughout Sub-Saharan Africa and other LMICs. Despite studies showing that nonoperative treatment is associated with worse outcomes [3] , operative rates remain low in resource-constrained settings [4, 5] . After multivariate analysis controlling for age, gender, insurance status, mechanism of injury, fracture stability, injury level, and exam on admission (ASIA grade), patients managed nonoperatively were 7.39 times more likely to die compared with patients undergoing surgery (95% CI: 2.18, 30.5 | p = 0.003) ( Table 3 ).
cord-010856-3g0123lk	2020	Cross-pathway referral for these cancers allows both general medical practitioners (GMPs) and general dental practitioners (GDPs) to refer patients to be seen within two weeks by a specialist secondary care consultant in an oral maxillofacial cancer unit. To analyse whether the positively diagnosed cancer patients were being given their initial diagnosis within 28 days, in preparation for the new guidelines to be implemented in the NHS Long Term Plan (2020) 5. One hundred percent of the patients positively diagnosed with cancer would receive diagnosis within 28 days and subsequent treatment within 62 days in line with the current guidelines for the 2ww referral system for HNCs. The standard for diagnostic cancer yield/positive oncological transformation would be set at 3%, as appropriate for a screening test as set out by NHS England.
cord-010921-yzv43e8l	2020	As such, dexmedetomidine is now being used as part of ERAS protocols along with regional nerve blocks and other medications, to create a satisfactory postoperative outcome with reduced opioid consumption in the Post anesthesia care unit (PACU). This manuscript will comprehensively discuss dexmedetomidine with regards to postoperative pain management, ERAS protocols, pharmacokinetics, pharmacodynamics, cardiovascular and respiratory effects, toxicity, drug interactions, abuse and dependence. Analgesia with non-opioids analgesics like dexmedetomidine are being used as part of an ERAS protocol intraoperatively, along with regional nerve blocks to attain a satisfactory postoperative outcome with reduced requirements of opioids in PACU in the pediatric population. In a 2015 meta-analysis, although dexmedetomidine reduced pain intensity, opioid consumption, and postoperative nausea and vomiting (PONV), it had no effect on recovery time [29] . Postoperative pain control after the use of dexmedetomidine and propofol to sedate patients undergoing ankle surgery under spinal anesthesia: a randomized controlled trial
cord-010929-d598h08w	2020	Patients who do not achieve the therapeutic target with corticosteroids or require long-term administration of high-dose corticosteroids, or patients unable to tolerate corticosteroids due to complications or adverse drug reactions, are transitioned to second-line treatment. High-dose intravenous immunoglobulin, methylprednisolone pulse therapy, or platelet transfusion should be considered for patients with severe bleeding symptoms, marked thrombocytopenia or who urgently require an increase in their platelet count because of surgery or for some other reason. In patients with underlying diseases (hypertension,diabetes,active infections, chronic infections,impaired immune status,osteoporosis,dys lipidemia,peptic ulcer, etc.) with a high probability of problematic adverse drug reactions associated with corticosteroid treatment, it is recommended that corticosteroids be started while controlling complications. However, the percentage of patients who had a partial response with a platelet count of 30,000-50,000/μL was 57.6% in the rituximab group and 46.7% in the standard treatment group, with a relative risk of 1.26 (95% CI: 0.95-1.67, p = 0.11), indicating that there was no significant difference in the bleeding inhibition effect between the two groups.
cord-010933-xuztu95a	2018	Uncertainty in patient resource demand is caused by several stochastic processes, including the number and timing of arrivals and discharges, length of stay (LOS), unit transfers, health improvement and deterioration, surgical complications, and same-day cancellations for outpatient and surgical appointments. Developing and applying an accurate model to forecast patient resource demand for multiple time periods into the future improves both the cost and safety of providing care when coupled with an adaptive staffing strategy. Most models make simplifying assumptions to manage tractability and fit data availability, including assuming stationary or cyclic demand patterns [16, 17, 36] , exponential-based inter-arrival times and LOS distributions [17, 36, 48, 49] , patient homogeneity [10, 31, 36] , singleday forecasts [47] , and point estimates instead of probability mass functions (PMFs) [14, 31] . The goal of this study is to forecast an accurate approximation for the multi-period PMF of bed demand using the exact surgical schedule at the time of the forecast, non-stationary inter-arrival times, and patient-level duration-varying LOS distributions.
cord-010980-sizuef1v	2020	We hypothesized that presentation to a PTC would yield increased mortality when subspecialty intervention was required and that this would be most pronounced at night when in-house attending coverage is absent at all state PTCs. Materials and methods: A review of the Pennsylvania Trauma Outcome Study (PTOS) database was performed to capture patients aged 12-18 who underwent any non-orthopedic trauma surgery. Traumatic subaxial cervical fractures: functional prognostic factors and survival analysis Introduction: The main goal of this study is to identify the risk factors for poor functional outcomes and to analyze the overall survival (OS) and complications rate in patients with traumatic cervical spinal cord injury (SCI) and subaxial cervical fracture (SACF) treated with open surgical fixation. After applying a multiple imputation on all the study variables, a logistic regression generalized estimating equation after adjustment for age, sex, mechanism of trauma, and the injury severity score as covariates and hospitals as a cluster assessed an association between quartile of patient volume in intensive care unit and hospital mortality.
cord-010999-u2guhh3h	2019	2019 ) by providing a qualitative, retrospective look at the process of decision-making for PWPs. Using case examples and excerpts from semi-structured interviews with 12 committee members, we will discuss how the protocol has translated into practice. If no legally acceptable surrogate can be located, the ethics consultant contacts the PWP committee members to recruit 2-3 individuals who can meet with representatives from the medical team within 24-48 h. • Demographic questions (age, sex, religion, education, occupation) • Personal experience in healthcare decision-making (for self or family members) • Member''s assessment of personal qualifications required for committee membership and preparation for role • Member''s experience with PWP cases (mechanics, medical and social information provided, quality of discussion, meeting the patient) • Member''s views on how personal values and religious beliefs affect their decision-making • Member''s experience and views on the post-decision period (second-guessing, need for feedback, debriefing)
cord-011062-ukz4hnmy	2020	Ming-Yueh Chou 1,3 , Ying-Hsin Hsu 1 , Yu-Chun Wang 1 , Chih-Kuang Liang 1,3 , Li-Ning Peng 2,4 , Liang-Kung Chen 2,4 , Yu-Te Lin 1 ((1) Center for Geriatrics and Gerontology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan; (2) Aging and Health Research Center, National Yang Ming University, Taipei, Taiwan; (3) Department of Geriatric Medicine, National Yang Ming University School of Medicine, Taipei, Taiwan; (4) Center for Geriatrics and Gerontology, Taipei Veterans General Hospital, Taipei, Taiwan) Background: Older people with frailty are at risk of adverse outcomes, such as falls, functional decline and mortality, and multi-domain intervention program may prevent those. Conclusion: Our study showed that a multicomponent exercise program is effective for posthospitalization patients because after 24-week intervention there were significant reductions in frailty and improving results in muscle strength and physical performance. Methods: Cross-sectional analysis of 757 communitydwelling older adults who completed multi-domain geriatric screen assessing for social vulnerability, mood, cognition, functional performance, nutrition, physical frailty (FRAIL) and sarcopenia (SARC-F).
cord-011093-d9dbvbcy	2019	Natural killer (NK) cell deficiency (NKD) is a subset of primary immunodeficiency disorders (PID) in which an abnormality of NK cells represents a major immunological defect resulting in the patient''s clinical immunodeficiency. In order to be as clear as possible: NKD is a subset of PID in which the NK cell abnormality represents the major immunological defect resulting in the clinical immunodeficiency. As delineated above an example of this broader subset of PIDs that include an impact upon NK cells is NK -SCID, where the lack of NK cells is potentially relevant but not the major immunological defect causing clinical immunodeficiency. That said, to be an NKD, again the NK cell abnormality must represent the primary immunological defect presumably leading to the patient''s clinical immunodeficiency. A patient with a known PID who also has abnormal NK cell numbers or functional tests should similarly not be labeled as having an NKD.
cord-011103-sstpidvk	2019	CONCLUSIONS: Among critically ill trauma patients, acute kidney injury, injury to the spine, face or sternum, massive transfusion and intensive care unit length of stay were associated with VAP. Variables collected from the patients'' medical records and trauma database included age, race, gender (demographics), presenting vital signs, injury type and severity, the presence of ventilator-associated pneumonia, hospital and intensive care unit length of stay and survival data. We found that, among critically ill trauma patients admitted to the intensive care unit, injury to the spine, face or sternum, massive transfusion, acute kidney injury and intensive care unit length of stay were associated with ventilator-associated pneumonia (VAP). Among critically ill trauma patients admitted to the intensive care unit, acute kidney injury, injury to the spine, face or sternum, massive transfusion and intensive care unit length of stay were associated with VAP.
cord-011138-y9v5ivzg	2020	We investigated the effect of intubation in trauma patients with a GCS 6–8, with the hypothesis that intubation would increase mortality and length of stay. CONCLUSION: Among patients with GCS of 6 to 8, intubation on arrival was associated with an increase in mortality and with longer ICU and overall length of stay. Likewise, the Eastern Association for the Surgery of Trauma (EAST) practice management guidelines (PMGs) give a level 1 recommendation for intubation for patients with a GCS of 8 [2, 3] . Using IPWRA analysis adjusted for GCS, age, sex, hypotension, maximum head, chest, and abdomen/pelvis abbreviated injury scale (AIS) scores, we determined that the average treatment effect (ATE) of intubation was associated with increased odds of mortality (OR 1.05, 95% CI 1.03-1.06). Among patients with GCS of 6-8, intubation on arrival was associated with increased mortality, ICU days, and overall length of stay.
cord-011159-k2kca8zl	2020	b Patient recruitment exceeded the 500 expected, because we anticipated a number of non-workable case report forms h More than one indication could be present for each BAL i Significantly higher than in the nasal high-flow oxygen therapy or non-invasive ventilation group (p < 0.001), and then in the invasive mechanical ventilation group (p = 0.001) j H0 indicates the time at which BAL has began k Experience in years in the specialty and in terms of number of BAL performed are detailed in Table S1 of the Online resource 1 l We defined the physician performing the BAL as an "experienced physician" when he/she was a pulmonologist or when he/she was an intensivist with the greatest experience (i.e., > 10 years in the specialty or > 50 BAL performed) 35-3.50 ]; p = 0.002) and the amount of BAL fluid (in ml) recovered handled as a linear predictor (OR 1.02 [1.01-1.03] per 1 ml increase; p < 0.01), were statistically significant predictors of a BAL fluid of good quality (Table S6 ).
cord-011181-9nvwk04v	2019	STUDY DESIGN: Prospective cohort study OBJECTIVES: To describe epidemiological data and complications after acute traumatic spinal cord injury (tSCI) in Former Yugoslav Republic of Macedonia (FYROM). The University Clinic for Traumatology, Orthopedics, Anesthesia, Reanimation, Intensive Care Unit and Emergency Center (TOARILUC), Mother Teresa, Skopje, FYROM, is a level one trauma hospital and the only public hospital treating patients with SCI in the country. The purpose of this study was to prospectively investigate incidence, cause of injury, demography and SCI characteristics, acute phase mortality/ survival, and early complications after tSCI among patients admitted to the University Clinic for TOARILUC. The information included: demographic data (gender, age at injury, marital status, and employment status), past illnesses, addiction habits (smoking, drugs, and alcohol consumption), preadmission records from patients transported from other hospitals, type of transport to the hospital, date of admission and discharge from TOARILUC, cause and type of injury, associated injuries, and mortality.
cord-011188-59hn9wsv	2020	This paper refutes the main arguments in favor of the status quo, identifies a series of harms related to continuing the current practice, and proposes an explicit consent policy for intimate exams along with specific changes to medical school curriculum and institutional culture. Recent surveys and reports reveal that some physicians and medical students still conduct unconsented intimate exams (UIEs) on male and female patients. Patients and members of the general public are often shocked to learn that physicians and medical students may perform intimate exams on them without explicit consent and believe such exams meet the criteria for battery, malpractice, or sexual assault. Interestingly, Ubel, a physician who examined UIE practices in teaching hospitals in a 2003 survey of 401 medical students, found that completion of the obstetrics/gynecology clerkship is associated with decreased interest in informed consent (Ubel 2003) .
cord-011221-rhyxp4v5	2019	title: Obesity is Associated with Worse Outcomes Among Abdominal Trauma Patients Undergoing Laparotomy: A Propensity-Matched Nationwide Cohort Study Patients who received laparotomies were analyzed using propensity score matching (PSM) to evaluate the mortality rate and LOS between obese and non-obese patients. In this study, a nationwide analysis was performed using the NTDB to evaluate the role of obesity in abdominal trauma patients who required laparotomies. However, there was no significant difference in mortality rate, hospital LOS, or ICU LOS between the SBP systolic blood pressure, ED emergency department, RR respiratory rate, GCS Glasgow coma scale, ISS injury severity score, BMI body mass index, CI confidence interval obese and non-obese in patients who did not receive laparotomy after matching (Table 3 ). Obesity is associated with increased mortality and LOS in abdominal trauma patients who received laparotomies versus those who did not.
cord-011255-9q2frk71	2020	The time intervals from the arrival of a patient in the resuscitation room to the start of CT and of emergency surgery has been defined as the main quality indicator for the whole process of trauma resuscitation. For those patients, we collected the time to CT (tCT), the time to emergency surgery (tOR), the injury severity score (ISS) and outcome variables (mortality, ventilator-dependent days and length of intensive care unit (ICU) stay). A new and large-scale trauma resuscitation area with a dual-room sliding gantry CT scanner for simultaneous treatment or two multiple trauma patients by its was introduced (SOMATOM Definition Edge, Siemens Healthineers, Erlangen, Germany). Focused Fig. 1 Large-scale trauma resuscitation area with a dual-room sliding gantry CT scanner assessment with sonography for trauma (FAST) is performed only on haemodynamically unstable patients or if the ''leading group'' decides to do so. Whole-body multislice computed tomography (MSCT) improves trauma care in patients requiring surgery after multiple trauma
cord-011284-u4qmvz3c	2020	However, evaluations of these interventions have failed to examine the role of LGBTQ identities in recovery from trauma, and existing PTSD treatments do not account for ongoing threat to safety or the pervasive minority stress experienced by LGBTQ patients. To begin the review of current best-practice interventions for PTSD, it is important to note that gold-standard PTSD treatments, such as PE and CPT, were not developed for non-criterion A trauma, and that debate continues regarding the appropriateness or sufficiency of these treatments in addressing the range of clinically significant experiences faced by many LGBTQ individuals (e.g., discrimination [29••] ). Given the pervasive nature of stress, stigma, and discrimination against LGBTQ people, and the concomitant high rates of trauma exposure, it is critical for health care providers to ensure cultural awareness, sensitivity, and responsiveness to the experiences and healthcare needs of this patient population. In this paper, we provided an overview of the key issues with respect to trauma, PTSD, minority stress, and evidence-based treatment for LGBTQ patients with which any health care provider should be aware.
cord-011296-nutl2ovk	2020	BACKGROUND: The prevalence, characteristics, and outcomes related to the ventilator-associated event(s) (VAE) in neurocritically ill patients are unknown and examined in this study. METHODS: A retrospective study was performed on neurocritically ill patients at a 413-bed level 1 trauma and stroke center who received three or more days of mechanical ventilation to describe rates of VAE, describe characteristics of patients with VAE, and examine the association of VAE on ventilator days, mortality, length of stay, and discharge to home. The main findings of this study are that (1) VAEs are prevalent among neurocritically ill patients, occur within the first week of mechanical ventilation, across age, sex, BMI, and GCS, and the rates differ among various diagnoses, (2) the most common trigger for VAE is an increase in PEEP, and (3) VAE is associated with increased time spent on mechanical ventilation but is not associated with increased in-hospital mortality or discharge to home.
cord-011297-4um9w2dx	2019	Despite treatment with multiple anti-epileptic drugs in addition to IV anesthetics, burst suppression was initially unsustainable and the patient remained in super-refractory status epilepticus. Clinical response with a goal of 1–2 bursts per screen on EEG monitor was eventually achieved after a course of rituximab and plasma exchange therapy as well as a 7-day barbiturate coma with a regimen of clobazam, lacosamide, Keppra, and oxcarbazepine followed by a slow taper of phenobarbital and the addition of fosphenytoin. We discuss treatment strategies for new-onset refractory status epilepticus and highlight the role of rapid initiation of burst suppression with high-dose IV anesthetics to ensure neuroprotection while the underlying etiology is addressed with immune-modulating therapy. A midazolam infusion was initiated and up-titrated to 60 mg h −1 but failed to achieve burst suppression, and the patient continued to have generalized epileptic discharges on EEG.
cord-011302-pfepyvaw	2020	In this review, we consider changes in practice and current treatment outcomes in older patients with aneurysmal subarachnoid haemorrhage, traumatic head injury, and haemorrhagic strokes. A recent systematic review of endovascular treatment of ruptured aneurysms in patients aged over 65 reported good outcomes in 66%, with a mortality rate of around 26% at 1 year [36] . Koffijberg analysed the cost-effectiveness of treating ruptured aneurysms in patients aged over 70, identifying key parameters including patient age (and thus life expectancy), good or poor clinical condition on presentation, conservative or occlusive treatment (clipping or coiling) and good or poor outcomes [18] . This is supported by collaborations such as IMPACT (International Mission for Prognosis and Analysis of Clinical Trials in TBI) and CRASH (Corticosteroid Randomisation After Significant Head injury), who have used available evidence to develop prognostic calculators for TBI, where age is a corestratifying component and significantly increases chances of a poor outcome [17, 38] .
cord-011327-zsoc4wec	2019	However, SAP is also commonly practiced in many ICUs. A single-centre study conducted recently in a Belgian ICU showed that SAP and prophylaxis for immunocompromised patients constituted two-thirds of prophylactic antibiotic treatments prescribed [13] . There are no randomised controlled trials on the effects of timing or choice of antibiotic prophylaxis on the outcomes of ICU patients requiring unplanned surgical procedures. However, French guidelines for the prevention, diagnosis and treatment of hospital-acquired pneumonia in ICU suggest consideration of selective digestive decontamination with both topical and systemic antibiotics (for a maximum of 96 h) to decrease the rate of pneumonia immediately after urgent intubation based on indirect evidence from several studies [22] . A metaanalysis of studies focused on antibiotic prophylaxis for chest drain insertion in non-ICU patients (i.e. thoracic injury), concluded that treatment after chest drain insertion was significantly associated with a reduced risk of empyema (RR 0.25; 95% CI 0.13-0.49) and pneumonia (RR 0.41; 95% CI 0.24-0.71) when compared with placebo alone [28] .
cord-011349-bykvn367	2019	PURPOSE OF THE STUDY: To evaluate the outcomes and complications using cemented megaprosthesis in elderly patients with distal femur nonunions (DFN). MATERIALS AND METHODS: Between 2012 and 2016, 24 patients of DFN with an average age of 71.8 years (66–83) and an average 1.9(1–3) prior surgery was managed with distal femur replacement using cemented modular endoprosthesis. CONCLUSION: By permitting immediate full weight-bearing ambulation and with most patients returning to an acceptable functional status, cemented megaprosthesis is a viable and useful single-stage management option in elderly patients with DFN. Cemented modular endoprosthetic replacement in managing DFN is a welldescribed option which enables immediate weight-bearing following surgery leading to faster recovery of geriatric patients [9] [10] [11] . This study was performed to evaluate the outcomes and complications following cemented modular distal femoral endoprosthesis used in managing DFN in elderly patients.
cord-011360-1n998win	2019	We had reported that the level of circulating cardiac miRNA-208a following surgery can serve as a sensitive biomarker for the postoperative course of pediatric patients with CHD undergoing heart surgery for the repair of their defect [4] . Logistic regression calculations in the group of patients with oxygen saturation levels below 90% yielded a statistically significant association between the preoperative level of miRNA-208a and the risk of developing postoperative complications: the lower the level of miRNA-208a in the patient''s blood before the operation, the higher was the risk for developing cardiac complications following surgery (crude OR 1.28; 95% CI 1.02-1.60; p = 0.02). The ability of preoperative levels of miRNA-208a to predict postoperative cardiac complications in the group of patients with oxygen saturation levels below 90% was studied using an ROC curve and the AUC. Our results indeed showed that high expression levels of preoperative circulating miRNA-208a were predictive of a better postoperative outcome, as reflected by fewer complications following surgery and, accordingly, were correlated with a low Aristotle score and a shorter LOH.
cord-011413-yv4x8viu	2020	The Extracorporeal Life Support Organization (ELSO) Coronavirus Disease 2019 (COVID-19) Guidelines have been developed to assist existing extracorporeal membrane oxygenation (ECMO) centers to prepare and plan provision of ECMO during the ongoing pandemic. 11 The interim recommendations presented here balance the need to provide high-quality ECMO care to those who may benefit most while being cognizant of available resources and maintaining an environment of patient and staff safety (Figure 1) . In addition, the Extracorporeal Life Support Organization (ELSO) COVID-19 Working Group Members completed a survey on patient selection criteria for ECMO to build consensus. We recommend the following contraindications for ECMO in patients with cardiopulmonary failure due to COVID-19 (Table 1) in centers functioning under significant resource constraints, for example, Contingency Capacity ≥ Tier 1. International ECMO Network (ECMONet): Position paper for the organization of extracorporeal membrane oxygenation programs for acute respiratory failure in adult patients
cord-011483-zc6ve6le	2020	Neurostimulant administration data were extracted from the electronic medication administration record, including medication (amantadine, modafinil, or both), starting dose, time from stroke to initiation, and whether the neurostimulant was continued at hospital discharge. Amantadine and modafinil are administered to patients following acute stroke in our intensive care unit (ICU) on an ad hoc basis, but data supporting this practice are largely limited to delayed treatment in rehabilitation or outpatient facilities with very few reports during the acute care hospitalization [17] [18] [19] . Two hundred five patients received amantadine and/ or modafinil during the 3.7 year study period and 118 patients were initially excluded: neurostimulant administered for an indication other than acute stroke (TBI [n = 50], cardiac arrest [n = 15], brain tumor [n = 6], encephalitis [n = 5], or encephalopathy [n = 4]); neurostimulant prescribed prior to hospital admission (n = 27) or administered for < 72 h (n = 8); or history of seizures (n = 3).
cord-011512-gw2sk90q	2020	Sir, the British Orthodontic Society (BOS) and the Oral Health Foundation have recently collaboratively launched a muchawaited campaign, Safe Brace Campaign, alerting the public to the dangers of direct to consumer orthodontics, also known as ''DIY Braces'' (www.safebrace.org). Sir, to determine the use and perceived benefit of webinars and online learning, a brief survey was sent to dentists across the UK; 50 responses were received from a mix of those working in general dental practice, hospital and community. 2 The calming and stress reducing effects of listening to music have been widely studied and this simple and cost-effective method of relaxation is something easily accessible to all members of the dental team. Sir, as a DCT3 in Oral Surgery I have seen several patients referred for removal of teeth under general anaesthetic (GA) due to dental anxiety. Experience of listening to music on patient anxiety during minor oral surgery procedures: a pilot study
cord-011533-im78xwl8	2020	MODS was diagnosed when a patient had symptoms of HLH/TMA and dysfunction of two or more organ systems: renal failure requiring renal replacement therapy (RRT) or cystatin C glomerular filtration rate (GFR) < 50 mL/min, invasive or non-invasive positive pressure ventilator support for > 24 h, diagnosis of pulmonary hypertension (as determined by echocardiogram and cardiology consultation), serositis (pleural or pericardial effusions), severe hypertension requiring either ≥ 2 medications or continuous infusion of an antihypertensive for > 12 h to maintain blood pressure < 99% for age, CNS symptoms (seizures, bleeding, posterior reversible encephalopathy syndrome (PRES), or altered mental status), or gastrointestinal symptoms (ileus and/or bleeding) [20] [21] [22] [23] [24] . We observed a high incidence of clinically significant complement-mediated thrombotic microangiopathy (TMA) associated with multi-organ injury in children and young adults with a diagnosis of HLH.
cord-011649-3dlsy8fl	2020	2 Early guidance from the Anesthesia Patient Safety Foundation and other sources regarding airway management in COVID-19positive patients has recommended rapid sequence intubation and avoidance of mask ventilation to reduce the risk of droplet spread and aerosolization of virus. 3 Given the penetrance of COVID-19 in the New York metropolitan area, the Weill Cornell Medicine NewYork-Presbyterian Hospital Anesthesiology and Psychiatry departments collaborated to develop guidelines to ensure that the patients who were in urgent need of ECTwere provided that care while minimizing exposure to the staff and potential spread of disease to other ECT patients. Whereas anesthesia for ECT had been performed by a single anesthesiologist in the past, the donning and doffing of PPE in addition to the necessity of ensuring complete mask fit if positive pressure ventilation is used require 2 anesthesia providers to be available at all times.
cord-011712-fyrbe8tw	2020	METHODS: We conducted a one-stage individual participant data (IPD) meta-analysis exploring the association between NAI treatment and LoS in patients hospitalized with 2009 influenza A(H1N1) virus (A[H1N1]pdm09) infection. CONCLUSIONS: When patients hospitalized with influenza are treated with NAIs, treatment initiated on admission, regardless of time since symptom onset, is associated with a reduced LoS, compared with later or no initiation of treatment. We undertook a one-stage individual participant data (IPD) [16] meta-analysis to explore the association between NAI treatment of patients hospitalized with 2009 pandemic influenza A(H1N1) virus (A[H1N1]pdm09) infection and the LoS during the 2009-2010 influenza pandemic. In Hong Kong, a study of 356 adult patients hospitalized with laboratory-confirmed seasonal influenza showed that early oseltamivir treatment was associated with a reduced LoS in both unadjusted and multivariable analyses [9] , compared with no or later treatment, with the median LoS decreasing from 6 to 4 days; this accords with our primary analysis.
cord-011725-t1jl4cy1	2020	In light of the current pandemic, monitoring strategies should focus on selecting high-risk patients in need of close surveillance and using alternative remote recording devices to preserve personal protective equipment and protect health care workers from potential contagious harm. 21-23 Virtual clinics move far beyond simple telephone contacts by integrating information from photos, video, mobile heart rhythm and mobile health devices recording ECG, and remote cardiovascular implantable electronic device (CIED) interrogations. In the outpatient setting, a recent statement from the US Food & Drug Administration (FDA) "cautions against use of hydroxychloroquine or chloroquine for COVID-19 outside of the hospital setting or a clinical trial due to risk of heart rhythm problems." (This does not affect FDA-approved uses for malaria, lupus, and rheumatoid arthritis.) 51 Exceptions to this practice are acknowledged to occur in some regions, as these drugs have been used outside the United States without regulatory warnings.
cord-011793-hlktpla4	2020	Although the desire to try to treat these patients with already approved drugs is understandable, what is less understandable is the desire in medical publications and on social media to abandon the principles of evidence-based critical care that we have established over the last 3 decades (9), because "I have never seen patients with ARDS act like this." Large, well-designed, multicenter randomized trials have set the foundation of an evidence-based practice of how to produce the best outcomes for critically ill patients. Instead, improved outcomes are seen through understanding and implementing best practices derived via strong scientific evidence generated from well-designed randomized controlled trials into the routine care of critically ill patients. Maintaining other principles of good critical care, as demonstrated in large, multicenter randomized trials, will also improve outcomes in these critically ill patients with COVID-19, even if "COVID-19 is completely different from other intensive care unit syndromes." Conservative fluid management once out of shock and without renal failure increases time alive and free from ventilation (15) .
cord-011836-zib8wkm2	2020	We performed metabolomic and proteomic analyses of bile from patients with benign (n = 36) and malignant conditions, CCA (n = 36) or PDAC (n = 57), undergoing endoscopic retrograde cholangiopancreatography with the aim of characterizing bile composition in biliopancreatic disease and identifying biomarkers for the differential diagnosis of biliary strictures. Alterations in BA In the present study we have performed parallel metabolomic and proteomic analyses of human bile from patients with benign and malignant (CCA and PDAC) biliary stenoses. Therefore, using a novel approach, we have combined metabolomic and proteomic measurements with machine intelligence modeling and synthetic data generation [51, 53, 54] to identify molecular patterns that can discriminate malignant from benign biliary strictures. An equivalent analysis was performed with the proteomic data obtained from a different set of bile samples from control and patients with PDAC-related malignant stenoses. An equivalent analysis was performed with the proteomic data obtained from a different set of bile samples from control and patients with PDAC-related malignant stenoses.
cord-011875-ga0dzj3v	2020	Indeed, they quote a sentence in which Dr. Laghi and I say that physicians do not initiate mechanical ventilation consequent to "slotting a patient into a particular diagnostic pigeonhole." (2) Dr. Modesto-Alapont and colleagues claim that the Berlin definition enhances the ability to make a precise diagnosis of acute respiratory distress syndrome (ARDS) in patients with coronavirus disease (COVID-19). Cardiac involvement probably complicates severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in patients, but the true incidence (considering specific echocardiographic findings) and the attributable mortality are aspects not yet well clarified. Very few reports have used echocardiographic criteria beyond biomarkers to diagnose cardiac injury, but none have differentiated between myocarditis, cardiomyopathy (stress or septic), ACS, and acute heart failure in the era of COVID-19. In a recent report involving 416 hospitalized patients from Wuhan, 19.7% presented with "acute myocardial injury." The diagnosis relied on increased cardiac biomarker (hypersensitive troponin I) levels, regardless of the electrocardiographic and echocardiographic findings (3).
cord-011975-8vl45xb7	2019	BACKGROUND: Despite the tremendous impact of swallowing disorders on outcome following ischemic stroke, little is known about the incidence of dysphagia after subarachnoid hemorrhage (SAH) and its contribution to hospital complications, length of intensive care unit stay, and functional outcome. The main goal of the current study was (1) to quantify the rate of swallowing disorders after SAH by using a simple clinical assessment tool, (2) to identify early predictors of dysphagia in all severity grades of SAH patients, and (3) to evaluate how dysphagia contributes to hospital complications, length of ICU stay, and poor outcome. CT computed tomography, EVD external ventricular drain, ICU intensive care unit, IQR interquartile range Statistical analysis was performed using the Wilcoxon rank-sum test (*), the Chi-square test ( †), and the linear-by-linear association test for trend ( ‡) Although it is well known that the high incidence of swallowing disorders after ischemic stroke contributes to impaired quality of life and poor functional outcome, only few studies report the incidence of dysphagia following SAH [9, 10] .
cord-012025-faj682bp	2020	(7) assessed the coagulation profile and outcomes of 449 severe COVID-19 patients. (8) Moreover, a negative D-dimer test could be used for decision-making on anticoagulation therapy discontinuation in venous thromboembolism patients, however, this approach remains arguable and additional studies are required to validate this proposal. (10) The diagnosis of DIC in critically ill patients is made by standard coagulation tests, which can only determine a 5% of thrombin generation and are not suitable to discriminate patients with prothrombotic states from those with increased risk of bleeding. For the present time, we suggest that additional studies should be performed focusing on coagulation testing, to provide a better understanding of the coagulation profile in severe COVID-19 patients, improve the assessment of coagulation-related risks, and support decisions on the appropriated anticoagulation therapy. High incidence of venous thromboembolic events in anticoagulated severe COVID-19 patients Anticoagulant treatment is associated with decreased mortality in severe coronavirus disease 2019 patients with coagulopathy
cord-012037-9kmul7he	2019	Recently, the CardioMEMS device (Abbott Inc., Atlanta, GA, USA), an implantable haemodynamic remote monitoring sensor, has shown promising results in preventing HF-related hospitalisations in chronic HF patients hospitalised in the previous year and in New York Heart Association functional class III in the United States. Multiple studies have investigated the remote monitoring abilities of implantable cardioverter defibrillator/cardiac resynchronisation therapy (ICD/CRT) devices in chronic HF patients to improve HF-related hospitalisation rates (Tab. 2). The IN-TIME RCT showed that using the remote monitoring abilities of the ICD and CRT devices leads to a reduction of a combined endpoint of all-cause death, overnight HF-related hospitalisation, change in New York Heart Association (NYHA) class, and change in patient global self-assessment [19] . In this trial, NYHA class III/IV chronic HF patients were included and investigated as to whether remote haemodynamic monitoring using the ePAD could reduce HF-related hospitalisation, emergency or urgent care visits requiring intravenous therapy.
cord-012115-hpsxi9ay	2013	The Cochrane Library, Ovid, PubMed, CINAHL Plus, PsycINFO, and ProQuest were searched for the subject headings music, music therapy, cancer, oncology, palliative care, pain, anxiety, depression, mood, quality of life, prevalence, neuroscience, functional imaging, endogenous opioids, GABA, 5HT, dopamine, and permutations of these same search terms. RESULTS: Available evidence suggests that music-based interventions may have a positive impact on pain, anxiety, mood disturbance, and quality of life in cancer patients. b Inferior view of neuroanatomic regions affected by music (and implicated in the pathophysiology of pain, anxiety, and/or depression) outcome to cancer patients in palliative care settings, future studies investigating the effect of music-based interventions on pain, anxiety, or mood disturbance in this patient population should incorporate QOL measurements into their outcome assessment.
cord-012117-c693oefo	2013	Dose-limiting toxicities (DLTs) were defined as adverse events (AEs) as least possibly related to study medication(s) and fulfilling one of the following criteria: a) grade 3 or 4 neutropenia complicated by fever ≥38.5°C, or grade 4 neutropenia of at least 7 days duration; b) grade 3 thrombocytopenia complicated by hemorrhage or grade 4 thrombocytopenia; or c) any grade 3 or higher non-hematologic toxicity (except anorexia, nausea, vomiting, and diarrhea that was not optimally controlled with appropriate medical intervention); d) any ≥grade 3 electrolyte abnormality including hypophosphatemia, hypocalcemia, or hypomagnesemia that did not resolve within 72 h with appropriate therapy or if it was associated with new ECG changes; e) treatment-related toxicities that resulted in failure to receive at least 75 % of the planned doses of RO4929097 and of temsirolimus despite maximal supportive care measures; f) inability to resume dosing for cycle 2 at the current dose level within 14 days due to treatment-related toxicity.
cord-012459-tge08va0	2020	We have designed a medical alert bracelet, similar to a hospital name band, that is placed on any patient where nonstandard equipment (anything other than iView video laryngoscope [Intersurgical, Wokingham, England] plus bougie) was needed to secure the airway or where the person intubating experienced difficulty. They then remain on the patient''s wrist for the duration of their ICU stay and provide a visual alert of their difficult airway, regardless of the bed space or even hospital if they are transferred for ongoing care (Figure) . The presence of this bracelet on a patient prompts a review of the electronic intubation notes before undertaking any procedure where the airway could be "at risk," and appropriate measures to be put in place-for example, a senior anesthetist with the relevant equipment present when airway alert patients are proned or deproned. Airway Alert Bracelets: Enhancing Safety in the Coronavirus Disease 2019 Era Figure.
cord-012469-6cvu5umd	2020	As a professor of literature and a professor of medicine, we are especially interested in what it might mean to "speak with" Victor Frankenstein and his Creature because this process can provide creative insight into the relationships that develop between modern-day physicians and the patients incorporates distance and disappointment as well as recognition and rehabilitation, unresolved fear as well as pragmatic hope. In treating Victor "as if" he were the medical doctor he is training to become and the Creature his perceived difficult patient, we do not place Shelley''s novel in a cultural history of medicine that it might be seen to allegorize. Speaking with Victor''s failure helps us imagine physicians who, instead of mirroring societal fears of decay and death, find the courage to stand with the patients they have helped to birth into a new life story. At the very least, we sense in Victor''s evasion of responsibility new openings to speak about the ethical relationship between physicians and patients.
cord-012518-ncrdwtdg	2020	The improvement in tear film quality (measured by TBUT) was shown after application of trehalose/hyaluronate tear substitute for one month in both, glaucoma and control group patients with mild to moderate dry eye symptoms. Methods: For 351 eyes (275 patients) who underwent DMEK for Fuchs endothelial corneal dystrophy (FECD), donor ECD decrease as compared to preoperative donor ECD was evaluated up to four years after surgery. The present study included fundus images of 111 individuals with a mean refractive error of -9.3 ± 3.8 diopters (range:-20.8, +1.75) and an axial length of 26.8 ± 1.9 mm (range: 22.55, 30.88) Results: The disc-fovea distance increased significantly with longer axial length, with a relatively flat slope in the non-highly myopic eyes (Disc-Fovea-Distance = 24.3 × Axial Length (mm)+514) and a steeper slope in the highly myopic group (Disc-Fovea-Distance = 58.7 × Axial Length (mm)-460).
cord-012560-p5s0p7fd	2020	We sought to quantify 1-year mortality and evaluate the association between mortality and (1) functional status, and (2) management of anticancer therapy in patients with high-grade glioma discharged alive from the intensive care unit. On multivariate logistic regression analysis, two factors were independently associated with lower mortality 1 year after ICU admission: continuation of anticancer therapy after ICU discharge (OR 0.18, 95% CI 0.03-0.75, p = 0.028), and Karnofsky performance status at ICU admission (OR 0.90, 95% CI 0.85-0.95, p < 0.001). The main results of the study can be summarized as follows: in HGG patients discharged alive after an unplanned medical ICU stay (1), we observed a substantial proportion of survivors 1 year after ICU admission (more than one quarter of patients) and most of these patients exhibited relatively favorable performance status even 1 year after ICU admission, (2) continuation of anticancer therapy was possible in almost 50% of patients and was strongly associated with cancer progression and use of corticosteroids at admission, and (3) continuation of anticancer therapy and Karnofsky performance status at admission were associated with higher 1-year survival rates.
cord-012665-fflye8a3	2020	key: cord-012665-fflye8a3 title: Statistical issues regarding the article by Liu et al. cord_uid: fflye8a3 I read with interest the article by Liu et al. [1] on the effect of malnutrition status among elderly patients with COVID-19. I have some questions regarding the analysis of the data. • For each patient, four nutritional risk scores were computed. Comparing the prevalence of "at risk" patients between scores cannot be performed by simple chi-square, as the data come from the same sample (i.e., the data is not independent). It seems that the authors computed the OR for the non-at risk patients. Recomputing the OR leads to a value of 9.80, which is more compatible with the effects of malnutrition on increased LOS. • I am surprised that p values of zero are presented. Clinical significance of nutritional risk screening for older adult patients with COVID-19
cord-012778-yr8zuvw9	2019	We quantified the time course of PSP improvement in patients after treatment with these three antipsychotics: olanzapine, risperidone, and aripiprazole reached an E(max) value of 80.3%, 68.2%, and 23.9% at weeks 56.7, 29.2, and 36.8, respectively. In addition, quantitative information on the long-term social functioning of schizophrenic patients treated with SGAs is scarce in current clinical practice [12, 13] , and the available information does not reflect the differences in therapeutic efficacies between various drugs. Using data from the Study of Long-term Outcomes for Schizophrenia by Atypical Antipsychotic Treatment in China (SALT-C) study, which is a multicenter, real-world clinical study, we examined the differences in efficacy between three antipsychotics (olanzapine, risperidone, and aripiprazole) to provide a guide for clinicians when choosing an antipsychotic for the individualized treatment of schizophrenia. The SALT-C study was registered at https://www.clinicaltrials.gov (identifier: NCT02640911) and produced a large data set of real-world schizophrenia patients in China recruited in an open-label 3-year follow-up clinical trial of widely used atypical antipsychotics.
cord-012902-efprpk72	2020	Methods: An iontophoretic pilocarpine-induced sweat sample, measures of TEWL (Tewameter ® , COURAGE +KHAZAKA electronic GmbH, Köln, Germany) and a skin punch biopsy were collected from adult, non-pregnant hypertensive patients at the Glasgow Blood Pressure Clinic (n = 90; age: 56 ± 16, range 21-86 years; females = 48.9%; BMI: median = 29.8, interquartile range 26.9-35.2 kg/m²). Results: Subjects with high NM (n = 30, 15 men) had greater body mass index than those with low NM (n = 30, 17 men): (mean ± SD) 31 ± 7 vs 27 ± 4 kg/m 2 (p < 0.05), but the two groups were similar with respect to age and brachial blood pressure (BP). This study investigates the feasibility of CPET for safe and effective cardiovascular exercise prescription in hypertensive patients Methods: 14 subjects (10 Male, 4 Female; aged 61.8 ± 10.8 years) with hypertension and undergoing medical therapy were recruited to the study. This study aims to investigate the patient factors associated with the prescribing of blood pressure lowering medications after any index stroke in Scotland.
cord-012934-c6pbr64i	2020	title: Vestibular prognosis in idiopathic sudden sensorineural hearing loss with vestibular dysfunction treated with oral or intratympanic glucocorticoids: a protocol for randomized controlled trial The primary outcomes will be vestibular function outcomes assessed by sensory organization test, caloric test, video head impulse test, cervical vestibular evoked myogenic potential, and ocular vestibular evoked myogenic potential; the secondary outcomes include self-reported vestibular dysfunction symptoms; dizziness-related handicap, visual analogue scale for vertigo and tinnitus; and pure tone audiometry. To evaluate the recovery of vestibular function, we set the recovery rates of the whole battery of vestibular function tests (SOT/caloric test/vHIT/VEMPs) as the primary outcome, which is the proportion of patients whose abnormal results of vestibular function tests at baseline recover to normal at 4-/8-week follow-up: in this study, we define a 10-dB PTA criterion as clinically significant difference based on a previous RCT [9] .
cord-013003-gxd29jxf	2019	INTRODUCTION: The authors present a case of a 55-year-old male with T10 complete paraplegia diagnosed with Charcot arthropathy of the spine (CAS). CAS is now a well-defined long-term complication following traumatic spinal cord injury (SCI), developing on average 17 years after injury. Here we describe the case of a patient with paraplegia who developed CAS following a traumatic SCI complicated by a complex hospital course. Autonomic dysreflexia associated with Charcot spine following spinal cord injury: a case report and literature review Charcot joint of the spine, a cause of autonomic dysreflexia in spinal cord injured patients Management of autonomic dysreflexia associated with Charcot spinal arthropathy in a patient with complete spinal cord injury: Case report and review of the literature Four-rod instrumentation for treatment of Charcot spinal arthropathy causing autonomic dysreflexia: case report and literature review
cord-013035-7sfj0czv	2020	We read with great interest the article by McCarthy et al., 1 regarding the favourable use of tocilizumab in a series of patients presenting with cytokine storm related to coronavirus disease 2019 (COVID-19) infection. Reducing short-term mortality from cytokine release syndrome may come at the expense of long-term fatality rate, due to secondary healthcare or ventilator-associated bacterial or fungal infections, especially in critically ill patients with increased length of hospitalization in intensive care units (ICU). However, observational studies demonstrate favourable outcomes regarding mortality and risk of proceeding to endotracheal intubation when IL-6RA are used in a pre-critical (pre-intensive care unit (ICU)) setting, such as that described in our report, before the onset of severe respiratory failure. To address these questions, our group has designed a phase 2, open-label, two-stage, multicentre, randomized trial comparing different doses of single-dose administration of tocilizumab in adults with severe, non-critical, COVID-19 with evidence of hyperinflammatory state.
cord-013105-tmhce7p5	2020	In addition, we propose that health-care providers can bring concrete and direct benefits to each of our critically ill patients at the bedside by preventing the excessive use of unnecessary antibiotics. The clinical deterioration of mechanically ventilated patients may be associated with a new infection process; however, the majority of ventilator-associated events leading to antibiotic administration is related to noninfectious processes [6] ; thus, the appropriate antimicrobial de-escalation is essential and can be safely done if culture results are negative [7, 8] . For many decades, critically ill patients have been treated with antibiotics during two to three weeks for severe infections including pneumonias, abdominal and urinary infections, all of which still comprise the majority of infections leading to sepsis and admission to the intensive care unit. Effect of aminoglycoside and beta-lactam combination therapy versus beta-lactam monotherapy on the emergence of antimicrobial resistance: a meta-analysis of randomized, controlled trials
cord-013116-n7auvqh3	2020	authors: Srinivas, A.; Moshkun, C.; Darcey, J. History revealed that the 17 had been removed four months prior to presentation due to similarly vague symptoms. He had already begun a course of antibiotics and was using chlorhexidine mouth rinses prescribed remotely via an urgent dental centre (UDC). The pain had reduced but there was still discomfort in the area and the patient reported it to feel sharp on his tongue. The patient contacted UDHM six weeks later with ongoing pain and a face-to-face review was arranged. In that time he had not been offered a face-to-face review but rather been given a further two courses of antibiotics after remote UDC consultations. Reflecting back over this patient''s history and clinical encounters there were signs that may have pointed towards a nonodontogenic diagnosis. Darcey, Manchester, UK https://doi.org/10.1038/s41415-020-2226-y missing a serious diagnosis or misdiagnosing.
cord-013139-b32xg7y7	2020	Since the discovery of BRAT1 variants as the molecular etiology of lethal neonatal rigidity and multifocal seizure syndrome (RMFSL, OMIM 614498), these variants have also been identified in patients with milder clinical forms including neurodevelopmental disorder with cerebellar atrophy and with or without seizures (NEDCAS, OMIM 618056), epilepsy of infancy with migrating focal seizures (EIMFS), and congenital ataxia (CA). This study aims to examine the consequences and pathogenicity of a novel homozygous splice site variant in BRAT1 in a patient presenting with migrating focal seizures since birth without prominent rigidity. RMFSL was first described in 2012; later, BRAT1 variants were also reported in patients with non-lethal milder clinical forms, including neurodevelopmental disorder with cerebellar atrophy and with or without seizures (NEDCAS, 618056), epilepsy of infancy with migrating focal seizures (EIMFS), and congenital ataxia (CA) [7] [8] [9] [10] .
cord-013148-qbxbndsl	2020	Propensity score matching extracted 1:1 matched pairs of subjects who were from an LMIC or a HIC based on age, gender, the presence of pupillary response on admission, impeding hypotension (SBP ≤ 80), trauma mechanism, ISS, the necessity of CPR on arrival, the location of REBOA insertion (emergency room or operating room) and the amount of PRBCs transfused in the first 24 h. CONCLUSION: There is considerable variation in the management practices of REBOA and the outcomes associated with this intervention between HICs and LMICs. Although we found significant differences in multiorgan and respiratory failure rates, there were no differences in the risk-adjusted odds of mortality between the groups analyzed. In order to address the variations between regions and countries in relation to their income, we aim to compare the management approaches and clinical outcomes of trauma patients resuscitated with REBOA according to the countries'' income based on the World Bank Country and Lending Groups.
cord-013149-y0dbhtef	2020	Timing der Intensivstationsaufnahme Die vorhandenen Daten über kritisch kranke Krebspatienten mit den häufigsten Intensivstationsaufnahmegründen, ARV und Sepsis, zeigen einmütig, dass eine möglichst frühzeitige Verlegung auf die Intensivstation, also bei manifestem oder eventuell auch nur drohendem Organversagen, erfolgen sollte [8, 9] . Bei Patienten mit "chronic obstructive pulmonary disease" (COPD) und hypertensivem Lungenödem stellt die nichtinvasive Beatmung (NIV) den Goldstandard der Therapie dar und es gibt keine evidenzbasierte Rationale, dass dies nicht auch bei Krebspatienten gelten sollte. These include defining proper goals of intensive care treatment, managing acute respiratory failure with diverse differential considerations, treating immunologic side-effects of ever new and innovative cancer therapies, as well as numerous clinical scenarios which may exclusively arise in cancer patients. Cancer · Intensive care unit · Acute respiratory failure · Immunotherapy · iCHOP und womöglich "um jeden Preis" nicht zu intubieren, kann somit als überholt, ja im Fall sekundärerIntubationenbeiNIV-Versagen sogar als potenziell gefährlich angesehen werden.
cord-013370-gktnz644	2020	We have partnered closely with the European Crohn''s and Colitis Organisation because of our shared desire to provide the best guidance to patients with inflammatory bowel disease at a global level, as well as to the physicians that are caring for these patients. The process is called a RAND panel wherein the members of IOIBD, as well as other very knowledgeable practitioners of IBD, voted on a series of statements largely having to do with the risk of infection with the SARS-CoV-2 virus and the development of COVID-19 in patients who have IBD. We urge you to continue to check the IOIBD or the ECCO websites for the most up-to-date information, and we hope to keep updating the guidance in all of the various dimensions of IBD care.
cord-013380-1jwzbgwb	2020	The management of these issues is considered time demanding, often causes anxiety in non-experienced non-specifically trained specialists and, in the real world, it represents the main obstacle for many physicians to voice prosthesis rehabilitation. The aim of this paper is to analyse a 1-year window of troubleshooting in a multidisciplinary setting for a large cohort of voice prosthesis rehabilitated patients, to quantify how demanding management is and to propose an algorithm that is useful to minimise the time and burden for dedicated clinicians. To address the first issue, we analysed a 1-year time frame of management in a large cohort of voice prosthesis rehabilitated patients and, as a result, we developed a trouble-shooting algorithm with a technical flow chart to achieve quick and correct identification and adequate treatment of complications (Fig. 1) . Our study highlights the importance of a systematic approach in the management of late complications in voice prosthesis rehabilitated patients.
cord-013457-rqon1adg	2020	The goal of the study was to obtain a better understanding of the short-term progression of functional capacity throughout multidisciplinary CR, measured as the change in walking distance between baseline six-minute walking test (6MWT) and four consecutive follow-up tests. Although the majority of studies on home-and center-based CR programs report data on changes in exercise capacity measured at baseline and on completion of the intervention limited information is available on the short-term progression in exercise capacity throughout the CR [20] [21] [22] . A one-way repeated measures ANOVA was conducted to determine whether there were statistically significant differences in mean 6MWT distance (6MWD) over the period of a three-month rehabilitation program. Future studies should investigate whether similar progression patterns emerge in both center-based (including with larger patient groups) and in home-based CR programs and whether this short-term information on progression can be used to optimize outcomes by improving exercise capacity and motivation.
cord-013558-0sa63lp3	2020	Eligible articles included peer-reviewed studies involving ophthalmology patients, who received a solely video-based educational intervention to assess for improvement in patient knowledge, behaviour and overall health-related outcomes. This systematic review of the existing literature aimed to assess the efficacy of using video-based media for patient education in ophthalmology. Studies were included in this systematic review if they involved the use of video-based media as a sole intervention for patient education in ophthalmology with endpoints focussed on its impact on patient knowledge, health behaviour or overall clinical outcome. We aimed to study the extent of use of video-based media in influencing patient knowledge, health behaviour and overall clinical outcome. Due to the low number of the studies and heterogeneity of the interventions used and outcomes reported, it is challenging to reach any firm conclusions on the validity of the use of video-based media as a patient education tool in ophthalmology.
cord-013589-3l8kar3k	2020	A homozygous missense variant leading to drastic decrease of PDE2A enzymatic activity was reported in one patient with childhood-onset choreodystonia preceded by paroxysmal dyskinesia and associated with cognitive impairment and interictal EEG abnormalities. The phenotype of the two oldest patients, aged 9 and 26, was characterized by childhood-onset refractory paroxysmal dyskinesia initially misdiagnosed as epilepsy due to interictal EEG abnormalities. Together with previously reported case, our three patients confirm that biallelic PDE2A variants are a cause of childhood-onset refractory paroxysmal dyskinesia with cognitive impairment, sometimes associated with choreodystonia and interictal baseline EEG abnormalities or epilepsy. reported a missense homozygous variant in PDE2A in a patient with cognitive impairment, interictal EEG abnormalities, and childhoodonset chorea [8] . indicate that biallelic variants in PDE2A leading to loss of function are involved in heterogeneous phenotypes characterized by early-onset paroxysmal hyperkinetic movement disorders associated with cognitive impairment and possibly epilepsy.
cord-014464-m5n250r2	2013	Results In preliminary analysis of categorical data, a signifi cantly (Fisher exact test) greater proportion of patients with compared with without the following fi ndings did not survive; history of alcohol use (P = 0.05); the presence of lethargy (P = 0.01), confusion (P = 0.03), nausea (P = 0.04), abdominal pain (P = 0.02), or the need for vasopressors (P = 0.002), oxygen, mechanical ventilation, or steroids (all P = 0.004) at presentation; and excessive bleeding at surgery (P = 0.01). Methods To prospectively re-evaluate the normal range and to analyze the potential impact of biometric data on ICG-PDR, we measured ICG-PDR (i.v. injection of 0.25 mg/kg ICG; LiMON, Pulsion, Munich, Introduction Mixed venous oxygen saturation (SVO 2 ) represents a well-recognized parameter of oxygen delivery (DO 2 )-consumption (VO 2 ) mismatch and its use has been advocated in critically ill patients in order to guide hemodynamic resuscitation [1] and oxygen delivery optimization.
cord-014533-6qfecv5h	2016	P. Tirapu; Navarro-Guillamón, L.; Cordovilla-Guardia, S.; Iglesias-Santiago, A.; Guerrero-López, F.; Fernández-Mondéjar, E.; Vidal, A.; Perez, M.; Juez, A.; Arias, N.; Colino, L.; Perez, J. Methods: This descriptive observational study was conducted on consecutive 100 pediatric surgical patients who admitted to PSICUs at Cairo University Hospitals starting from 1/6-1/12/2015.After approval by research ethics committee,informed consents were obtained from parents and pediatric cases aged from 1 month-18 years and stayed for > 48 h were enrolled.MPV and PLC were obtained and recorded at baseline(preoperative values),on the day of ICU admission(day 0),1 st ,2 nd ,3 rd ,5 th and 7 th days.To measure daily MPV changes; (ΔMPV) was constructed and computed where ΔMPV = ([MPVday(X) − MPVday (0)]/MPVday(0) × 100 %. Results: The results obtained after analyzing the two homogeneous groups according to age, gender, type of admission and severity influencing the physiotherapy care in ICU quality indicators, in the Sagrada Esperança clinic, highlights the decrease of the average number of days with mechanical ventilation but it is not observed a significant relation between physical therapy and this indicator (p = 0:06).
cord-014538-6a2pviol	2017	Other parameters that were significantly different between the patients who died and those who survived were an advanced age, an elevated IGS II score at hospital admission, an elevated SOFA score at study entry, a late healthcare-associated infection and several biological variables: a high C reactive protein, low albumin and prealbumin and a poor percent of monocytes expressing HLA-DR, all measured at day 7. Parameters collected were demographic features, comorbidities, regular treatment, dyspnea assessed by the MRC scale, initial clinical severity reflected by SAPS II and APACHE II scores, modalities and ICU admission deadlines, initial arterial blood gas analysis, management of patients in the ICU (ventilation modalities, prescription of antibiotics, use of vasoactive drugs) and their outcomes (incidence of nosocomial infections and their sites, length of stay and ICU mortality).
cord-014540-27hnlu5v	2017	A secondary questionnaire was sent to determine whether any cases showed a positive blood or cerebral spinal fluid culture for Extended Spectrum Beta-lactamase (ESBL) producing GNB, AmpC β-lactamases producing GNB, or carbapenem-resistant enterobacteriacae (CRE) between April 2012 and March 2015.The following data were collected; demographic data pertaining to both the care facilities and patients, clinical diagnosis, and outcomes. Utilization of diagnosis-procedure combination data for advancing the antimicrobial stewardship program Haruo Nakayama, Toshiko Ota, Naoko Shirane, Chikako Matuoka, Kentaro Kodama, Masanobu Ohtsuka Toho University Ohashi medical center, Tokyo, Japan Background Infection with antibiotic-resistant bacteria results in increased morbidity, mortality and economic burden. The purpose of this study was to test the effectively of the Infection Control Risk Assessment (ICRA) monitoring tool developed by the Infection Prevention and Control Unit (IPCU) of Asian Hospital and Medical Center with the aim to increase the compliance of construction workers to recommended infection prevention and control measures during construction, renovation and demolition in the hospital.
cord-014670-e31g8lns	2004	Over a 12-month period patients who needed reintubation after successful trial of weaning and planned extubation, in a polyvalent intensive care unit (ICU) were identified.Data including clinical features (age, sex, SAPS II on admission, Glasgow Coma Score (GCS) on day of extubation, type of patient, length of intubation and mechanical ventilation (MV) before extubation, length of ICU stay (LOS), ICU and hospital mortality) were collected.Moreover we considered two parameters that asses airway patency and protection like predictors of EF:cough strength and suctioning frequency after extubation.Cough strength on command was measured with a semiobjective scale of 0 to 5 (0= weak cough, 5= strong cough). (3/23)(13.2%), pulmonary embolism(1/23)(4.3%)and severe sepsis(1/23)(4.3%).Seven of patients who received reintubation a cause of defective airway manage needed at least one suctioning every two hours; moreover the same patients and other three with alteration in neurological function had weak cough (grade 0 to 2).The LOS of EF patients was 23±24.3 days, their ICU and hospital mortality were 39.1% and 47.8%, respectively, both higher when compared with not reintubated patients.Results of logistic regression showed that SAPS II is the only independent risk-factor of reintubation (odds ratio 1.056, sig.
cord-014687-0am4l5ms	2012	This presentation will focus on recent developments that have lead to a better understanding of the embryopathogenesis for fibropolycystic liver diseases (including choledochal cysts and Caroli disease), histopathological findings that have led to new classification systems for of pediatric vascular anomalies, technological advances and contrast agents in magnetic resonance imaging that are useful to characterize and limit the differential diagnosis of hepatic masses. Disclosure: Dr. Annapragada has indicated that he is a stock holder and consultant for Marval Biosciences Inc. Paper #: PA-067 Cardiovascular Image Quality Using a Nanoparticle CT Contrast Agent: Preliminary Studies in a Pig Model Rajesh Krishnamurthy, Radiology, Texas Children''s Hospital, rxkrishn@texaschildrens.org; Ketan Ghaghada, Prakash Masand, Abhay Divekar, Eric Hoffman, Ananth Annapragada Purpose or Case Report: Image quality in a separate study using a long circulating, liposomal-based nanoscale blood pool iodinated contrast agent (NCTX) suggests clinical utility in pediatrics, potentially reducing difficulties in contrast-CT of children with congenital heart disease (CHD) including the size of intravenous cannula, need for accurate timing, inability to simultaneously opacify multiple targets of interest (requiring repeated contrast administration and/or repeated imaging).
cord-014712-5u4e00q6	2014	
cord-014794-yppi30a0	2003	These parts were in a high percentage associated with fibrosis and lymphocyte rich areas and showed a higher mitotic activity than usual PTCs. Discussion The differences in the occurrence of TCV and TCmorphology between the presented series and previously reported cases might result from until now not clearly defined tall cell morphology as well as from similarities to PTCs, such as the oxyphilic variant, which is extremely rare in our series, and maybe also from often described squamous changes within PTCs. Due to these data it is not clear which tumor parts have relevance for prognosis and which tumors should be treated more aggressively than others. The aims of this study were to characterize the group of patients with BSOT and evaluate the significance of various molecular markers expression versus serous papillary ovarian carcinomas (SPOC) Material and methods We analyzed a total of 102 cases including: 64 cystadenoma, 10 borderline and 28 cystadenocarcinoma.
cord-014833-ax09x6gk	2016	title: Data Decision and Transmission Based on Mobile Data Health Records on Sensor Devices in Wireless Networks History data, collection data, and doctor-analyzed data could be computed and transmitted to patients using sensor devices. This study establishes a new method that can decide and transmit effective data based on sensor device mobile health in wireless networks. This study establishes a new method that can decide and transmit effective data based on sensor device mobile health in wireless networks. According to an established mobile health system, patients can obtain timely treatment from doctors or hospitals by using wireless sensor devices. In mobile health, sensor devices and mobile device are the cheapest and most convenient means of data collection and transmission among doctors, patients, and hospitals. Formula (8) assumes that a ¼ 0:15; b ¼ 0:35; c ¼ 0:5: Sensor devices may calculate the probability and transmit diagnosis data to the mobile APP to be evaluated by patients and doctors.
cord-014933-3jezc081	2019	authors: Özdemir, Seray Karagöz; Iltar, Utku; Salim, Ozan; Yücel, Orhan Kemal; Erdem, Ramazan; Turhan, Özge; Undar, Levent The first aim of study was to determine the difference in frequency of febrile neutropenic episodes (FNEs) according to months and seasons. Febrile neutropenia (FEN) is the most common complication requiring hospitalization and causing mortality in patients with hematological cancer. The primary aim of the study was to investigate whether there is a relationship between the frequency of febrile neutropenic episodes (FNEs) and seasons in hematological cancer patients. In addition, neutrophil count, C-reactive protein (CRP) level, length of hospitalization, culture results of blood and other body specimens, isolated pathogens, detected foci of infection, and antibacterial, antiviral, or antifungal treatments were reviewed. The second aim of the study was to determine the type and frequency of pathogens detected in FNEs in patients with hematologic cancer.
cord-014965-efmozngq	2001	To evaluate the influence of the helicobacter pylori (h.p.) infection on gastrointestinal complications after high-dose chemotherapy and stem cell transplantation (STX) we tested 114 patients (54 female, 60 male) by the 13C-urea breath test prior to initiation of conditioning therapy. 26 immunocompromised patients (15-70 y, median 44; 17 leukemia, 7 myeloma, 2 lymphoma) received 32 courses of ABLC at the median daily dose of 2 mg/kg rounded off to the nearest vial size (range, 1.3-2.7 mg/kg) after autologous (n=7) or allogeneic (n=8) stem cell transplantation or chemotherapy (n=17). Seven of the 12 allogeneic transplanted patients with at least one positive PCR-result had a VZV-disease. All (n=2) of the autologous transplanted patients with a positive PCR-result developed a VZV-disease. Background: Severe acute graft-versus-host-disease (aGvHD) of the gut is still a major complication after allogeneic stem-cell transplantation (SCT) as response rates to treatment (tx) of intestinal GvHD (iGvHD) are lower than those observed for GvHD of the skin.
cord-014976-546zaoxn	2006	In order to evaluate if malignant and non malignant hematological diseases quantitatively and qualitatively affect BM derived MSCs, bone marrow from children with acute lymphoblastic leukemia (ALL diagnosis n=9, different phases of treatment n=29, end of therapy n=10), idiopathic thrombocytopenic purpura (n=16), autoimmune neutropenia (n=12) and control patients (solid tumors without BM involvement, n=30) was harvested and the mononuclear cell (MNC) fraction isolated. Case: In our hospital a total of 3 patients with relapsed Hodgkin''s disease underwent reduced-intensity conditioning (RIC) allogeneic stem cell transplantation (allo-SCT) from an HLA-identical sibling. We report a case of a young male patient of 19 years old with aggressive MS who was treated with a high-dose immunosuppressive regimen (HDIS) using myeloablation followed by autologous blood stem cell transplantation (ASCT) that has induced a dramatic and long-lasting remission of the disease.
cord-014980-cz1gx9oj	2020	Stepwise selection was applied to the data, which resulted in a final model with 8 independent predictors [including initial PaO(2)/FiO(2) ratio ≤300 mmHg, age ≥60 years, chronic diseases, poor hand hygiene, time from illness onset to the first medical visit, incubation period ≤5 days, peak C-reactive protein ≥120 mg/L], and initial bilateral lung infection. 11 To better evaluate the predictors associated with survival outcomes, based on a matched case−control study (1:2 ratios), we retrospectively investigated the sociodemographic, clinical and epidemiological data of 227 laboratoryconfirmed cases of H7N9 VI in Zhejiang province, China, between March 1, 2013, and May 31, 2019. With 8 variables of training set such as IPFR ≤300 mmHg, IBLI, peak CRP ≥ 120 mg/L, TIOFMV, IP ≤ 5 days, CD, PHH, and age ≥60 years in Table 4 , it was possible to create a nomogram to predict the probability of survival from influenza A (H7N9) (Figure 2 ).
cord-014987-nycbjqn6	2006	In the "Prevalence of severe sepsis and septic shock in Intensive Care Units in Germany" study, a prospective observational cross-sectional study, data from 454 ICUs in 310 randomly selected hospitals in Germany were collected by local one-day visits of trained physicians from SepNet''s 17 regional study centers. Despite the higher APACHE II score in both groups (median score 21 or 18.5, respectively compared with 16.5 in the enteral group, p<0.01) our results indicate that parenteral nutrition has an important attributable effect on mortality in septic patients. In this follow up study, we document the impact of intensive insulin therapy on long term mortality and objective and subjective well-being of high risk cardiac surgical patients. 4 years after ICU-admission, we assessed long term outcome of the subgroup of cardiac surgical patients (N=970) included in the original insulin trial (1) .
cord-014996-p6q0f37c	2009	Data recorded on admission were the patient demographics with, acute physiology and chronic health evaluation II score (APACHE II), and type of admission; during intensive care stay, sepsis-related organ failure assessment score (SOFA) and clinical concomitant factors and conditions. For each severe septic patient the following data was registered: time delay, APACHE II and SOFA scores at ICU admission, diagnosis, the rate of compliance with the resucitation and management bundles, microbiological data, evolution of levels of serum lactate, empiric antibiotic therapy, length of stay and mortality in ICU. Sepsis and septic shock remain the most important causes of acute kidney injury (AKI) in critically ill patients and account for more than 50% of cases of acute renal failure (ARF) in intensive care units (ICU). There were no significant differences between the demographic data (sex, age) or the data on admission to intensive care (APACHE II score, ratio of medical to surgical patients) and duration of mechanical ventilation between the two groups.
cord-015021-pol2qm74	1994	It is our current understanding that LPS is responsible for many of the pathophysiological events observed during gramnegative infections and that one of the major mechanisms leading to shock and death is the LPS-induced activation of macrophages resulting in the production and release of lipid and peptide mediators, among which tumor necrosis factor seems to be the most important. However plasma IL-6 estimation revealed a statistically significant reduction at 6 hours in tanrine-treated animals compared to glycino and TW controls ( Objective: To evaluate the effects of allogeneic blood transfusion, thermal injury and bacterial garage on interteukin 4 (IL-4), tumor necrosis factor alpha (TNF) production and host mortality and to study if the administration of thymopentth (THY) could affect these events.
cord-015024-2xzc0uc5	2010	We performed a prospective clinical study in a 17-bed multidisciplinary intensive care unit, including 21 patients with controlled mechanical ventilation and monitored with the Vigileo Ò monitor, for whom the decision to give fluids was taken due to the presence of circulatory, including arterial hypotension (MAP B 65 mmHg or systolic arterial pressure \90 mmHg), and preserved preload-responsiveness condition, defined as SVV C10%. The aim of this study was to compare and evaluate four severity scoring systems in intensive care unit (ICU), including APACHE II, APACHE III, SASP II and MODS in severe septic patient. A prospective observational study was performed in 16 mechanically ventilated critically ill patients (12 M, age 49 ± 17 yr, BMI 25 ± 5 kg/m 2 , ICU admission day 5 ± 3, APACHE II on study 20 ± 7; mean ± SD) and 6 healthy subjects (3 M, age 24 ± 9 year, BMI 24 ± 45 kg/m 2 ).
cord-015082-l629n8is	2002	14 patients awaiting urgent cardiac surgical re-vascularisation were studied with measurement of: spirometry; percentage increase in transfer factor from sitting to lying position (TF) as an indicator of micro-vascular lung disease; overnight oximetry on air; and 24hour holter monitoring Patients, who were reintubated on decreased indices of arterial oxygenation under MOSF progressing died in 100% cases ( NIMV is effective method in complex therapy of ARF, developing in postoperative period after cardiac surgery, that leads to significant improvement of lungs biomechanics and gases change function. In a prospective observational study we performed bedside ptO2 measurements in 8 patients with sepsis/septic shock to gain insight in ptO2 values and their dynamic changes related to the course of the illness, as well as investigating the practical applicability of tissue oxygen measurement in the ICU setting.
cord-015090-n6f4xupw	2005	We designed this study to examine the effects of fiberoptic bronchoscopy (FOB) with and without BAL on body temperature, systemic arterial pressure, heart rate and supportive therapies requirements in mechanically ventilated patients. Clinical characteristics (Glasgow scale, heart rate, systolic blood pressure), cardiac enzymes (troponin I, total serum creatine kinase and myocardial isoenzyme, myoglobin), ECG changes (ST-T changes, prolonged QT and corrected QT intervals), echocardiographic assessment of cardiac function (left ventricular ejection fraction, hypokinesia) were studied on the day of the admission. It is a prospective study performed during 12 months of the patients with brain trauma admitted in a 24-beds medical-surgical ICU of a 650-beds university hospital. This prospective observational study included 200 adult patients admitted to a 31-bed university hospital medical-surgical ICU during a 3-month period.
cord-015126-cyhcbk1j	2007	
cord-015162-6be21d59	2016	Aim of the study: To investigate whether the use of Ticagrelor in comparison to other platelet-inhibitors is associated with a greater risk of bleeding or death in patients with acute myocardial infarction in the emergency room. Initiale Laborwerte: pH 7,2, pO 2 9,3 kPa (unter 3 l O 2 /min), pCO 2 5,8 kPa, BE -10, HCO 3 17; K+ 3,4; Na 143; Hb 6,8; Kreatinin 106; Harnstoff 3,5; Lactat 7,3; Glucose 9 (je mmol/l); Leukozyten: 12 (je Gpt/l); Methode: Therapie in den ersten 12 Stunden: Übernahme auf die Intensivstation, dort Intubation, rasch sich entwickelnder exzessiver Katecholaminbedarf mit Kreislaufstillstand und Reanimation. This difference does not lead to higher in-hospital mortality as compared to men in Hintergrund: Akute Herzinsuffizienzsyndrome (AHFS) sind die häufigste Ursache für Hospitalisierungen in Deutschland, verursachen enorme Kosten und zeigen eine hohe Mortalität. Ziel der Studie ist es den fungalen Biomarker 1,3-Beta-D-Glucan (BDG) hinsichtlich einer frühen Detektion einer IM und als Outcome-Parameter bei immunsupprimierten Intensivpatienten mit septischen Schock zu evaluieren.
cord-015306-us58wwmp	2013	The incidence of renal involvement varies from 20 to 60% and there have been some reports showing that nephritis might be related to an older age at onset, persistent purpura (> 1 month), severe abdominal pain, and relapsing disease.Recently, several studies have shown that galactose-deficient IgA1 (Gd-IgA1) is recognized by anti-glycan antibodies, resulting in the formation of the circulating immune complexes and their mesangial deposition causing renal injury in HSP nephritis and serum galactose-deficient IgA1 levels were highly inherited in children with HSP nephritis.Regarding the treatment of HSP, one randomized double-blinded controlled study recently showed that patients with abdiminal pain or arthralgia may benefit from early treatment with prednisone, but the drug has not been proven to be capable of preventing the development of renal symptoms.
cord-015324-y44sfr0c	2007	In order to further validate this approach, we performed a prospective randomized open-label multicenter trial in 41 low-risk pediatric renal transplant recipients (12 f, 29 m; mean age 10.1 yrs; range, 3.4 to 17.8) on CsA (target trough level 100-200 ng/ml), MMF (1200 mg/m 2 per day) and methylprednisolone (3) (4) mg/m 2 per day), who were randomly assigned >1 year posttransplant to continue steroids or to withdraw over a period of 3 months. We evaluated MMF in 15 children with LN, 11 F/4 M, mean age: 12.4±3.9 yrs, proteinuria >3 g/day, decreased C3 and increased anti-dsDNA serum levels, normal renal function. Patients and methods: 91 children and adolescents (60 male, 31 female, mean age at transplantation 9.7±5.2 years) with stable renal function and observation period exceeding 6 months were included.
cord-015334-8p124rwp	2008	Based on the results of the pharmacoeconomic analysis, development of clinical pharmacy and CIVAS for some drugs will be discussed with the paediatric department Background and Objective: Studies show that up to 38% of patients starting treatment with antidepressants fill only a single prescription at the pharmacy, apparently not accepting treatment. Main Outcome Measures: Data collected were: nurses'' profile (age, length of service, competencies'' self-assessment), knowledge on drugs prescribed to their patients (usage, administration, side-effects, drug interactions…), use of existing tools (i.e. drugs database) and possible tools to be developed by the pharmacy ward to help them in their daily practice. The objectives were:(1)To identify the most relevant minor ailments, agreeing on the specific criteria for referral to the GP.(2)To select the non-prescription drugs, with evidence of safety and effectiveness, for the treatment of the identified minor ailments Design: Qualitative study with an expert panel which was made up of 2 primary care physician from SEMFYC and six community pharmacists (two members of SEFAC and four members of GIAF-UGR).
cord-015335-l0kjxhd1	1995	The results suggest that an aneuploid DNA pattern is a predictor of high risk potential for metastases to the liver and may be a useful tool in the "followup" of patients with gastric carcinoma in detecting those at high risk of developing metastases following surgical resection. A partially purified preparation of oesophageal tumour-derived inimune suppressor factor that has been shown to be free of all known cytokines was tested in dose-ranging studies on cell proliferation and apoptosis using lymphocytes from the mutant and control mice. Currie et al have demonstrated that arginase is cytotoxic to tumour cells by depletion of the essential amino acid L-arginine, therefore the aim of this study was to determine the role of this enzyme in colorectal tumour-derived MOs. Human peripheral blood monocytes (PBM) were isolated from aged-matched controls (CON) and from blood pre-operatively obtained from patients undergoing surgery for colorectal cancer.
cord-015348-qt0worsl	2010	However, the application of the compounds in clinical trials has revealed promising results only when predictive procedures have been available for determining which patients will benefit from targeting therapy, so-called eligibility or predictive tests, e.g. Her2 in breast cancer, KRAS and EGFR mutations in colorectal cancer and non-small cell lung cancer. Conclusion: We report on the development of a quantitative tissue-based immunohistochemical (IHC) methodology employing activation-specific antibodies against multiple components of the BCR signaling pathway that will assess the activity of the BCR pathway in formalin-fixed paraffinembedded primary DLBCLs. This approach will identify the subset of patient tumors that are actively signaling through the BCR pathway and, therefore, will predict therapeutic responsiveness to targeted inhibition of BCR signaling. Method: In our study, we investigate 120 cases diagnosed with invasive breast carcinoma in which we established microscopic characterization, immunohistochemical profiles (expression of proliferation markers, steroid receptors and Her2) and computer-assisted morphometric profiles by determining the mean values for nuclear area, cellular area and N/C ratio with Lucia Net Software.
cord-015352-2d02eq3y	2017	
cord-015354-yknwveyz	2007	Material and Methods: Fourteen individuals (mean age 47±19y range 21-75y; 4W, 10M; including 10 volunteers and 4 patients with angiographically proved CAD) underwent dynamic PET imaging studies (21 frames) at rest and during adenosine stress (0.14mg/kg/min for 6 min) after injection of 1100MBq of 82Rb (Discovery LS, GEMS). Methods:Twenty-nine patients (21 males,8 females;62±11 yrs) with recent AMI were studied.Within 6 days after AMI, the patients were performed Tl-201 R-RD perfusion SPECT using 4 mCi activity.CMR was carried out 5-20 minutes after 0,15 mmol/kg of iv.Gadobutrol injection.Myocardial perfusion and contrast enhancement was analyzed using a 17 segment model.Myocardial perfusion was scored in Tl-201 SPECT as follows:0=normal (70%-100% maximal myocardial activity(mma), 1= 69-50% mma, 2= 49-30% mma ,3=29-10% mma and 4=<10% mma ;Myocardial contrast enhancement on CMR images was graded as:0=no contrast enhancement, 1=hyperenhancement of 0-25% of the wall thickness(WT) 2=hyperenhancement of 26-50 % of the WT, 3=hyperenhancement of 51-75 % of WT and 4=hyperenhancement of 76-100 % of WT.In CMR the existence of microvascular obstruction(MO) was also evaluated.Total segment scores(TSS) in R,RD and CMR for each patient were calculated by summing of 17 segment score values.
cord-015359-gf32a6f1	2002	Methods and materials: 73 consecutive patients, clinically considered to have stage 1B tumour (confined to the cervix), underwent MR imaging studies at 1 T, according to the following protocol: fast spin-echo (FSE) T2-weighted, gadoliniumenhanced SE Tl-weighted, and fat-suppressed gadolinium-enhanced SE Tlweighted sequences. Purpose: To describe the radiological (thin section CT) findings correlated to activity and remission in ANCA associated pulmonary-renal small vessel vasculitis (SVV) Material and methods: We used retrospective analysis of 37 CTs, 27 in disease activity (8 first manifestations, 19 relapses) 10 im remission of 17 patients with pulmorenal syndrome (9 Wegener, 4 microscopic polyangiitis-MPA, 3 Churg-Strauss-syndrome, 1 idiopathic crescentic glomerulonephritis following the Chapel Hill classification) 7 women, 10 men, median 65.5 years (34 -84). Varghese, P.R. Mueller; Boston, MA/US Purpose: We sought to determine the incidence of malignancy and to assess a possible role for image guided biopsy of this category of renal masses Materials & methods: Of the 397 renal biopsies performed at our institution between 1991 and 2000; a total of 28 patients with 28 category III lesions, were identified for analysis.
cord-015365-iqdi99pd	2011	
cord-015368-a0qz4tb9	2007	Surgical treatment and evaluation, complications, short and long term patency of our patients were compared to interventional techniques and international literature. The aim of the study was to investigate: i) relevant and combined determinants of the development, management and outcome of a representative patient cohort (n ¼ 9.991) with acute appendicitis enrolled in a prospective unicenter study through a time period of 27 years (middle Europe), and ii) the frequency and impact of specific categories (e.g., characteristics of the medical history, clinical and intraoperative findings, complications), correlation and relative risk factors of the disease and its prognosis. From 01=1997 until 12=2006 198 TEM procedures were performed in 194 patients, 104 males, 90 females, mean age was 68.9 years (38-91), the median hospital stay was 8 days . No conversion to open technique had to be performed, no postoperative surgical complications were observed, one patient died 4 weeks postoperative due to liver failure following esophageal varices bleeding.
cord-015369-72cjogxz	2009	
cord-015370-4jfgsic7	2014	Obwohl die fehlerhafte Aufklärung durch Ärzte unter Juristen schon länger ein "Renner" ist, hat sich in der Praxis häufig noch nicht herumgesprochen, wie und vor allem wann der Patient vor einem chirurgischen Eingriff aufgeklärt werden muss. Objective: This study aimed to investigate the effect of single and combined baseline concentrations of b vitamins on postoperative survival of vascular surgery patients over a time of 8.5 years in a region without folate fortification. Laparoscopic resection of 2 gastric duplication cysts in a pediatric patient: report of a case Ergebnisse: Mit Ausnahme von 6 der Mädchen mit 32 funktionellen Zysten, die konservativ behandelt wurden, wurden alle anderen Tumoren nach Durchführung einer Schnellschnittuntersuchung reseziert, bei 2 Mädchen mit malignen Tumoren war nur ein Tumordebulking möglich. Methods: Twenty-two patients, who underwent endoscopic band removal between June 2002 and December 2013, were ret-und in manchen Fällen ist die Amputation der einzige Ausweg, wenn auch diese sorgfältig gegen Risiko und Nutzen einer komplexen Rekonstruktion abgewogen werden muss, um im Endeffekt dem Patienten ein paar Jahre mit hoher Lebensqualität zu ermöglichen.
cord-015372-76xvzvdg	1996	
cord-015389-vwgai4k9	2009	This study evaluates the safety of this approach, in terms of infusion-related toxicity and hematopoietic reconstitution, in 385 consecutive autologous transplantations performed from 4/97 to 9/08 in 348 patients (median age 46; underlying disease: lymphoma in 178, myeloma in 131, acute leukaemia in 17, breast cancer in 22). Patients and methods: Eight pts after allogeneic hematopoetic stem cell transplantation (HSCT) underwent MSCs infusions (median age of pts was 11 years, male/female: 6/2) between 2006 and 2009. Akiyama Tokyo Metropolitan Komagome Hospital (Tokyo, JP) Acute graft-versus-host disease (GVHD) is one of the major factors that have infl uence on the outcomes of allogeneic hematopoietic stem cell transplantation (HSCT). Material and methods: during a 8 years period we have performed 144 stem cells transplantation in 134 patients with different hematological malignancies(AML: 74; ALL: 6; CML: 7; CLL: 1, NHL: 13; Hodgkin Diseases: 16; Multiple myelomas: 24; Aplastic anaemia: 1;Myelofi brosis:1 Ewing Sarcoma: 1; Male:78 Female 66.
cord-015569-vy49r1zd	2012	In this study, in order to test whether the cadherins are required for formation of synapse between gustatory nerve fibers and taste receptor cells, we have investigated expression patterns of cadherin superfamily in the taste buds. Therefore, this study aimed to examine differences in immunoreactivities under various tissue-preparing conditions in rat vallate taste buds for some typical markers of gustatory cells as follows: gustducin, type III inositol triphosphate receptor (IP 3 R3), synaptobrevin-2 (VAMP2), protein gene product 9.5 (PGP9.5), and neural cell adhesion molecule (NCAM). Mainly developing artificial-lipids-based taste sensors with global selectivity, our research group have studied for realization of �taste-odor fusion biosensor system,� which estimates quality (deliciousness and safety) of foods or beverages using several sensor outputs through analysis and evaluation of subjective-objective relation. As a first step, we conducted a series of human sensory tests to investigate perceptual similarities between odorants, and then compared the results with activity patterns evoked on the glomerular layer of the olfactory bulb in rats.
cord-015640-zdwmxaz3	2011	Viruses are significant causes of nosocomial infections, particularly in intensive care unit (ICU) where seriously ill and vulnerable patients are being cared for. Adherence to effective infection control measures (hand hygiene, enteric precautions; Table 20 .3), as well as adequate staffing and patient cohorting/ isolation can therefore help prevent or manage an outbreak [41] . Neonates and immunocompromised patients can shed the virus for a prolonged time over months, which emphasises the need for rigorous adherence to effective infection control measures (Table 20. Postexposure prophylaxis (PEP) should therefore be offered to all health care workers who have significant exposure to blood or body fluid from a patient known to be at high risk of or to have HIV infection. Preliminary estimation of risk factors for admission to intensive care units and for death in patients infected with A(H1N1)2009 influenza virus
cord-015884-mtpbzgr9	2013	The CDC, in cooperation with the Healthcare Infection Control Practices Advisory Committee (HICPAC), established Standard Precautions to address the prevention of the spread of infectious agents in healthcare settings and are the result of combining the key components from Universal Precautions and Body Substance Isolation along with the understanding that all blood and body fl uids, except sweat, are potentially infectious, and inanimate objects are potentially contaminated with infectious agents, therefore are capable of being reservoirs in the chain of transmission of infectious agents [ 11 , 12 ] . Standard Precautions group together infection prevention practices consisting of the use of Personal Protective Equipment (PPE), such as gowns, gloves, masks, goggles or face shields, and the performance of hand hygiene, washing hands with soap and water, especially when they are visibly soiled, or using an alcohol-based hand sanitizer.
cord-015922-5wwy0m2k	2008	Other prophylactic strategies commonly utilized in HSCT patients include acyclovir to prevent herpes simplex virus (HSV) and VZV reactivation, fluoroquinolones [5] to prevent gram-negative sepsis and fluconazole to prevent yeast infection. It has been suggested that EBV viral load surveillance in peripheral blood be carried out in high risk patients (those with primary EBV infection, anti-T cell antibody therapy for GVHD, HLA-mismatched or T cell-depleted HSCT recipients), with decreased immunosuppression +/− antiviral therapy (acyclovir or ganciclovir) carried out in the setting of high viral loads [1, 4, 41, 42] . Infliximab use in patients with severe graftversus-host disease and other emerging risk factors of non-Candida invasive fungal infections in allogeneic hematopoietic stem cell transplant recipients: a cohort study
cord-015930-18qznqp0	2019	Given his unremarkable bone marrow biopsy 7 days before and elevated fibrinogen, the possibility of hemophagocytic lymphohistiocytosis (HLH) was dismissed as his hyperferritinemia and elevated sIL-2R were attributed to history of blood transfusion and occult infection. A recent consensus review on malignancy-associated HLH suggests tailoring treatment to the underlying trigger, performance status, organ function and additional therapies the patient is receiving [12] . In critically ill adults, however, the increased prevalence of conditions which elevate ferritin, such as infection, malignancy, autoimmune disease, liver injury and chronic blood transfusion make hyperferritinemia a nonspecific finding for HLH [26, 27] . While effective in inducing bone marrow remission [43] [44] [45] , CAR-T cells may be associated with the development of cytokine release syndrome (CRS) which frequently requires treatment in the ICU. Several important clinical syndromes, including HLH, MAS, IPS, and CRS can mimic sepsis and cause critical illness through immune dysregulation in the absence of infection.
cord-015946-biu5zxd1	2016	Most commonly proposed sepsis and infection biomarkers including C-reactive protein (CRP), procalcitonin (PCT) [5, 6] , cytokines (TNF-α, IL-1, IL-6, IL-10, osteopontin) [7, 8] , chemokines [macrophage migration inhibitory factor (MIF), high-mobility-group box 1 (HMGB1)] [9, 10] , soluble receptor [soluble triggering receptor expressed on myeloid cells 1 (sTREM-1), soluble urokinase-type plasminogen activator receptor (suPAR)] [11, 12] etc. When it comes to sepsis, by using genome-wide miRNA profiling with microarray in peripheral blood leukocytes and quantitative RT-PCR, Vasilescu [71] found that miR-150 levels were significantly reduced in both leukocytes and plasma of sepsis patients and had a negative correlation with the level of disease severity measured by the Sequential Organ Failure Assessment (SOFA) score, which made it a biomarker of early sepsis. As they were significantly correlated with disease severity, classical markers of inflammation and bacterial infection, as well as organ failure, high miR-133a levels were considered as independent biomarkers for unfavorable prognosis of critically ill patients.
cord-016105-jkaxemmb	2011	Through such quasi experience-based studies, medical students can not only acquire knowledge and develop the desired professional attitudes and behaviors but can also come to learn about the psychological and social problems actually experienced by patients. The case-method approach also offers the advantage of using actual cases to learn about the multidimensional issues involved in various aspects of medical practice, such as drawing on knowledge as the basis of actions, understanding the backgrounds of patients, and maintaining awareness of personal motivations and ethical concerns. Based on the need for these procedures, the proposed problem-solving paradigm includes the following phases: (1) defining the problem, (2) measuring its magnitude, (3) understanding key determinants, (4) developing prevention/intervention strategies, (5) setting policy/priorities, (6) identifying the best solution, and (7) implementing and evaluating the solution. Our experiences with CBT have identified problems with using this approach to treat depression in Japan and have underscored issues that require further consideration to improve the effectiveness of treatment offered in actual clinical settings.
cord-016110-mlwe7fzz	2014	In the context of a vasculitis syndrome, the lungs and lower airways can be affected by three major pathologic processes: (1) infl ammatory cell infi ltration and necrosis of the pulmonary parenchyma; (2) infl ammation of the tracheobronchial tree often leading to stenoses; and (3) pulmonary capillaritis causing diffuse alveolar hemorrhage (DAH). DAH can result from a variety of underlying or associated conditions that cause a disruption of the alveolarcapillary basement membrane integrity including immunological infl ammatory conditions causing immune-complex deposition or capillaritis (e.g., anti-GBM disease (Goodpasture''s), systemic lupus erythematosus (SLE), ANCA-associated vasculitis), direct chemical/toxic injury (e.g., from toxic or chemical inhalation, abciximab use, all-trans-retinoic acid, trimellitic anhydride, or smoked crack cocaine), physical trauma (e.g., pulmonary contusion), and increased vascular pressure within the capillaries (e.g., mitral stenosis or severe left ventricular failure) (Table 10 .1 ).
cord-016127-tbot0fc9	2009	Since 2002 the Surviving Sepsis Campaign was introduced with the initial goal of increasing clinicians'' awareness about severe sepsis mortality and to improve outcome in this patient population. Despite the fact that most of these recommendations were not supported by high levels of evidence, they represented the international consensus on the best available standards of care for the management of sepsis. Mortality increases according to the presence of shock, and metabolic markers like arterial lactate are useful to characterize disease severity and the response to treatment [8] . The current management of severe sepsis and septic shock aims to control infection, achieve hemodynamic stabilization, modulate the immune response, and provide metabolic and organ support. The SSC is a global initiative that involves several international organizations with the common objective of elaborating evidence-based guidelines and recommendations for the management of severe sepsis and septic shock. Early goal-directed therapy in the treatment of severe sepsis and septic shock
cord-016135-44pgjah8	2016	In this chapter, we will discuss general and specifi c postoperative management of patients following CTA. Face transplantation is a complex and long surgery that is associated with signifi cant perioperative challenges, and multiple postoperative complications. Postoperative severe graft edema is expected in most patients and head elevation at 30-45° will promote venous drainage and prevent VAP [ 1 ] . The most severe infections occur during times of over-immunosuppression, such as the induction phase or management of acute rejection. Maintenance immunosuppression involves a regime of tacrolimus, mycophenolate mofetil, and prednisone, and must be closely followed up for the duration of the patient''s or allograft''s life. The fi rst hand transplant recipient lost his graft due to rejection from noncompliance. Management of graft failure involves amputation followed by use of prosthesis or another transplant. Helping hands: caring for the upper extremity transplant patient
cord-016177-fz48wydz	2020	Emergency medical services are a key element in health systems for the evaluation and treatment of patients exposed to highly infectious diseases or bioterrorism agents. • Developing a case definition for person under investigation • Standardized questions for dispatchers to identify possible infection • Preparation for and evaluation upon arrival on scene by EMS personnel • Precautions while transporting patients and contacting appropriate receiving hospital • Monitoring of potentially exposed EMS personnel • Maintenance of transportation vehicles and equipment • Decontamination processes Similar peer-reviewed frameworks have been proposed for a pandemic of influenza and other respiratory illnesses [4] . Appropriate implementation of these principles can potentially help prevent further spread of disease or agent exposure, initiate appropriate care of ill patients, protect essential EMS responders, and promote efficient use of healthcare resources.
cord-016208-u12ngkpc	2018	Intensive care units (ICUs) are treating hospital''s poorest patients that need medical assistance during the most extreme period of their life. Intensive patients are treated with extensive invasive procedures, which may cause a risk of hospital infections in 10–30% of the cases. The hospital''s management should provide resources and written guidelines regarding infection control work, proper patient/care ratio, sufficient patient areas, isolation capacity and documented competence. Intensive care unit (ICU) should have a large enough area and furnished for a good, safe and effective infection protection [1] . Recent studies indicate that patients in separate ICU rooms will have fewer hospital infections and thus a lower risk of fatal outcome [72, 73] . An outbreak of multidrug-resistant Pseudomonas aeruginosa associated with increased risk of patient death in an intensive care unit Single rooms may help to prevent nosocomial blood stream infection and cross-transmission of methicillin-resistant Staphylococcus aureus in intensive care units
cord-016211-8j8n9enn	2015	Statistical analysis has demonstrated that 60-70 % human infection of avian infl uenza is severe, which may clinically develop into acute lung injury (ALI) or acute respiratory distress syndrome (ARDS). Within 1 week after onset, the conditions may rapidly progress and deteriorate into acute lung injury, acute respiratory distress syndrome, pulmonary hemorrhage, pleural effusion, pancytopenia, multiple organ failure, shock, Reye syndrome, and secondary bacterial infection and septicemia. In severe cases of human infection by avian infl uenza, the patients develop pleuritis and pleural effusion at the middle or advanced stage, mostly 6-12 days after the onset. The patients experience typical symptoms of human infection with avian infl uenza, including fever with a body temperature above 38 °C, headache, general pain, fatigue, dry throat, and poor appetite. Some severe cases with human infection of avian infl uenza might develop rapid heart rate, nodal tachycardia, and acute heart failure at day 10-18 after the onset.
cord-016235-2lhrkmrv	2010	Unlike the situation with heart transplant recipients, chronic vascular rejection in lung transplants has not resulted in graft loss; however, some patients develop pulmonary hypertension particularly those with BOS [92, 111] . However, based on the link between acute rejection and development of BOS, surveillance transbronchial biopsies in asymptomatic lung transplant recipients has become common practice in many large lung transplantation centers because evidence suggests that patients who have multiple episodes of low grade (A1) lesions within the first 12 months posttransplantation develop early onset BOS. A study [49] in which surveillance transbronchial biopsies were performed at 3, 6, 9, and 12 weeks posttransplantation, at the time of symptoms, and for follow-up of acute rejection or CMV pneumonia showed that patients who develop acute small airways rejection within the first year after transplantation are at risk of development of BOS at 1.76, 3.3, and 5.5 years after detection of B3/ B4 lesion (by 1996 ISHLT criteria, see Table 7 .2), B2 lesion or B0/B1 lesion, respectively.
cord-016237-sk1wzghx	2018	Patients with life-threatening pneumonia, especially those who are immunocompromised, are more likely to undergo lung biopsy to rule out unusual infections not easily diagnosed using conventional microbiologic methods and for which treatment strategies may be different. Nocardiosis ( Fig. 4 .5) occurs almost exclusively in immunocompromised patients and is caused by a gram-positive filamentous organism (Nocardia spp.) common in soil and as normal oral microflora. Some viral infections cause unique cytopathic changes that can be identified on routinely stained sections (Figs. Fungal infections more commonly seen in immunologically intact hosts may also occur in immunocompromised patients in whom the histologic findings may be more variable. It causes disease in both immunocompetent and immunocompromised patients and may be biopsied or excised because of its tendency to form a localized lung nodule. Pneumocystis pneumonia is affiliated with highly variable histologic features and therefore should always be in the differential diagnosis of infections in immunocompromised patients.
cord-016248-dxk0i6t7	2009	Indications for support in patients with cardiac pathology are based on clinical signs of decreased peripheral perfusion, including hypotension, despite the administration of fl uid resuscitation and inotropes, oliguria (urine output < 0.5 ml/kg/h), an elevated arterial lactate, and a decreased SvO 2 . The advantages of VV and DLVV over VA ECMO include avoidance of arterial cannulation and permanent ligation of the carotid artery, maintaining pulsatile fl ow to the patient, continued blood fl ow to the lungs, and avoiding arterial emboli. Weaning and Decannulation: As the patient''s underlying process improves, less blood fl ow is required to pass through the ECMO circuit in order to maintain adequate tissue oxygenation. According to the 2005 ELSO registry, 13.2% of neonates and 43% of pediatric patients treated with ECMO for respiratory failure required the use of inotropes while on bypass. The incidence of acute renal failure was 10% in neonates and 14% in pediatric patients on ECMO for respiratory support, with 10-15% requiring hemofi ltration or dialysis.
cord-016280-d47e3art	2008	In addition to the discomfort, chest tube placement may be accompanied by a number of complications including empyema, lung injury and bleeding, and death." Therefore, coagulation profiles and immunocompetency should be taken into consideration for all patients considered for this procedure . If a large air leak is anticipated or if there is significant effusion associated with the pneumothorax, then a standard 28-French chest tube should be placed. Some of the indications for surgical treatment of a spontaneous pneumothorax include a second pneumothorax (ipsilateral recurrence or a new pneumothorax on the contralateral side); tension physiology; synchronous bilateral pneumothoraces; associated hemothorax (likely secondary to a tom adhesion and complicating approximately 5% of spontaneous pneumothoraces); failure of tube thoracostomy; and lifestyle factors. Chylothorax is an exudative effusion caused by disruption of the lymphatics in the chest, most commonly the thoracic duct, and subsequent drainage of chyle into the pleural space.
cord-016300-vw11c2wt	2017	Association of ECM turnover with severity and outcome of COPD has been assessed in a prospective, observational, multicenter study, Global Initiative for Chronic Obstructive Lung Disease grades II to IV, and serum samples were analyzed at stable state, during exacerbation as well as 4 weeks after exacerbation (Stolz et al. A study has revealed that serum levels of the neuroendocrine activity biomarker chromagranin A (CgA) are increased in male smokers with impaired lung function, and are associated with both respiratory symptoms and the degree of airway obstruction (Sorhaug et al. Although the aim of management of patients with asthma is to control their symptoms and prevent exacerbations and morbidity of the disease, optimal management may require assessment and monitoring of biomarkers, i.e., objective measures of lung dysfunction and inflammation. Several biomarkers have been assessed following treatment with corticosteroids including measures of lung function, peripheral blood and sputum indices of inflammation, exhaled gases and breath condensates.
cord-016301-vqmqnipq	2011	Current success in transplanting kidneys into older recipients has quieted misconceptions within medical communities and the general public, among them the erroneous belief that advanced age alone prevents a successful surgical outcome, that the elderly patient with ESRD has a very limited life expectancy, and thus cannot receive a transplant, and that older recipients have poor results based upon outdated information from the previous era of transplantation and immunosuppression. While ECD kidneys carry a relative risk of graft failure greater than 1.7 compared to a reference group of donors aged 10-39 years without any of the above three conditions, elderly recipients of ECD kidneys were found to have a survival benefit compared with waiting-list candidates (RR = 0.75; 95% CI 0.65-0.86; p < 0.0001) [8] . One study evaluated 91 transplant recipients over the age of 60 over a 13-year span and reported a 10-year patient survival of 35% in the elderly group and 60% in the younger patients ( p < 0.05).
cord-016308-qzkcwrit	2015	• Initial signs of respiratory distress include tachypnoea and increased work of breathing (Table 11 .1 ) • As distress progresses, newborns are at risk of developing respiratory failure and apnoea. • RDS presents in the fi rst days of life (Table 11 .2 ) • Bronchiolitis is a clinical diagnosis based on physical exam and history [ 3 ] . • Consider hypoglycaemia, metabolic dysfunction, hyperbilirubinemia, congenital heart conditions, and neurologic dysfunction when assessing a patient with the above features. • Most cases of hyperbilirubinemia are physiologic, or secondary to normal delayed conjugation and excretion of bilirubin in the newborn, though pathologic aetiologies must be considered. • Management of Hirschsprung''s Disease is reviewed in Table 11 .11 • In the case of toxic megacolon, provide resuscitation as clinically indicated and IV antibiotics • Consider thyroid studies in patients with clinical signs or maternal history of antithyroid antibodies.
cord-016372-opojt70e	2010	Ninety percent of all postoperative open-heart patients demonstrate a transient low cardiac output (LCO) related to the release of oxygen free radicals in response to the induced inflammatory state of cardiopulmonary bypass, or from ischemic/reperfusion injury as a result of cardioplegic arrest. Doses greater than 2 mcg/ min (>0.03 mcg/kg/min) produce effects that cause vasoconstriction with an increased SVR potentially decreasing cardiac output further as well as increasing myocardial oxygen demand. 88, 89 The indications for IABP counterpulsation are perioperative ischemia, mechanical complications of myocardial infarction (such as acute mitral regurgitation, ventricular septal defect, and cardiogenic shock), postoperative low cardiac output states not responsive to moderate doses of inotropic agents, and for the acute deterioration of myocardial function to provide temporary support or a bridge to transplantation. Inotropic effect of triiodothyronine in low cardiac output following cardioplegic arrest and cardiopulmonary bypass: an initial experience in patients undergoing open-heart surgery
cord-016413-lvb79oxo	2018	Adult-onset Still''s disease (AOSD) is a rare systemic, autoinflammatory disorder that often presents in adolescence and early adulthood with fever, rash, and polyarthritis. Mutation of perforin and the MUNC13-4 genes have been seen in patients with macrophage activation syndrome (MAS), a known severe, life-threatening complication of AOSD [3] . Patients who have the chronic articular disease pattern can present with joint erosions making the differential diagnosis from RA problematic, especially in the absence of systemic signs and symptoms. Interleukin-1 receptor antagonist (anakinra) treatment in patients with systemic-onset juvenile idiopathic arthritis or adult onset Still disease: preliminary experience in France Effectiveness of first-line treatment with recombinant interleukin-1 receptor antagonist in steroid-naive patients with new-onset systemic juvenile idiopathic arthritis: results of a prospective cohort study Clinical manifestations of adult-onset Still''s disease presenting with erosive arthritis: association with low levels of ferritin and Interleukin-18
cord-016460-39yniw0t	2018	• Rat sarcoma homolog gene family, member A (Rho A) protein is a peptide which controls the action of GTPases thereby affects tubulin dynamics • Pyrin is a specific immune sensor (pattern recognition receptor-PRR) for bacterial modifications of Rho and GTPases • Activation of RhoA inhibits pyrin activity while inactivation of RhoA causes over activation of pyrin resulting in increased production of interleukin (IL)-1, thereby enhancing inflammation • Colchicine may activate RhoA by guanine nucleotide exchange factor (GEF)-H1, thereby suppressing pyrin activity and inflammation • Colchicine also disrupts microtubules structure reducing neutrophils membrane elasticity and relaxation, thereby preventing their extravasation from the blood vessels to the inflammatory site
cord-016476-78r0rsio	2017	Several risk factors of leflunomide-induced pneumonitis have been reported in small numbers of patients in case series and retrospective studies including preexisting lung disease [32, 35, 36] , a prescribed loading dose, smoking, low body weight [32] and increased C-reactive protein, hypoalbuminaemia, hypoxia and lymphopaenia [36] . Whilst experience of using abatacept in the context of pre-existing ILD is limited, a case report of rapid-onset interstitial pneumonia 2 days post initiation of Administration, MHRA medicines and healthcare products regulatory agency, NA data not available, RA rheumatoid arthritis a Includes cases reported as idiopathic pulmonary fibrosis, pulmonary fibrosis and pulmonary toxicity treatment has been described in a Japanese patient [103] . Association of disease activity with acute exacerbation of interstitial lung disease during tocilizumab treatment in patients with rheumatoid arthritis: a retrospective, case-control study
cord-016478-gpl0zbvd	2018	The differential diagnosis for anemia after solid organ transplant includes hemolysis, drug toxicities, iron deficiency, infection, posttransplant lymphoproliferative disorder, graft-vs.-host disease, and hemophagocytic syndrome. Sirolimus and calcineurin inhibitors such as tacrolimus and cyclosporine have been shown in renal and lung transplant recipients to cause hemolytic anemia, thrombotic thrombocytopenic purpura, and atypical hemolytic uremic syndrome [15] [16] [17] . While this etiology is more often identified as a drug-related phenomenon, particularly due to the immunosuppressants required to prevent organ rejection (see next section), there have been multiple case reports associating CMV infection as a trigger of TMA in the posttransplant setting [53, 54] . When this is identified, numerous case studies in multiple different organ systems (lung, liver, kidney solid organ transplant) have reported that changing from one CI to another (tacrolimus to cyclosporine or vice versa) or to another class of medication such as sirolimus or mycophenolate mofetil can prevent further episodes of TMA from occurring [61] [62] [63] [64] .
cord-016498-j72vrvqf	2020	In a recent study of 70 children <5 years of age hospitalized for CAP without an identifiable etiology and 90 asymptomatic controls, metagenomics [next-generation sequencing] and pan-viral PCR were able to identify a putative pathogen in 34% of unidentifiable cases from nasopharyngeal and oropharyngeal swabs [18] . More recently in Britain, 325 adult patients with confirmed pneumonia admitted to two tertiary-care hospitals had cultures and comprehensive molecular testing [multiplex real-time PCR for 26 respiratory viruses and bacteria] from sputum [96%] and endotracheal aspirate [4% or 13 cases] [32] . Incidence of respiratory viral infections detected by PCR and real-time PCR in adult patients with community-acquired pneumonia: a meta-analysis Severe thinness is associated with mortality in patients with community-acquired pneumonia: a prospective observational study Effect of corticosteroids on treatment failure among hospitalized patients with severe community-acquired pneumonia and high inflammatory response: a randomized clinical trial
cord-016521-ouwwkxox	2016	
cord-016559-tqd7m2i1	2014	Danshen has the function of effectively dilating the coronary artery, increasing coronary blood flow, reducing heart rate, inhibiting platelet aggregation and thrombopoiesis induced by platelet activation factors, promoting the recovery of injured cardiac muscle, increasing cardiac contractility, and protecting cardiac muscle cells; thus it can be widely applied in treating the diseases of the circulation system. [7] reported the application of 0.5/ 250 ml of puerarin and glucose injection combined with 16 ml of CDI in the treatment of 44 patients with coronary heart disease and angina pectoris, and the results showed that in the treatment group there were 31 patients with a marked effect, 10 patients with an effect, 3 patients without effect, and the total effective rate was 93.2 %. Patients with cerebral hemorrhage were treated with CDI, and the rates of recovery and significant improvement in the treatment group were significantly better than those in the control group, and no side effects were observed.
cord-016572-6fu5s89c	2005	All three illnesses occur in normal hosts, although histoplasmosis and coccidioidomycosis are also major opportunistic mycoses in patients with depressed cell-mediated immunity, and especially in patients with acquired immunodeficiency syndrome (AIDS) [4] , [5] . Histoplasmosis, blastomycosis and coccidioidomycosis are major T-cell opportunistic infections, as demonstrated by the very aggressive course seen in patients with AIDS, in whom T-cell deficiency is most severe. The most severe form of progressive disseminated histoplasmosis (PDH) occurs in patients with AIDS with profound T-cell dysfunction [21] . By that time, most patients have either recovered or have required other more invasive methods of diagnosis because of rapidly worsening disease There are two ways to make a rapid diagnosis of PDH, sampling and examination of likely infected tissue with the use of special stains and the use of the ultrasensitive assay for fungal antigens.
cord-016601-gp259urb	2017	Hospital environments are characterized by high infective risk, firstly cause of the compromised immunologic conditions of the patients that make them vulnerable to bacterial, viral, parasitological and fungal opportunistic infections (D''Alessandro et al. The potential transmission of biological matter during surgery operations and medical treatments of infected individuals makes hospital environments strongly designated to become easily contaminated with spread of pathogens among patients (Baglioni and Capolongo 2002) . In addition, technological devices such as hydraulic, heating and air-conditioning systems may represent a potential source of bacteria, fungi (moulds), virus and other organisms if not adequately designed and submitted to a planned preventive maintenance. These difficulties are exacerbated in hospitals where the patient health status, the activities that take place and the potential spread of pathogenic biological agents increase the level of complexity respect to other indoor environments.
cord-016757-3d320c0a	2008	
cord-016814-tf17dpo5	2019	Despite increasing number of preclinical studies demonstrating that systemic MSC administration can prevent or treat experimental COPD and emphysema, clinical studies have not been able to reproduce the preclinical results and to date no efficacy or significantly improved lung function or quality of life has been observed in COPD patients. performed a Phase I, prospective, open-label study (NCT01306513) where they aimed to assess the safety and feasibility of intravenously infused bone marrow-derived MSCs for ten patients with severe emphysema that had serial lung volume reduction surgeries (LVRS). Current clinical trials that aimed to evaluate the effect of MSC administration in COPD patients differ in a wide range of factors such as routes of administration, number of MSC administered, number of administrations, use of fresh MSCs or culture-expanded MSCs. Furthermore, all the investigations discussed above, were phase I-II studies that were underpowered in order to detect potential efficacy and no improved pulmonary function or respiratory quality of life was observed.
cord-016871-1mlamf20	2012	In acutely bleeding patients, massive transfusion protocols are often activated in order to ef fi caciously restore blood volume and hemostasis and thawed plasma is critical to their success [ 5, 6 ] . DCR is also supported by fi ndings from the US Army''s Institute of Surgical Research, which demonstrated improvement in outcomes in severely bleeding patients who were transfused in ratios of products similar to whole blood. However, some groups have shown that those patients receiving less than massive transfusion levels may still bene fi t from higher plasma to red blood cell ratios [ 20 ] . Silver et al.''s randomized, double-blind, placebo-controlled trial investigated the role of epoetin alfa, a recombinant erythropoietin, in reducing the RBC transfusion requirement of long-term acute care patients, thereby reducing risks associated with transfusions [ 29 ] .
cord-016960-xhzvp35g	2012	The importance of maternal anti-idiotypic antibodies are believed to prime the fetal immune system with epitopes of etiologic agents infected the mother during her whole life before pregnancy and delivery. Neonatal lupus is a model of passively acquired autoimmunity in which a mother-, who may have systemic lupus erythematosus (SLE) or Sj€ ogren''s syndrome (SS) or may be entirely asymptomatic-synthesizes antibodies to SSA/Ro and/or SSB/ La ribonucleoproteins that enter the fetal circulation via trophoblast FcRn receptors and presumably cause tissue injury (Lee 1990 ) as mentioned above. Teplizumab (CD3-specific, hOKT3g1-Ala-Ala), a humanized Fc mutated anti-CD3 monoclonal antibody induced tolerance, on the progression of type 1 diabetes in patients with recent-onset disease even 2 years after the first diagnosis (Herold et al. Clinical and immune responses in resected colon cancer patients treated with anti-idiotype monoclonal antibody vaccine that mimics the carcinoembryonic antigen Clinical use of anti-CD25 antibody daclizumab to enhance immune responses to tumor antigen vaccination by targeting regulatory T cells
cord-016973-s32jp0ej	2016	
cord-016982-qt25tp6t	2010	The statement of claim alleged the following: (1) isoniazid was directly responsible for the plaintiff''s fulminant hepatitis which resulted in the need for a liver transplant, (2) informed consent was never obtained to prescribe the drug, as the plaintiff was never counseled on the adverse effects, nor given a choice of treatment, (3) use of the isoniazid was never indicated, as the patient had no symptoms or signs of active disease, (4) the physician should have realized that the positive Mantoux test was due to a previous BCG vaccination as a child (the defendant was informed of this fact) and therefore there was no need to treat the plaintiff for latent tuberculosis.
cord-017012-yl0vanuh	2009	Renal involvement in infectious diseases may occur by a variety of mechanisms: direct microbial invasion of the renal tissues or collecting system may take place in conditions such as staphylococcal abscess of the kidney as a result of septicemic spread of the organism or as a consequence of ascending infection; damage to the kidney may be caused by the systemic release of endotoxin or other toxins and activation of the inflammatory cascade during septicemia or by a focus of infection distant from the kidney; ischemic damage may result from inadequate perfusion induced by septic shock; the kidney may be damaged by activation of the immunologic pathways or by immune complexes resulting from the infectious process. However, in addition to this post-infection immunologically mediated disorder, in recent years there have been increasing reports of GAS causing acute renal failure as part of an invasive infection with many features of the staphylococcal toxic shock syndrome (28) .
cord-017016-twwa9djm	2008	These occult aspirations may lead to interstitial fibrosis, and perhaps account for the 20% to 54 % incidence of associated and unexplained pulmonary fibrosis in patients with esophageal abnormalities, most commonly hiatal hernia or simple reflux,39,40 The role of reflux in asthma, chronic bronchitis, chronic cough, recurrent pneumonia, cystic fibrosis, and sudden infant death syndrome has been reviewed by Allen et al. 130 In their reviews, Phillips and Rao l3l and Penner and colleagues130 note that similar predisposing factors as those with community-acquired pneumonia, such as aspiration and abscess formation, pertain to this entity, but the location helps distinguish it from the other typical sites of aspiration, When in the upper lobes, it appears to progress through necrotizing pneumonia with thrombosis of arteries (pulmonary and bronchial) and veins, [129] [130] [131] Although not strictly abiding by the foregoing definition (of localization in upper lobe), in one case total unilateral lung gangrene was attributed to hilar vessel involvement following treatment of a massive hilar recurrence of Hodgkin''s disease.
cord-017040-4zajnrsf	2019	Pseudomonas aeruginosa, usually a nosocomial pathogen has emerged as a common cause of infection in immunocompromised patients; most often in neutropenic leukemics during chemotherapy. The dermatologic manifestations of Pseudomonas sepsis include ecthyma gangrenosum, hemorrhagic bullae, necrotizing/gangrenous or bullous cellulitis, painful vesicular lesions, and small papules on the trunk resembling rose spots of typhoid fever, grouped petechiae, erysipelas-like lesions with hyperesthesia, erythematous or violaceous subcutaneous painful nodules, and necrotizing or malignant external otitis [3] . In the immunocompromised, the typical history of previous trauma or surgery is absent, thus cutaneous Mycobacteria infection are most probably the result of hematogenic dissemination, resulting in multiple skin lesions. Although aspergillus is one of the most common etiologies of invasive fungal infections in patients with underlying malignancies, dermatologic manifestations occurs in less than 5% of cases [41, 42] . Cutaneous lesions typically present in cases of disseminated disease and often mimic other dermatologic infections due its'' ability to manifest with many skin findings including papules, plaques, nodules, ulcers or pustules.
cord-017105-mljywm9p	2017	
cord-017142-vx3rgs4r	2019	Suspicion of cast nephropathy in newly diagnosed myeloma patients with serum FLC above 1000 mg/L should be high, especially if associated selective proteinuria composed of FLC/BJP exists, as the degree of renal injury is usually related to tumor load [55] . MM patients are at high risk for cardiac complications secondary multiple factors including an older age group of patients with underlying comorbidities, concurrent kidney involvement, MM-associated deposition disease, and/or anti-MM drug-related side effects. Cardiac amyloidosis can be clinically silent initially, and a MM patient presenting with progressive dyspnea, worsening edema with evidence of heart failure, or dysrhythmia presenting as syncope or hypotensive event requires a thorough work-up to rule out coexisting amyloid disease. Immunosuppression is mediated by disease-and treatment-related factors including decreased ratio of functional to dysfunctional immunoglobulins, defects in antibody opsonization, steroid-related T cell defects, secondary immunodeficiency related to chemotherapy, restricted pulmonary reserve from thoracic rib fractures and opiate use, mucosal damage, indwelling catheters, and presence of renal failure [53, 88, 100] .
cord-017184-1ewi3dka	2008	In this disease, microorganism phagocytosis by polymorphonuclear (PMN) leukocytes appears annulled, and the patient is subject to severe infections supported by capsular bacteria: the deficiency, described in association with severe and recurrent infantile infections [175, 485, 487] , depends on the lack of mannose-binding lectin (MBL) [487] , its Primary Immunodeficiencies a possible atopy dependence on IgA underproduction rather than on IgE hyperproduction ( Fig. 4.1 ): in children with levels of IgA at the minimum normal level, and followed from birth until the age of 18-23 months, a greater severity of atopic manifestations and an increased cumulative incidence of asthma, AD and otitis media with effusion (OME) were observed compared to controls.
cord-017217-zjab7o2o	2008	A 47-year-old patient with Crohn''s disease presents for evaluation of new onset arthritis. Although the patient has not had prior thromboses she is at high risk for developing antiphospholipid antibody syndrome in view of these blood tests. A 19-year-old previously healthy student is evaluated for new onset fever, joint pain, and rash. Her lab work reveals leukocytosis with lymphocytic predominance, normal renal function, mild transaminitis, and low serum albumin. Yousaf Ali, Self Assessment Questions in Rheumatology, DOI: 10.1007/ 978-1-59745-497-1, Humana Press, a part of Springer Science + Business Media, LLC 2009 A 55-year-old female with chronic renal failure is seen for evaluation of lower extremity edema and ankle pain. This 41-year-old patient presents with a 4-year history of recurrent sinusitis in the setting of a positive P-ANCA, destructive nasopharyngeal mass, and ophthalmoplegia.The differential diagnosis includes infection with a refractory organism, such as mucormycosis or tuberculosis, malignancy, midline granuloma, or vasculitis.
cord-017227-66dx2dkv	2012	
cord-017252-88b3preq	2014	
cord-017302-xez0zso3	2019	Hematopoietic stem cell transplant (HSCT) has become an essential therapeutic modality in the treatment of malignant and non-malignant hematologic disease. Allogeneic transplants are associated with more morbidity and mortality than autologous transplants, and are further categorized based on conditioning regimen (myeloablative [MA] vs non-myeloablative [NMA]), donor-recipient relation (related vs unrelated), HLA matching (full match vs haploidentical vs mismatched), and stem cell source (bone marrow, peripheral blood, umbilical cord blood). Refinement of transplant techniques over the last 2 decades has dramatically decreased transplant-related mortality, but approximately 15% of HSCT patients require critical care [10] and earlier ICU admission has been associated with improved survival rates [11, 12] . Outcomes of stem cell transplant patients with acute respiratory failure requiring mechanical ventilation in the United States Management of respiratory viral infections in hematopoietic cell transplant recipients and patients with hematologic malignancies Bronchiolitis obliterans syndrome after allogeneic hematopoietic stem cell transplantation-an increasingly recognized manifestation of chronic graft-versus-host disease
cord-017309-pt27efu1	2012	Activation of endothelial cells (EC) with different stimuli induces the expression of E-and P-selectins, and other adhesion molecules (ICAM-1, VCAM-1), involved in their interaction with circulating cells. Accordingly, population studies have explored the association of ischaemic heart disease with gene polymorphisms of the inflammatory molecules: tumor necrosis factors (TNF) a and b, transforming growth factors (TGF) b1 and 2, P and E selectins, and platelet endothelial cell adhesion molecule (PECAM) 1. Endothelial dysfunction in type 2 diabetic patients is associated with inflammation, increased levels of circulating soluble adhesion molecules (VCAM-1 and E-selectin), and inducing production of ROS, and urinary albumin excretion (Potenza et al. The A 561 C polymorphism of E-selectin gene may be associated with disease progression in patients with chronic HBV infection and control the expression of plasma soluble levels, while the G 98 T polymorphism may be related to fibrotic severity in Chinese population (Wu et al.
cord-017324-l3d3t4wh	2008	Balkan nephropathy does not spread beyond its already defined foci; the disease is distributed mosaically : non-endemic villages exist in the most affected regions, and there are spared families and households in the most affected settlements. Optic microscopic, immunofluorescent and electron microscopic studies of renal biopsies in children aged 5-15 from affected families in endemic regions failed to detect any Balkan nephropathy related changes [79] . The diagnosis of Balkan nephropathy is now established according to the first two criteria (residence in endemic village and positive family history) suggested by Danilović [106] , presence of tubular proteinuria and ruling out other renal diseases. Although no specific indicators of Balkan nephropathy have been recognized, epidemiological data, familial history as well as clinical characteristics of the disease enable differential diagnosis. However, recent studies indicated that patients with Balkan nephropathy are at increased risk for the development of upper urothelial tumors in both native and transplanted kidneys [117] .
cord-017337-vq3edhxn	2009	Building on a system that had emerged at the Fifth Toronto Sepsis Roundtable held in Toronto, Canada, in 2000 [6] , the sepsis defi nitions conference participants, therefore, proposed the PIRO system [5] , which can classify patients on the basis of their predisposing conditions, the nature and extent of the infection, the nature and magnitude of the host response, and the degree of concomitant organ dysfunction. The PIRO system for the grading of sepsis uses clinical and laboratory parameters to aid diagnosis and patient classifi cation, with each element being divided according to the degree of involvement (e.g., infection can be classifi ed as localized, extended, or generalized; immune response can be classifi ed as limited, extensive, or excessive; organ dysfunction can be classifi ed as mild, moderate, severe). Improved classifi cation of septic patients using the PIRO system may, thus, facilitate the development and evaluation of clinical trials of sepsis therapies and will also encourage further study into the pathophysiology and epidemiology of sepsis.
cord-017350-rwqaw5ii	2010	This review will focus on the immune dysfunctions described so far in septic patients regarding monocytes and T lymphocytes (as examples of innate and adaptive immune cells) and their potential use as biomarkers on a routine standardized basis for prediction of adverse outcome or occurrence of secondary nosocomial infections and for guidance of putative immunotherapy. With that said, the down modulation of CD14 expression on monocytes after septic shock (a cell surface marker decreased during monocyte apoptosis) tends to confirm this increased apoptotic process especially because its downregulation was more pronounced in patients who were not going to survive [12] . A growing body of evidence has now confirmed that the lymphocyte-mediated immune response may be dysfunctional after severe sepsis and may play a major role in the development of a state of immunosuppression in such patients [1, 18] .
cord-017374-clctlm5l	2017	Other frequent causes include cardiogenic and noncardiogenic pulmonary edema (acute respiratory distress syndrome [ARDS]), antineoplastic therapy (chemotherapy, radiation therapy)-induced lung injury, cancer-related medical disorders (such as venous thromboembolism, transfusionrelated acute lung injury), and direct involvement of the respiratory system by malignancy and progression of underlying disease. HRCT yields an overall sensitivity and negative predictive value of 90%, in identifying the cause of ARF in cancer patients with lung infiltrates, but low specificity and positive predictive value [7] . Pulmonary toxicity of antineoplastic agents, known as drug-induced toxicity (DIT), is a common cause of respiratory failure in oncologic patients and should be included in the differential diagnosis of ARF in patients who are on or have been treated with antineoplastic agents. Cardiogenic pulmonary edema (CPE) should always be included in the differential diagnosis of acute respiratory failure in oncologic patients, in particular when chemotherapy with cardiotoxic drugs has been preceded.
cord-017392-ja9b5vy9	2010	Randomized, controlled trials have shown corticosteroids reduce mortality in AIDS patients with Pneumocystis carinii pneumonia and significant hypoxia, if instituted at or prior to the onset of anti-pneumocystis therapy [8, 9] . Anecdotally, corticosteroids are frequently used in the setting of severe fungal pneumonia, particularly due to Histoplasmosis [11, 12] , and a small controlled trial of 55 patients supported their use in miliary tuberculosis [13] . Following the success of pre-antibiotic corticosteroids in children with meningitis [14] , Marik and colleagues [15] studied the effect of a single dose of hydrocortisone (10 mg/kg) 30 min prior to antibiotic therapy in a small randomized placebo controlled trial of 30 adult patients with severe CAP (SCAP). Once respiratory failure has ensued, supportive measures such as patient positioning and differential lung ventilation can improve oxygenation at no additional risk in some patients, particularly those with severe unilateral pneumonia.
cord-017393-kx8kmdej	2009	Despite numerous clinical studies, since the 1970s, no single empirical antibiotic regimen has been shown to be superior for initial treatment of patients who become febrile during a neutropenic episode after therapy with chemotherapy drugs for hematological malignancies (see Table 5 -2) [4, 9, [34] [35] [36] [37] [38] [39] [40] [41] [42] [43] [44] . Similarly, bacteremias due to Staphylococcus aureus, Pseudomonas aeruginosa, and Clostridium species as well as candidemias are more frequently encountered in patients with acute leukemia who suffer from neutropenic enterocolitis or typhlitis, the most serious disturbance of the delicate balance between mucosal damage and microbial flora in the setting of prolonged exposure to antibiotics after intermediate or high-dose cytarabine chemotherapy. In addition, if a persistently neutropenic patient has no complaints and displays no clinical, radiological, or laboratory evidence of infection, cessation of antibiotic therapy or a change to oral antimicrobials should be considered after 4 days without symptoms.
cord-017420-tjwxec77	2019	Neutropenic patients with septic shock tend to have more frequently positive blood cultures, more fungal infections, more multidrug-resistant bacterial infections, and higher mortality rates than immunocompetent patients. Accordingly, current guidelines for the management of neutropenic fever and sepsis recommend monotherapy with an antipseudomonal beta-lactam unless otherwise dictated by circumstances such as patient allergies, the presence of resistant organisms, or refractory hemodynamic instability [28, 57, 61] . The use of surveillance rectal cultures, performed pre-transplant and then weekly after HSCT, to identify patients with MDR infections and allow immediate initiation of antibiotic therapy targeted against MDR organisms may result in better outcomes [26] . Patients with neutropenia and sepsis are at high risk of developing multi-organ failure, particularly the acute respiratory distress syndrome (ARDS) [4, 5] . Neutropenic sepsis continues to confer a poor prognosis, with recent data suggesting an approximate 46% mortality rate in patients with hematologic malignancies who develop septic shock [7, 39, 47] .
cord-017461-xw02c7u5	2009	Candida species are the most common cause of opportunistic fungal infections, and bloodstream infections are usually treated with fluconazole or an echinocandin antifungal agent. The endemic fungi, Histoplasma capsulatum, Coccidioides species, and Blastomyces dermatitidis, cause infection when the mold form is dispersed and inhaled from the environment in those specific areas of the country in which these organisms flourish. Amphotericin B is used for initial treatment of severe histoplasmosis, coccidioi­domycosis, and blastomycosis; itraconazole is the therapy of choice for most mild to moderate infections due to these endemic mycoses. Serious fungal infections can be separated into two major categories: The opportunistic mycoses that include candidiasis, cryptococcosis, and invasive mold infections such as aspergillosis and zygomycosis, and the endemic mycoses, which in the United States, includes histoplasmosis, blastomycosis, and coccidioidomycosis.
cord-017489-ftz9190a	2005	Pneumonia is the most common complication, which occurs in high-risk patients including those with comorbid illness such as cardiovascular or pulmonary disease, diabetes, renal failure, immunosuppression, the elderly, or residents of nursing homes. A study performed in our ICU indicates that corticosteroids may dramatically alter the course of the most severe disease and should be considered in addition to antiviral therapy along with appropriate supportive care in any previously well patient with life threatening varicella pneumonia (42). Patients with HIV or AIDS (acquired immunodeficiency syndrome) who are hospitalized with chickenpox appear to be at high risk for developing varicella pneumonia, which manifests in a similar clinical fashion to that in immunocompetent individuals. In another study of 68 adult patients admitted with measles diagnosed on clinical and serological grounds, 9 required intensive care, six mechanical ventilation for approximately 15 days, and two deaths occurred.
cord-017516-qbksb83c	2009	Our prototype Infectious Disease Detection and Quarantine Management System (IDDQMS), which can identify and trace clusters of infection by mining patients'' history, is introduced in this paper. The SARS (Severe Acute Respiratory Syndrome) outbreak in 2003 and recent world-wide avian flu infections have contributed to the urgent need to search for efficient methods for prevention and control of highly infectious diseases. Given this background, this research aims to develop a decision support system which can be used to locate the source of an outbreak by mining clusters and communities from the patients'' past activities (testimonies) using techniques from infectious disease control, information visualization, and database management systems. IDDQMS (see Figure 1 ) consists of four modules; information extraction, data analysis, hidden cluster detection, and quarantine management. In this paper, we have described our novel prototype system on Infectious Disease Detection and Quarantine Management, which can be used to identify and trace clusters of infection by mining patients'' history.
cord-017518-u2gsa4lg	2019	
cord-017531-fm8gl5b3	2018	All transport of infectious patients from the place of arrival to the hospital should take place in ambulances using the same infection control regime as for the individual infectious disease (contact infection, airborne infection, strict isolation); see isolation regimes; Chaps. • Ambulance staff and other personnel use the contact and airborne infection regime when picking up and transporting a patient. Short-time airborne isolation of exposed cases until the infection state is clarified/effect of antibacterial therapy 82.5.6 Anthrax After Staying in Turkey, Sick on the Plane Home 82.5.6.1 Patient: Strict Isolation-Air Pressure Isolate with Pressure [21, 22] Example: Two out of six people who have been on family visits in Turkey for a week, on farms with goats and skin production, are acutely ill on the plane home with cough, shortness of breath and fever. Less severe disease: isolation of index case and close contacts • Registering: All exposed persons are registered (name, address, telephone number) and followed up.
cord-017534-0ai8chbu	2018	There is an increased need of isolates for patients with infections, especially due to pulmonary tuberculosis, MRSA, VRE, Clostridium difficile (CD), multiresistant gram-negative bacteria and other "multidrug-resistant organisms" (MDRO) [23, 24, 36, 37, [48] [49] [50] [51] . In 2009, a European investigation was done as regards the number of "high-level isolation rooms" (HIRs), i.e. airborne infection isolation units with negative pressure (not defined) with at least 6 air changes per hour and sluice (anteroom) [61] . CDC defines contact isolation, using gown and gloves when in contact with patients infected with resistant bacteria like MRSA and other MDROs (multidrug-resistant organisms), and single rooms are recommended [19] . Spread of pathogenic infectious agents through the air and droplets requires a defined negative pressure ventilation isolate and a system which reduces airborne infection in the patient''s room.
cord-017569-fv88n70v	2017	Although each facility may wish to tailor the composition of the HICS team to their own particular needs, and each situation may require adjustment, key team members would typically include logisticians to plan to replenish PPE supply levels and address waste management issues, a public information officer (PIO), medical technical specialists to include infectious disease physicians and nurse leaders to manage the clinical care of the patient and staffing within the patient care unit, a laboratorian to address testing logistics and specimen transport challenges, a clinical research expert to facilitate the use of experimental therapies when necessary, a nurse concierge or other dedicated individual to support family needs, and a behavioral health expert to address staff well-being as well as the psychological and emotional needs of patients and families. The HLCC facilities in the United States that admitted patients infected with Ebola virus disease (EVD) have well developed teams of nurses who are able to provide skilled and effective patient care within their isolation units.
cord-017581-6lubp7io	2019	Pregnant patients can suffer from the same respiratory diseases as the general population in addition to unique syndromes of pregnancy (such as pre-eclampsia and tocolytic induced pulmonary edema, and pregnancy induced cardiomyopathy). Low pulmonary reserves that arise from reductions in functional residual capacity (caused by the gravid uterus and changes in the chest wall morphology) [1] and increased oxygen consumption make pregnant women develop hypoxemia more rapidly during apnea [4] . The most common causes of non-cardiogenic acute pulmonary edema in pregnancy are, fluid overload, preeclampsia, tocolytic agents, sepsis, trauma or following aspiration of gastric contents [6, 7] . A partial pressure of carbon dioxide within the normal range of 36-40 on an arterial blood gas can be an early sign of imminent respiratory failure in the gravid patient. Some of the risk factors for pneumonia in pregnancy include anemia, asthma, antepartum corticosteroids given to enhance fetal lung maturity, and the use of tocolytic agents to induce labor [27] .
cord-017617-13m7pmvq	2017	
cord-017715-99ri6x0y	2015	
cord-017772-zpf1xjqi	2019	In general, ICU patients who develop thrombocytopenia are sicker than patients with normal platelet counts, with higher illness severity scores, more need for vasoactive infusions, and more organ dysfunction [8, 9] . TMAs are a diverse group of disorders that can be classified broadly as primary (thrombotic thrombocytopenic purpura, hemolytic uremic syndrome, drug-mediated, etc.) or secondary to a systemic disorder (disseminated intravascular coagulation, severe hypertension, hemolysis with elevated liver enzymes and low platelets during pregnancy, etc.) [23] . The diagnosis of DIC should be suspected in any critically ill patient with thrombocytopenia, abnormal coagulation parameters (e.g., a prolonged prothrombin and partial thromboplastin times), MAHA, and laboratory evidence of fibrinolysis (e.g., an elevated d-dimer and reduced fibrinogen) [38] . Indeed, a recent systematic review did not identify a single high-quality study that investigated the impact of prophylactic platelet transfusions on bleeding rates in critically ill patients [72] .
cord-017784-4r3fpmlb	2019	Severe community-acquired pneumonia and acute exacerbations of chronic obstructive pulmonary disease (AECOPD) are causes of acute respiratory failure (ARF) in elderly patients. This process termed immunosenescence or immune dysregulation, together changes in lung function who occur with advancing age, play a critical role in the manifestation of age-related pulmonary diseases such as infections (i.e., pneumonia), chronic obstructive pulmonary disease (COPD), and increased the risk for develop sepsis [1] . Triggering causes of ARF in advanced aged patients are especially acute heart decompensation, severe community-acquired pneumonia (CAP), acute exacerbations of COPD (AECOPD), and pulmonary embolism. Lower respiratory tract infections, including pneumonia and exacerbation of chronic obstructive pulmonary disease, are among the most common causes of ARF in elderly people and the most important cause of hospitalization. Antibiotic therapy and treatment failure in patients hospitalized for acute exacerbations of chronic obstructive pulmonary disease
cord-017786-kfl6xt31	2013	
cord-017799-2nvrakbs	2018	Acute bacterial rhinosinusitis most commonly occurs as a complication of viral infection, complicating 0.5-2.0% of cases of the common cold [10] , However, other factors may also predispose to ABRS, such as allergy, immune dysfunction, impaired ciliary function, anatomic narrowing of the sinuses, or poor dentition [11] . Only for suspected complication involving orbit or central nervous system Similar recommendations for adults Initial therapy of ABRS Antibiotics for worsening course or severe onset ("2" or "3" above), but antibiotics or watchful waiting (for up to 3 days) for "persistent illness" ("1" above) 
cord-017815-0t7jvvz5	2018	
cord-017862-9fkjjmvf	2007	Only 12-25% of all "sore throats" seen by physicians have a true pharyngitis-most are simple viral upper respiratory infections such as the common cold. infl uenzae, Staphylococcus aureus, Legionella pneumophila, and Allergens such as pollens, molds, animal dander, dust mites, and cockroaches Irritants such as strong odors and sprays, chemicals, air pollutants, tobacco smoke, and cold air Viral or sinus infections including colds, pneumonia, and sinusitis Exercise, especially in cold, dry air Gastroesophageal refl ux disease (GERD), a condition in which stomach acid fl ows back up the esophagus Medication and foods Emotional anxiety others) is the most common source of infection for most patients. Infl uenza, rubeola and rubella, Mycoplasma pneumonia, group A β-hemolytic streptococcal infections, and allergic rhinitis may all be confused with the common cold and should be considered when appropriate. When a common cold has lasted for 7-10 days and is no better or worse, acute bacterial sinusitis may have developed and additional medical care may be required.
cord-017883-6a4fkd5v	2018	There are various factors which contribute to the increased susceptibility to infections in pediatric hematology/oncology (PHO) and HSCT patients, most prominent of them being disruption of cutaneous and mucosal barriers (oral, gastrointestinal, etc.), microbial gastrointestinal translocation, defects in cell-mediated immunity, and insufficient quantities and inadequate function of phagocytes. Based upon such data in adults, the IDSA Guidelines for the Use of Antimicrobial Agents in Neutropenic Patients with Cancer state that fluoroquinolone prophylaxis should be considered for high-risk patients with prolonged severe neutropenia [20] . Though some authors suggest that antibiotic prophylaxis should be considered in children undergoing induction chemotherapy for ALL, there is currently insufficient data to inform definitive guidelines for antibiotic prophylaxis to prevent bacterial infections in pediatric oncology patients [19] [20] [21] .
cord-017897-mbwm0ytg	2018	
cord-017946-fa4ehlb0	2018	This chapter will focus on adjuncts to damage control resuscitation (DCR) including massive transfusion protocols, the "other" tenets of damage control resuscitation, hypertonic saline, tranexamic acid, pharmacologic resuscitation, Factor VIIa, and prothrombin complex, and viscoelastic testing. Looking at the incorporation of the other two principles (permissive hypotension and minimizing crystalloids) into a mature trauma center already incorporating a transfusion strategy approaching whole blood, investigators found an improvement in survival among emergent laparotomy patients [4] . The authors noted a significantly improved mortality compared to that predicted by the Trauma Related Injury Severity Score (TRISS) in patients who received fibrinogen concentrate during their initial resuscitation. Animal models of liver injury associated hemorrhagic shock have shown decreased blood loss, increased mean arterial pressure, and significantly higher hemoglobin levels with vasopressin administration compared to standard crystalloid resuscitation [74] . A randomized, placebo-controlled study (AVERT Shock) is currently underway to investigate the potential benefit of vasopressin administration during the early resuscitation of bleeding trauma patients [79].
cord-018005-53cl75gk	2012	
cord-018106-5giapmcf	2019	
cord-018110-mcw4v13c	2010	In the case of partial or no remission, prednisolone treatment should be continued orally for 16 days together with gastric proton pump inhibitors and additional haemodilutive/haemorheological infusion therapy together with α-lipoic acid should be administered as described for high-frequency idiopathic sensorineural hearing loss. Acute tinnitus due to noise-induced damage or acoustic trauma of the inner ear, idiopathic sensorineural hearing loss (sudden deafness), acute attack of Ménière''s disease, toxic labyrinthitis, rupture of the round window, perilymphatic fistula of the round or oval window, labyrinthine contusion or fractures of the temporal bone due to head trauma should be treated with a daily dose of 250-500 mg prednisolone intravenously on three consecutive days.
cord-018182-lleti89n	2016	Acute exacerbations of chronic obstructive pulmonary disease (AECOPD) are frequently encountered in the intensive care unit (ICU). Important differential diagnoses in patients with severe dyspnea and/or impending respiratory failure include congestive heart failure, acute coronary syndrome, pulmonary embolism, cardiac arrhythmia, pneumothorax, pleural effusion, acute infectious processes such as bacterial or viral pneumonia, and exacerbations of other underlying pulmonary conditions such as interstitial lung disease. Given their complexity, the use of RHC and ongoing invasive hemodynamic monitoring is recommended for patients with evidence of RV failure requiring ICU admission, particularly in the setting of vasoactive agent titration [32] . Hospital and 1-year survival of patients admitted to intensive care units with acute exacerbations of chronic obstructive pulmonary disease Antibiotic therapy and treatment failure in patients hospitalized for acute exacerbations of chronic obstructive pulmonary disease Noninvasive positive pressure ventilation in the setting of severe acute exacerbations of chronic obstructive pulmonary disease: more effective and less expensive
cord-018209-v2crgj5w	2010	Infectious and noninfectious pulmonary complications occur in 30-60% of patients with hematological malignancy and recipients of hematopoietic stem cell transplantation (HSCT) and are associated with signifi cant morbidity and mortality [1] . This chapter will review the infectious and noninfectious pulmonary findings that have been described at autopsy in patients with hematological malignancies, including blood and bone marrow transplant recipients. Table 20 .1 lists the infectious and non-infectious pulmonary disorders reported in autopsy studies of patients with hematologic malignancy, including HSCT recipients. Several autopsy series have reported diagnostic discrepancies between premortem clinical diagnosis and postmortem autopsy findings ranging from 5% to 64% in patients with hematologic malignancy and HSCT recipients (Table 20. Infectious and noninfectious pulmonary diseases are commonly found on postmortem autopsy studies in patients with hematological malignancy and HSCT recipients. Major diagnostic discrepancies between clinical premortem diagnoses and postmortem autopsy findings have been reported in patients with hematologic malignancy.
cord-018225-dozmy3lb	2008	The paper by Harrison and co-workers, again from the King''s Liver Unit, investigates the effects of n-acetylcysteine in patients with acute liver failure, and the findings of this study have resulted in widespread use of this agent in this setting. The incidence of hypoxic hepatitis was prospectively studied for 1 year in a group of high-risk patients suffering from low cardiac output in a coronary care unit. In intensive care patients, a rapid decrease in MEGX test values is associated with increased risk of developing multiple organ failure, and a poor outcome, and consequently may have a role in investigation of the role of the liver in the multiple organ failure syndrome. We studied the effect of acetylcysteine on systemic hemodynamics and oxygen transport in 12 patients with acetaminophen-induced fulminant hepatic failure, and 8 patients with acute liver failure from other causes. The increase in oxygen delivery and consumption in response to acetylcysteine may account for its beneficial effect on survival in patients with fulminant hepatic failure induced by acetaminophen.
cord-018243-hyvu9nuq	2010	
cord-018303-dvuwhpyq	2019	Topics include a review of the ecology of aircraft cabins and engineering features of aircraft ventilation systems that minimize the risk of disease transmission; examples of point source outbreaks related to air travel; in-flight preventive measures including the use of patient isolators; and US military and international policy and legal aspects of transporting patients with communicable diseases. Examples include in-flight transmission of tuberculosis, severe acute respiratory syndrome (SARS), smallpox, and measles.The chapter will also discuss experience in transporting patients with contagious diseases including viral hemorrhagic fevers and new patient isolation technologies that were used for the long-distance transport of patients with Ebola virus disease during the 2014–2016 West African epidemic. In response to concerns generated by lethal viral hemorrhagic fevers, and a possible need to transport patients with these diseases by air, the ventilation and air-conditioning systems on pressurized, long-range transport aircraft were studied to evaluate the aerodynamics of aerosolized microorganisms [19] .
cord-018318-vzzrsqsn	2017	
cord-018363-qr1pk78u	2015	Results of physical examination are as follows: temperature, 38.9 °C (102.1 °F); heart rate, 116 bpm; blood pressure, 96/60 mmHg; respiratory rate, 35 breaths/min; and O 2 saturation, 74 % on 100 % O 2 with a nonrebreather mask. In the past 20 min, the patient has become abruptly short of breath, hypoxic, and severely hypotensive with a blood pressure of 72/palpation mm Hg. On physical exam, she is obtunded and in serve respiratory distress. A 64-year-old female with a past medical history signifi cant for type 2 diabetes mellitus is admitted with increasing shortness of breath. A meta-analysis of 15 studies reports that hyperglycemia increased both in-hospital mortality and incidence of heart failure in patients admitted for acute myocardial infarction. Continuing warfarin treatment at the time of pacemaker in patients with high thrombotic risk was associated with a lower incidence of clinically signifi cant device-pocket hematoma, as opposed to bridging with heparin.
cord-018408-ttae193b	2008	
cord-018412-kv3vxmcw	2017	In future, increases in the number of ICU beds relative to bed numbers in other hospital wards will probably be contemplated, even in a scenario of decreasing costs; clinical protocols will be computerized and/or nurse-driven; more multicenter and international trials will be performed; and organizational strategies will concentrate ICU personnel in a few large units, to promote the flexible management of these healthcare workers. Moreover, extracorporeal organ support technologies will be improved; technology informatics will cover all the bureaucratic aspects of healthcare work, aiding the staff in workload assessment; and critical care multidisciplinary rounds and follow-up services for post-ICU patients will be implemented. • Development of methods for fast recognition of acute patients at high risk of rapid deterioration • Minimally invasive organ support technologies • New approaches to enhance patient comfort while reducing changes of consciousness • Effective process and outcome measurements for critical illness research and palliative and EOL care.
cord-018414-6ffhm895	2016	
cord-018430-u3k8pds6	2007	The classification states that "myocarditis is diagnosed by established histological, immunological and immunohistochemical criteria." The Dallas criteria 5 provide consensus-derived histologic criteria: "an inflammatory infiltrate of the myocardium with necrosis and/or degeneration of adjacent myocytes not typical of ischemic damage associated with coronary artery disease." However, many have speculated that less pronounced histologic abnormalities may be present and that additional molecular, immunologic, and immunohistochemical diagnostic criteria can be used productively. 330 These criteria define active myocarditis (see also Fig. 59 .7A) as "an inflammatory infiltrate of the myocardium with necrosis and/or degeneration of adjacent myocytes not typical of ischemic damage associated with coronary artery disease." Furthermore, other causes of inflammation (e.g., connective tissue disorders, infection, drugs) should be excluded. 392 An interesting hypothesis to explain the high frequency of dilated heart muscle disease is the presence of myocarditis in HIV-infected patients with left ventricular dysfunction. The ECG abnormalities suggesting myocardial involvement are present in a high proportion of patients, 414 but clinical evidence of cardiac dysfunction occurs in only 10% to 25% of cases.
cord-018447-z4jyjczy	2006	The Antiphospholipid Antibodies in Stroke Study (APASS) Group also found a prevalence of aCL in 4.3% of 257 hospitalized non-stroke patients with a mean age 66 [16] . In a meta-analysis, Wahl examined the risk of venous thromboembolism in aPL-positive patients without autoimmune disease or previous thrombosis. The largest prospective study of 1000 SLE patients showed that after 10 years of follow up there were 68 deaths of whom 18 (26.5%) died from thrombosis associated with aPL [7] . However, studies in patients without lupus who are aPL positive have shown increased carotid intima-media thickness associated with an increased risk of arterial thrombosis [38] . In general, there are no significant differences in the cardinal clinical features of APS, such as arterial or venous thrombosis or pregnancy morbidity, whether the syndrome is primary or secondary to an underlying connective tissue disorder [33, 50] .
cord-018454-sy21cpff	2019	(continued) Identifying the disease subset might orientate the therapeutic strategy c Serum ferritin levels are significantly higher in the systemic subtype [110] , but high ferritin levels after adequate treatment may predict chronic articular course [61] d Calprotectin levels help rule out rheumatoid arthritis, but further studies are needed to validate it as a diagnostic biomarker because of no statistical difference between AoSD and septic patients, although the populations were small [42] e Elevated plasma levels of IL-1β, IL-6, and TNFα have been found during AoSD, but the cytokine profile is not specific and cannot differentiate AoSD patients from those with sepsis f S100A12 was found an efficient diagnostic and monitoring biomarker in systemic juvenile arthritis, but further studies are needed for validation in AoSD Procalcitonin, a marker of severe systemic infection, was also found elevated in patients with active AoSD and does not appear relevant to distinguish acute infection from AoSD flare [42, 113] .
cord-018545-fk17n2bx	2012	Herpes Simplex Virus (HSV, types 1 and 2) (a) Systemic infection in the neonate with shock and coagulopathy and severe liver failure (b) Encephalitis, hepatitis (c) Local (mouth, esophagus, larynx, lungs, heart, liver, kidneys, CNS) or systemic disease in organ and stem cell transplant and immunocompromised patients 2. Pneumonia means inflammation of the lung parenchyma caused by infection and the diagnosis is made clinically in a febrile child with respiratory signs and symptoms who has evidence of consolidation on CXR. • Development of an empyema or less commonly a lung abscess • Underlying lung disease such as: bronchopulmonary dysplasia (BPD, in ex-premies), cystic fibrosis, inhaled foreign body, tracheobronchomalacia or post tracheal surgery, or infected congenital lung cyst • Diagnosed or undiagnosed immunodeficiency states (primary, HIV, leukemia) • Children with neuromuscular diseases, weakness, or spasticity such as muscular dystrophies, myasthenia, spinal muscular atrophy, or cerebral palsy • Inappropriate antibiotics, inappropriately low dose or resistant bacteria • Non bacterial pneumonia (viral pneumonia or alternative pathogen such as Tuberculosis)
cord-018590-rkp89dqo	2010	
cord-018595-x3tleomb	2017	2. Delayed-type drug hypersensitivity: Delayed-type drug hypersensitivity reactions usually take several days to weeks following drug exposure, with variable clinical presentations that may include Maculopapular Eruption (MPE), Fixed Drug Eruption (FDE), Acute Generalized Exanthematous Pustulosis (AGEP), Stevens-Johnson Syndrome (SJS), Toxic Epidermal Necrolysis (TEN) and Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS). Examples of strong associations of HLA alleles with specific drug-induced hypersensitivity reactions include abacavir, nevirapine, carbamazepine, and allopurinol (Table 25. [61] , who reported the weak associations of HLA-A29, B12, and MPE maculopapular drug eruption, DRESS drug reaction with eosinophilia and systemic symptoms, SJS/TEN Stevens-Johnson syndrome/toxic epidermal necrolysis DR7 in sulfonamide-related TEN, and HLA-A2, B12 in oxicam-related TEN in Europeans [61] . Drug specific cytotoxic T-cells in the skin lesions of a patient with toxic epidermal necrolysis
cord-018601-mk66097y	2007	18 Primary PHT was defined as mean pulmonary artery (PA) pressure >25 mm Hg at rest (or >30 mm Hg with exercise) in the absence of secondary causes for PHT, a definition different from the current definition of PAH, which includes PHT due to more common diseases like collagen vascular disease, HIV infection, portal hypertension, congenital heart disease as PAH (Table 105 .2). The following tests should be obtained in all patients in whom the cause of PHT is not evident: electrocardiogram (ECG), chest radiograph, arterial blood gases, complete blood count, electrolytes and liver function tests, pulmonary function tests (PFTs), ventilation/ perfusion lung scan, serology for rheumatic diseases (e.g., fluorescent antinuclear antibody, FANA), serology for HIV, ventilation perfusion (V/Q) scan, and an echocardiogram with Doppler assessment of PA acceleration time and tricuspid regurgitation velocity as well as an echo-contrast study, to exclude shunting.
cord-018620-3kqx8arn	2016	In this chapter we will discuss the definition, clinical manifestations, workup, and management of acute and chronic liver failure and the general principles of treatment of these patients. Other mechanisms that may explain this symptom include the endogenous opioids theory which proposes that the liver failure patient has elevated opioid levels secondary to decrease clearance and metabolism. Past medical history plays a key role in determining if the patient has chronic liver disease or if they are experiencing an acute failure. A decrease in glutathione levels, enhanced cytochrome P450 activity secondary to medication use, acetaminophen overdose, or decreased liver function from chronic disease make patients more susceptible to developing toxicity. Patients with hepatitis secondary to shock present with several symptoms related to their hemodynamic instability including altered mental status, respiratory distress, severe hypotension, and renal failure.
cord-018623-of9vx7og	2019	Further, human studies provided evidence pointing to the increased development of emotional problems and EDR-related disorders in patients with various types of AIDs, such as SLE and multiple sclerosis (MS), in a disease state/severity-dependent manner [12] [13] [14] [15] [16] [17] . Thus, it is not surprising that the inflammatory response and respective cytokines are supposed as one of the possible mechanisms linking the experience of negative emotions or ER-related disorders and the progression of cardiovascular diseases, of course along with the neuroendocrine system and apoptosis signaling pathways [27, 30, [32] [33] [34] [35] . Mice subjected to short-term (1-3 weeks) HFD also exhibited anxiety-like behaviors in addition to learning and memory impairments and had significantly higher levels of homovanillic acid-a metabolite of dopamine-in their hippocampus and cortex but without any alteration in the gene expression of inflammatory markers [89] . Increased emotional distress in daughters of breast cancer patients is associated with decreased natural cytotoxic activity, elevated levels of stress hormones and decreased secretion of Th1 cytokines
cord-018638-4pyjhpbk	2019	Acute non-purulent cervical lymphadenopathy Table 4 .2 AHA 2017 diagnostic criteria for KD [28] Diagnosis of classic KD can be proffered in the presence of fever for at least 5 days associated with at least 4 of the 5 following principal clinical features. Cervical lymphadenopathy (>1.5 cm diameter), usually unilateral A careful history may reveal that ≥1 principal clinical features were present during the illness but resolved by the time of presentation Exclusion of other diseases with similar findings (e.g., scarlet fever, viral infections like measles, adenovirus, enterovirus, Stevens-Johnson syndrome, toxic shock syndrome, drug hypersensitivity reactions, systemic juvenile idiopathic arthritis) unusual for KD. Perianal desquamation is virtually pathognomonic of KD and is a useful clinical sign for diagnosis of the disease during the acute phase ( Fig. 4 .3c). Epidemiological and clinical characteristics of Kawasaki disease and factors associated with coronary artery abnormalities in East China: nine years experience
cord-018714-i291z2ju	2016	• If possible identify the physiopathologic mechanism involved in the reaction; • Identify as rapidly as possible the drug inducing the reaction and always opt for its withdrawal; in some circumstances the choice is difficult as there is no alternative drug and its use is essential for the maintenance of life; • A careful and intensive observation is recommended for the occurrence of warning signs regarding the appearance of a potentially severe adverse drug reaction, especially in relation to mucous, oral, ocular, and genital involvement and progression of any present cutaneous eruption; • It is imperative that the drug responsible may be withdrawn on a permanent basis together with chemically related com-pounds, and this advice is also valid for first-degree relatives who can present the same type of reaction.
cord-018780-zeok60hn	2018	A patient presenting to healthcare facilities with specific clinical and epidemiological risk factors for infection with one of these pathogens may be termed a person under investigation (PUI) for the disease, and healthcare staff should utilize carefully developed protocols and procedures to guide their subsequent isolation and clinical evaluation practices until the disease has been ruled in or out. After the patient has been safely isolated, senior clinic staff must be notified and must contact appropriate subject matter experts for direction on next steps including (1) whether (based on information already available) the patient meets PUI criteria or if additional information is required; (2) if the latter, direction on the safe use of PPE and distancing from the patient; (3) advice on what types of care can safely be provided in that setting for patients confirmed as PUIs; and (4) instructions on transferring the patient to another more appropriate location for further clinical evaluation and management if deemed necessary.
cord-018801-amet0wx4	2018	Depending on acuity, patients with decompensated chronic or acute fulminant liver failure generally require preoperative intensive care unit admission to manage organ dysfunction. Depending on acuity, patients with decompensated chronic or acute fulminant liver failure generally require preoperative intensive care unit (ICU) admission to manage organ dysfunction. In patients that develop AKI post-liver transplantation, treatment includes the prevention of hypotension and decreased use of unnecessary blood products. Early postoperative infections in liver transplant patients are typically bacterial and related to the donor''s status (previous infections from advanced cirrhosis), the surgical procedure itself, prolonged use of invasive catheters, and duration of mechanical ventilation. The resulting lack of blood flow and developing ischemia and necrosis from hepatic artery thrombosis present with signs and symptoms similar to fulminant liver failure patients with elevated liver serum tests, coagulopathy, and severe metabolic acidosis.
cord-018809-3nrvm4jt	2006	In combat, fresh whole blood for massive transfusion becomes a blood bank multiplier, providing within a single unit, RBCs, volume, coagulation components, and functional platelets in a warm fluid. Appropriate use following established guidelines can be beneficial and may even be superior to packed RBCs. A fluid containing the vital properties of fresh whole blood would serve as a bridge to allow a patient to be resuscitated without initiating the''bloody cycle of death'' that is seen all too often in our current paradigm of massive resuscitation. Appropriate use following established guidelines can be beneficial and may even be superior to packed RBCs. A fluid containing the vital properties of fresh whole blood would serve as a bridge to allow a patient to be resuscitated without initiating the''bloody cycle of death'' that is seen all too often in our current paradigm of massive resuscitation.
cord-018834-4ligp4ak	2016	HSA is the most important antioxidant capacity of human plasma, in addition to its ability to protect the body from the harmful effects of heavy metals such as iron and copper and reduce their ability to produce reactive oxygen radicals. Recently, its use has been questioned following a widely publicized meta-analysis in 1998 that reported increased mortality in patients who received albumin solutions; the role of albumin administration in critically ill patients became highly controversial. However, the results of this meta-analysis have been challenged by several metaanalyses, randomized controlled trials that not only proved the safety of HSA but its benefi t especially in patients with sepsis, liver failure, hypoalbuminemia, and burns [ 1 -4 ] . HSA administration favorably infl uences plasma thiol-dependent antioxidant status, as well as levels of protein oxidative damage in patients with sepsis and acute respiratory distress syndrome (ARDS) [ 21 , 22 ] .
cord-018840-ts2g1ux7	2018	
cord-018907-c84t1bo5	2012	In providing empirical antibiotic therapy in patient with pulmonary infiltrate and defect in cell-mediated immunity one need to consider Pneumocystis jiroveci, nocardia, legionella, mycoplasma, in addition to aerobic Gram-positive cocci and Gram-negative bacilli therefore it is advised to use trimethoprim-sulfamethoxazole, macrolides including erythromycin or clarithromycin and agent active against Gram-positive and Gram-negative; for example, thirdgeneration cephalosporin with or without aminoglycoside with anti-Gram-positive either nafcillin or vancomycin based on the incidence of methicillin-resistant Staphylococcus aureus (MRSA) and penicillin resistant Streptococcus pneumoniae. The factors influencing antimicrobial selection include the types of bacterial isolates found in the institution, antibiotic susceptibility patterns, drug allergies, presence of organ dysfunction, chemotherapeutic regimen whether the patient was receiving prophylactic antibiotics, and condition of the patient at diagnosis, for example, presence of signs and symptoms at initial evaluation and presence of documented sites requiring additional therapy.
cord-019010-9xgwjvsv	2010	Consistent with this particular situation, the health system in the metropolitan area of Buenos Aires began to show evidences of collapse, use of ventilators increased critically, achieving an extremely unusual level; about a quarter of the available ICU beds were occupied by young and previously healthy patients with ARDS associated with severe bilateral pneumonia due to ''swine flu'' who needed mechanical ventilation. These figures are difficult to extrapolate globally and to confirm, as epidemiological studies looking at the population at risk in different world areas are lacking, but the huge number of severely ill patients with ARDS due to primary influenza pneumonia (an extremely unusual complication) observed in the Southern Cone, suggest that these estimations could be realistic. Viral cultures of respiratory specimens, especially if A 29 year-old obese male with arterial hypertension secondary to Cushing''s disease (hypophyseal adenoma) developed bilateral pneumonia and died from respiratory failure secondary to acute respiratory distress syndrome (ARDS) after 13 days on mechanical ventilation, with multiple organ failure, including renal and hemodynamic compromise requiring high doses of vasopressors.
cord-019027-6chba2ru	2014	
cord-019043-cqmqwl3i	2014	The incidence and prevalence of chronic kidney disease (CKD) and end-stage renal disease are increasing, and these patients have a higher risk of developing critical illness and being admitted to the intensive care unit (ICU) compared to the general population. Factors that have been shown to be associated with ICU mortality in ESRD patients are older age, higher illness severity score (i.e., APACHE II or SAPS II), burden of nonrenal organ dysfunction/failure, medical or nonsurgical admission type, and provision and duration of life-sustaining technologies (i.e., mechanical ventilation, vasopressor therapy). Synthetic colloids, such as hydroxyethyl starch (HES), have appeal for resuscitation fluids based on the premise that they attenuate the inflammatory response, mitigate endothelial barrier dysfunction, improve microcirculatory flow, and contribute to more rapid hemodynamic stabilization; however, accumulated data have now suggested use of these fluids in critical illness is associated with dosedependent risk for severe AKI requiring RRT, bleeding complications, and death (Box 32.2).
cord-019046-q6uv2ayi	2015	The chapter reviews the diagnostic approach to laryngeal infections, focusing on key points of the history and physical exam, including concerning signs and symptoms suggestive of airway distress. Viral and bacterial laryngitis, croup, epiglottis, recurrent respiratory papillomatosis, as well as some less common causes of bacterial infections are discussed in detail with each etiology''s epidemiology, clinical features, associated diagnostic evaluation, and management reviewed. The assessment of a patient with a suspected laryngeal infection should include a prompt evaluation for airway compromise focusing on stridor, increased work of breathing with retractions and accessory muscle use, and cyanosis. In the most severe cases of croup, patients may require direct laryngoscopy, bronchoscopy and intubation, although this is typically avoided as the endotracheal tube can contribute to the development of subglottic stenosis. There are several additional, however, less common causes of laryngeal infection that may present with airway symptoms.
cord-019063-mcxbl8mv	2013	
cord-019064-e5z92vg8	2011	
cord-019347-tj3ye1mx	2010	Method:Case Report:A 15y/o w/f athlete presented with a two month history of recurrent hives and angioedema which she associated with ingestion of Halloween candy .One week before evaluation she had hives with Coconut as well.Her history was othewise unremarkable except for recurrent UTI''S, annual sinusitis, pneumonia in 1998 as well as migraines.She denied sexual activity.Her physical exam was normal.Results:An evaluation for autoimmune disease revealed normal ESR, ANA, DSDNA, mono and hepatitis serology as well as lyme titers however her CH50 was low17u/ml(normal 26-58U/ml)and evaluation of complement revealed c4 14mg/dl(normal 16-47mg//dl)and c2 <1.3mg/dl(normal 1.6-3.5mg/dl)with normal c3, c5-c9.Her father had nor-malc4 but c2 was 1.4mg/dl (normal 1.6-3.5mg/dl)Her sister had c2 of 1.5mg/dl and normal c4 and her mother had normal c2 and c4.Her workup included positive prick skin test to ragweed, ash and grass and she was started on Rhinocort and Clarinex seasonally.She has been followed for one year with resolution of hives and is asymptomatic.Her diagnosis had been confirmed by a pediatric rheumatologist.Conclusion;We present an atypical case of C2 complement deficiency in an currently asymptomatic individual.
cord-019490-m1cuuehi	2015	Tigecycline Evaluation Surveillance Trial (TEST) -Global in vitro antibacterial activity against selected species of glucose non-fermenting organisms Objective: Despite the introduction of new antimicrobials to treat resistant gram-positive bacteria, Staphylococcus aureus continues to be a therapeutic challenge for the clinician. Two prospective studies from our centre identified common causes of CAP in India to be Mycoplasma pneumoniae [MP] and Legionella pneumophila [LP] by serology in 11% each, and SPN in 10% by culture of respiratory secretions/blood/ Conclusion: Although SPN is the most common isolate, the rising numbers of gram negative organisms (38%) and atypical pathogens associated with increasing mortality stress the need for review of initial antibiotic choice for adults with higher PORT classes. Conclusion: The spectrum of isolates among our patients were shifting towards gram positive bacteria with high resistance to different groups of antimicrobial agents limiting few choices for alternative therapies for infection control.
cord-019964-9leljj8j	2005	
cord-019968-o5bdb37q	2005	Faecal specimens from 60 patients (under six years old), most of whom were Maoris and Pacific Islanders admitted to Auckland Hospital with gastroenteritis during the months of June and July 1977, were examined for the presence of faecal viruses, bacterial pathogens and parasites. Non-agglutinable rotavirus, presumably a different serotype, was seen in both gastroenteritis and control patients. In June and July, 1977 , patients admitted to Auckland Hospital with gastroenteritis were studied to determine the relative isolation rates of (1) rotavirus, (2) other viruses identifiable by electronmicroscopy of stools, (3) enterotoxigenic Esch. Three of 18 (17 per cent) control stools contained rotavirus (one of which had non-agglutinable virus detectable on IEM). From Table III it is seen that enterotoxigenic isolates were found in both groups of gastroenteritis patients and also in non-diarrhoeal controls. Rotavirus-like particles that failed to agglutinate on IEM were seen in two gastroenteritis patients'' stools and in one control patient''s stool.
cord-020342-u8jzmloq	2003	Impact on hospital resources of patients with severe congestive heart failure who use the emergency department for primary care Antiemetic therapy in US emergency departments: findings from the year 2000 National Hospital Ambulatory Medical Care Survey database Elevated blood lead levels associated with the consumption of moonshine among emergency department patients in Bioimpedance monitoring changes therapy in dyspneic emergency department patients: the IMPACT trial Use of ischemia-modified albumin in emergency department risk stratification of chest pain is both clinically effective and cost-effective Mathematical model of the hypoventilating patient: implications for the emergency department Clinical characteristics of emergency department patients who rule in versus rule out for pulmonary embolism by computed tomography chest angiography and indirect lower extremity computed tomography venography Role of air bags in preventing motor vehicle crash-related serious injuries: perceptions among emergency department patients Eight-hour emergency department observation for blunt abdominal trauma patients with initially negative diagnostic studies
cord-021075-8hba6au3	2004	Les patients n''ayant eu qu''une poussée ne peuvent pas être classés dans une des quatre formes, alors qu''une majorité d''entre eux présente déjà probablement une SEP et que la répétition des IRM permet d''établir le diagnostic précocement en montrant l''apparition de nouvelles lésions (voir plus loin les critères diagnostiques). Ces critères stipulent que chez des patients ayant eu un premier épisode démyélinisant et réunissant les critères de Barkhof, l''apparition d''une lésion rehaussée par le gadolinium dans un territoire ne correspondant pas à la poussée initiale, sur une IRM réalisée au moins 3 mois après le début des troubles, est suffisante. De même, une méta-analyse des études longitudinales des formes rémittentes et secondairement progressives ayant utilisé le Gd a montré que le nombre de lésions Gd+ mesuré chaque mois pendant 6 mois était modestement prédictif du taux de poussées de l''année suivante mais pas de l''évolution du handicap dans les 12 à 24 mois suivants.
cord-021087-n4epxwn9	2004	Conclusions: MRI is useful to identify tumor response to Imatinib Mesylate in advanced GIST as from the early months of therapy with the following indicators of treatment activity: A) Size of lesions; B) signal intensity; C) vascularization; D) amount of degenerative tissue or necrosis; E) presence of peritoneal fluid. Materials and Methods: 34 patients (13 female, 21 male) from two centres with proven myocardial infarction by ECG, clinical and echo criteria underwent stress/ rest Tc99 sestamibi Gated SPECT scanning with a dual headed gamma camera and late contract enhanced MRI on identical 1.5 Tesla scanners in each centre using a protocol which imaged 15 minutes after injection of 0.1 mmol/kg IV gadolinium. These preliminary results illustrate the ability of MRI to assess the integrity of the TFCC and suggests its use as the first imaging method following plain radiography in the evaluation of patients with chronic posttraumatic pain on the ulnar side of the wrist.
cord-021206-4zyqqgs0	2007	Purpose: To analyze the clinical and imaging fi ndings of BI-RADS category 3 breast lesions by mammographic and ultrasonographic (US) assessment ultimately diagnosed as malignancy in retrospect Methods and Materials: Of 3,207 cases of US-guided core needle biopsy for 4 years, category 3 was given after biopsy, based on mammographic and sonographic evaluation, in 1,099 lesions (41.7%) that were composed of 462 palpable and 637 nonpalpable lesions. Background: Regional kinesis alteration of IVS is associated with different cardiac conditions which may have both pathological and physiological meanings of which the most important are the following: a) left bundle branch block that may determine intra-left ventricular asynchrony and may represent an independent predictor of severe cardiac events in heart failure patients; b) pulmonary embolism that increase right ventricle pressure; c) constrictive pericarditis; d) restrictive cardiomyopathies; e) post-operative cardiac surgery.
cord-021571-7kbq0v9w	2009	The fact that a hand hygiene campaign was associated with increased hand hygiene compliance and a lower rate of CONS-positive cultures supports this ~ontention.''~ Enterococcus has been shown to account for 10% of total nosocomial infections in neonates, 6% to 15% of bloodstream infections, 0% to 5% of cases of pneumonia, 17% of urinary tract infections, and 9% of surgical site Sepsis and meningitis are common manifestations of enterococcal infection during NICU outbreak^''^,^^; however, polymicrobial bacteremia and NEC frequently accompany enterococcal sepsis.77 Identified risk factors for enterococcal sepsis, after adjustment for birth weight, include use of a nonumbilical CVC, prolonged presence of a CVC, and bowel resection?'' Because Enterococcus colonizes the gastrointestinal tract and can survive for long periods of time on inanimate surfaces, the patient''s environment may become contaminated and, along with the infant, serve as a reservoir for ongoing spread of the organism.
cord-021701-yan5q2r7	2009	In the aftermath of recent terror events and subsequent disaster planning, hospital architects have begun to design EDs to better meet the needs anticipated from a terror attack. The technology needed to respond to a terrorist event, such as personal protective equipment (PPE), is becoming more widely available and is stored where easily available in EDs. Although mass decontamination can occur close to the disaster scene, EDs are gearing up to decontaminate, isolate, and treat individuals or groups contaminated with biologic or chemical materials. [8] [9] [10] [11] [12] Sensor technology is an area of active research that continues to yield new solutions that are being incorporated into EDs. In concept, all entrances could be designed to identify persons using scanning to detect unwanted chemicals,biologic agents,or explosives and to detain and decontaminate as needed. Overflow patients in hallways and adjacent spaces can be managed with mobile computing, which is available in many EDs. Wireless handheld devices can facilitate preparation for disasters and allow immediate access to information by providers in hallways and decontamination spaces.
cord-021713-e0hzcag6	2015	A 38-year-old man developed ischemic optic neuropathy after taking ribavirin 800 mg/day þ peginterferon alfa for 6 months; his visual acuity and field defect failed to improve despite withdrawal of interferon and therapy with high dose systemic steroids [46] . Type 1 diabetes mellitus and thyroid disease reportedly develop in 0.08-2.6% and 10-15% of patients treated with combined interferon-alfa þ ribavirin for chronic hepatitis C, but rarely coexist; however, both conditions have been reported in a 33-year-old woman [65] . A 49-year-old man who took long-term ribavirin þ peginterferon alfa for chronic hepatitis C developed an autoimmune hemolytic anemia after 56 weeks of therapy and required transfusion and withdrawal of both agents [67] . In a randomized controlled trial of high-dose interferon alfa-2b plus oral ribavirin for 6 or 12 months in 50 patients with chronic hepatitis C, the sequential effects of treatment on hemoglobin, leukocytes, and platelets were recorded [78] .
cord-021721-80pp1ra4	2015	
cord-021742-sdz6d1r5	2009	
cord-021816-gk8rwyq4	2018	In practice, several factors frequently cause enough impairment of host defenses to contribute to the development of pneumonia, even though individuals with such impairment are not considered "immunosuppressed." Viral upper respiratory tract infections, ethanol abuse, cigarette smoking, heart failure, and preexisting chronic obstructive pulmonary disease (COPD) are a few of the contributing factors. Three major settings in which this organism is seen as a cause of pneumonia are (1) as a secondary complication of respiratory tract infection with the influenza virus; (2) in the hospitalized patient, who often has some impairment of host defense mechanisms and whose oropharynx has been colonized by Staphylococcus; and (3) as a complication of widespread dissemination of staphylococcal organisms through the bloodstream. One issue that has sparked controversy is whether an attempt should be made to identify a specific etiologic agent, using Gram stain and culture, in patients with community-acquired pneumonia, or whether empirical therapy should be used based on the patient''s risk factors, clinical characteristics, and local bacterial resistance patterns.
cord-021905-fjcks7w4	2009	The level of cat allergen that is required to induce asthma symptoms is not well defined, so strict avoidance and proper cleaning after an animal has been removed from the household are key to preventing morbidity. Accordingly, improper setting of the central air humidifier (commonly part of a home''s central heating and air-conditioning unit) may worsen asthma control; while dehumidifiers set to keep humidity levels lower than 50% may be beneficial in reducing asthma symptoms from house-dust mite exposure. Similar to the aforementioned avoidance measures for pollen-sensitive asthmatic individuals, asthma symptoms from exposure to mold spores may be minimized by staying indoors as much as possible (especially during peak spore concentrations) and keeping home and automobile windows closed. Other important outdoor asthma triggers include exposure to vehicle traffic (especially diesel exhaust), which might exacerbate preexisting allergic conditions by enhancing airway responses to allergen, a potential compounding effect.
cord-021917-z9wpjr0d	2009	• Health care workers, accustomed to putting the welfare of patients ahead of their own in emergency situations, must be prepared for the proper use of personal protective equipment and trained in specific plans for the response to an infective or bioterrorism event. Although intensivists working in developed countries generally have little experience treating specific illnesses caused by serious bioweapon pathogens, these diseases result in clinical conditions that commonly require treatment in intensive care units (ICUs) (e.g., severe sepsis and septic shock, hypoxemic respiratory failure, and ventilatory failure). An optimal medical response to a bioweapon attack will require all or most of the following: early diagnosis, rapid case finding, large-scale distribution of countermeasures for postexposure prophylaxis or early treatment, immediate isolation of contagious victims, and enhanced capacity for providing medical care to seriously and critically ill victims.
cord-022050-h24f0fpd	2009	• Hypercapnic chronic obstructive pulmonary disease (COPD) patients should be treated with noninvasive ventilation and supplemental oxygen sufficient to overcome hypoxemia but avoid hyperoxia. Uncontrolled oxygen administration may precipitate acute hypercapnia in patients with acute COPD exacerbations as a result of relaxing hypoxic vasoconstriction, thereby allowing increased perfusion to regions with reduced alveolar ventilation. Most commonly, patients with severe asthma have a history of previous hospitalizations for asthma (some that may be near fatal), low socioeconomic status, female gender, obesity, nighttime symptoms, FEV 1 less than 60% with optimal treatment, continual symptoms, reduced quality of life, use of oral or systemic steroids in the past 12 months, use of more than canister of SABA per month, elevated residual volume-tototal lung capacity (RV:TLC) ratio on pulmonary function testing, and a peak expiratory flow rate variability of more than 30% (i.e., variability-(bestworst)/best reading). Non-invasive positive pressure ventilation for treatment of respiratory failure due to exacerbations of chronic obstructive pulmonary disease.
cord-022103-4zk8i6qb	2017	A series of IPC guidelines have been developed and updated at varying intervals by the HICPAC/CDC, IDSA, Society for Healthcare Epidemiology of America (SHEA), American Academy of Pediatrics, Association for Professionals in Infection Control and Epidemiology, and others to provide evidence-based and rated recommendations for practices that are associated with reduced rates of HAIs, especially those infections associated with the use of medical devices and surgical procedures. (2) clinical microbiology laboratory services needed to support infection control outbreak investigations, including ability to perform molecular diagnostic testing; (3) data-mining programs and information technology specialists; (4) multidisciplinary programs to ensure judicious use of antimicrobial agents and control of resistance; (5) development of effective educational information for delivery to HCP, patients, families, and visitors; and (6) local and state health department resources for preparedness.
cord-022119-bzd9e1q6	2018	Deep neck space infections can also extend directly into the mediastinum or the lungs causing life-threatening mediastinitis or pneumonia, underscoring the importance of early recognition and treatment. The initial approach to a patient with suspected pharyngitis or parapharyngeal space infection, however, should always include a careful assessment for signs of airway compromise. Patients with persistent symptoms, who do not respond to empiric therapy based on the suspected diagnosis of infection, should undergo additional diagnostic testing to evaluate for the presence of the more unusual infectious and noninfectious entities. Deep neck space infections can present as discrete organized abscesses within specific neck spaces, as a soft tissue phlegmons without clearly forming collections of pus, or rarely, as a very rapidly destructive life-threatening process called necrotizing fasciitis. Complications of bacterial pharyngitis and deep neck space infections are uncommon, particularly if appropriate antibiotic therapy has been instituted and immediate surgical concerns have been addressed; however direct extension and invasion into surrounding structures or spaces are always a risk.
cord-022173-kb6mez61	2015	Chest HRCT plays a fundamental role---urgent when there are clinical signs of severity and early (<24 h) in the absence of a response to antibiotics therapy in 72---96 h because treatment of a possible invasive fungal infection (IFI) requires an early administration, a determinant factor for prognosis. 20, 40 Noninfectious complications secondary to treatment In the 6 h following the transfusion of blood products, the sudden appearance of consolidations simulating an edema and accompanying a respiratory failure usually reflect acute pulmonary damage (APD) called TRALI (transfusion-related alveolar lung injury) which associates high mortality rates. In patients with HP the thoracic HRCT helps us come close to the differential diagnosis of infectious and non-infectious pulmonary complications by integrating image findings and clinical data.
cord-022216-k4pi30sd	2009	Neonatal necrotizing enterocolitis (NEC) is a disease of unknown origin that predominantly affects premature infants in level II, or more often level III, neonatal intensive care units during the infant''s convalescence from the common cardiopulmonary disorders associated with prematurity. 1, 7 Indeed, NEC is the most common cause of gastrointestinal perforation (followed by isolated idiopathic focal intestinal perforation) and acquired short bowel syndrome among patients in the neonatal intensive care unit. 1, 12 Although NEC is noted predominantly in premature neonates, approximately 10% of cases occur in nearly full-term or full-term infants whose preceding risk factors have included polycythemia, cyanotic heart disease or heart disease producing low cardiac output (before or after surgery), chronic diarrhea, endocrine disorders (hypothyroidism, panhypopituitarism, congenital adrenal hyperplasia) or a prior anatomic obstructive gastrointestinal malformation (volvulus or gastroschisis). 1, 12, 14 Alternatively, direct pharmacologic effects of an agent on systemic host defense (vitamin E), motility (morphine) or regional blood flow (indomethacin) may result in mucosal injury, increasing the risks for NEC in susceptible neonates.
cord-022292-msz4au4b	2009	
cord-022501-9wnmdvg5	2015	Methods: Using published data on (1) the prevalence of MRSA and other bacterial pathogens causing cSSSI in the US, (2) the in-vitro susceptibility rates of commonly used regimens in cSSSI in the US in relation to the most pervasive pathogens identified above, and (3) estimated costs of failure of initial, empiric treatment from a recent study of a large US multi-hospital database, we developed a model to predict the expected clinical and economic impact of increasing prevalence of MRSA. Small outbreaks of VEB-1 ESBL producing Acinetobacter baumannii in Belgian nursing homes and hospitals through cross-border transfer of patients from northern France Methods: From 01/04 to 03/05, all Belgian acute hospitals were invited to report cases of nosocomial infections/colonisations due to MDR Ab isolates presenting a resistance profile similar to the French epidemic strain (resistance to all agents except carbapenems and colistin) and to send such isolates to the reference laboratory for phenotypic confirmation and for genotypic characterization (PCR of VEB-1 and class 1 Integron, PFGE typing).
cord-022521-r72jtoso	2010	However, in the United States and other developed countries, severe malnutrition and new cases of perinatal HIV-1 disease are rare because of relatively high standards of living and effective highly active antiretroviral therapies (HAART) given to pregnant HIV-infected women that prevent transmission of HIV to the infants. Examination of both acute simian immunodeficiency virus (SIV) and HIV infection have documented reduced CD4 cell levels in GALT prior to a detectable reduction in T cells of the peripheral blood, highlighting the gastrointestinal tract''s role and susceptibility. Previous studies have shown that activated mucosal T cells play a role in the pathogenesis of enteropathy in the human small intestine 37 and can affect the morphology of the villi and crypts in a manner similar to that seen in patients with HIV-1 infection. Immune restoration disease after the treatment of immunodeficient HIV-infected patients with highly active antiretroviral therapy
cord-022527-a0x6lws3	2012	The role of the eosinophils as key players in the pathophysiology of asthma has been debated, despite evidence that the cells are present and activated in the airway lumen and tissue 1 of patients with current asthma; are increased in number when asthma is uncontrolled 2 or severe 3 and decreased when asthma is controlled 4 ; and treatment strategies that aim to control airway eosinophilia are significantly more effective and less expensive in improving asthma control 5,6 and decreasing asthma exacerbations compared to guideline-based clinical strategies. 11 Since allergic asthma is primarily a T-helper type 2 (T h 2)-mediated disease, it is not surprising that cytokines driving eosinophilia are T h 2 cell products: specifically, granulocyte-macrophage colony-stimulating factor (GM-CSF), interleukin-3 (IL-3), and interleukin-5 (IL-5), which signal through specific high-affinity cell-surface receptors linked to a common b-chaindall of which can act as eosinophil growth factors that promote formation of eosinophil/basophil (Eo/B) colony-forming units (CFU) in functional assays.
cord-022594-fx044gcd	2009	If a patient presents with a history of two or more attacks, but objective clinical evidence only suggests one lesion, the following additional data is needed to confirm the diagnosis: the disease process has to be disseminated in space as demonstrated by MRI; alternatively, two or more MRI-detected lesions consistent with MS plus positive CSF would suffice to meet the newly defined criteria. The EBM calculations regarding this trial show an RRR of 24%, and ARR of 11%, and an NNT of 9 patients over 2 years in order to prevent one conversion to "clinically definite MS." These two studies provide support for considering early treatment in patients presenting with first attack, in the presence of multiple asymptomatic MRI lesions, but further studies are needed to determine whether this approach will provide a prolonged benefit on disease course.
cord-022633-fr55uod6	2012	Staff satisfaction was evaluated through pre/ post-shift and study surveys; administrative data (physician initial assessment (PIA), length of stay (LOS), patients leaving without being seen (LWBS) and against medical advice [LAMA] ) were collected from an electronic, real-time ED information system. Communication Background: The link between extended shift lengths, sleepiness, and occupational injury or illness has been shown, in other health care populations, to be an important and preventable public health concern but heretofore has not been fully described in emergency medical services (EMS Objectives: To assess the effect of an ED-based computer screening and referral intervention for IPV victims and to determine what characteristics resulted in a positive change in their safety. Objectives: Using data from longitudinal surveys by the American Board of Emergency Medicine, the primary objective of this study was to evaluate if resident self-assessments of performance in required competencies improve over the course of graduate medical training and in the years following.
cord-022646-f7qs1obg	2010	The authors in this study report the incidence and risk factors associated with the development of solid tumors in 4349 pediatric and adult patients who underwent allogeneic stem cell transplant (SCT) for acute myelogenous leukemia (AML) in CR1 or chronic myelogenous leukemia (CML) in first chronic phase. The lower hOCT1 mRNA expression level in LEU from IMA naïve de novo CML patients compared to healthy volunteers as well as its progressive increase after the start of IMA therapy could be explained by the initial presence and subsequent gradual disappearance of tumor cells from the measured cell population. To confirm this hypothesis, we performed an analysis on the relationship of hOCT1 expression with the percentage of immature myeloid cells in the LEU samples (as a marker of disease burden) obtained from IMA naïve de novo CML patients.
cord-022650-phsr10jp	2018	0685 | Skin prick test reactivity to aeroallergens in adult allergy clinic in a tertiary hospital: a 12-year retrospective study Results: Five different human sera were screened for specific IgE level against 29 different allergen sources using test methods of three different suppliers. Conclusion: This multicenter prospective study confirmed that stepwise single-dose OFC to egg will help to clarify the severity of egg allergy, and will contribute to improved food allergy manageMethod: The study design was a retrospective cohort study extracting data from the electronic chart of children older than 4 years who visited our out-patient clinic for egg or milk allergy and who underwent an oral food challenge test (OFC) twice within 24 months between November 2013 and December 2017. Results: In the base case analysis, using Italy clinical practice patients with moderate-to severe allergic rhino-conjunctivitis (SS ranging from 6 to 15 points) and a mean age at entry of 21 years, both SCIT and SLIT were associated with increased cost but superior efficacy compared to pharmacotherapy alone.
cord-022653-qa1uph35	2017	
cord-022658-mq91h15t	2008	Patients with rhinitis or asthma caused by allergens for which the clinical efficacy and safety of SIT have been documented by placebo-controlled, doubleblind studies, and those requiring daily pharmacotherapy for longer periods (e.g., preventive treatment during a pollen season or perennially) are candidates for SIT. in most cases when significant airway comorbidity is present (asthma, chronic sinusitis, nasal polyps, or otitis media with effusion) when the diagnosis is in question or special diagnostic testing is required when occupational rhinitis is suspected, to distinguish between clear-cut allergic reactions and toxic or nonallergic reactions when poor symptom control necessitates a consultation for environmental control measures, pharmacotherapy, or specific immunotherapy when medication side-effects are intolerable when rhinitis is only part of a complex series of mucosal allergies.
cord-022659-chwk2bs4	2004	We investigated the usefulness of informant-based data in Alzheimer''s disease (AD) by comparing caregivers'' subjective evaluations of 83 probable A D patients'' performance on an abbreviated version of the Memory Self-Report Questionnaire to objective evaluations derived from an extensive battery of neuropsychological tests and to clinicians'' evaluations. Compared with 89 subjects (mean age 75.2 yr; 34 men, 55 women) with dementia of the Alzheimer type (DAT), there were no significant group differences for comparable Clinical Dementia Rating stages of dementia for measures of language, Activities of Daily Living, or general cognition. The mean age at onset did not differ significantly between handedness groups (F [ l,lOO] = .82), but the mean duration of symptoms ( Alterations in the optical properties of brain can be used to detect pathological changes in patients with Alzheimer''s disease (AD).
cord-022888-dnsdg04n	2009	Methods: Phospho-specific Western blot analyses were performed to verify the functionality of the different IFN-g pathway components, intra-and extracellular flow cytometry experiments were employed to determine the expression of antigen processing components and HLA class I cell surface antigens, quantitative real time-PCR experiments to confirm the absence of JAK2 and presence of pathway relevant molecules as well as, genomic PCR and chromosome typing technique to prove the deletion of JAK2. In order to accomplish these objectives we induced priming or tolerance of ovalbumin (OVA 323-339 peptide)-specific T cells from DO11.10 TCR transgenic mice in vitro or, following adoptive transfer of near physiologically relevant numbers of such cells into recipients, in vivo and correlated functional outcome (via proliferation and cytokine readout assays or antibody production) with E3 ubiquitin-protein ligases expression and the ubiquitination status of the TCR signalling machinery.
cord-022940-atbjwpo5	2016	We have studied the effect of inhibition of IRE1 (inositol requiring enzyme 1), which is a central mediator of endoplasmic reticulum stress and controls cell proliferation and tumor growth, on hypoxic regulation of the expression of different proliferation related genes in U87 glioma cells. Transient inhibition of Akt and mTOR protein kinase activation in tumor cells followed by reactivation of signaling pathway did not result in a time-dependent difference on EGFR, HER2 and HER3 expression levels. In our study we aimed to determine cytotoxic effect of RES in K562 human CML cell line and to evaluate the expressions of miRNAs that are associated with genetics of leukemia after treatment with RES; to investigate target genes of miRNAs which show significant expression alterations and molecular mechanisms of RES treatment.
cord-023017-k6edtg58	2006	14/55 (25%) patients in AC who did not discontinue by week 24 received ribavirin dose reduction in comparison to 31/108 ( The clinical outcome in response to combination therapy for treatment of chronic hepatitis C virus (HCV) infection appears to be different for Caucasian versus African American patients. Over the period of combination therapy, most patients in which serum virus titers were reduced to non detectable levels had significant increases in T cell responses to HCV proteins. CHRONIC Background: Recent large prospective trials demonstrated that the combination therapy of interferon (1FN)-alphalribavirin significantly increased the ratio of a sustained virological response in patients with chronic hepatitis C in comparison with IFN monotherapy, especially in patients with high HCV-RNA titer and genotype lb. Results: Patients with chronic HCV infection showed higher MxA gene expression levels than healthy controls, indicating that hepatitis C virus induces IFN production.
cord-023033-tgt69ir6	2006	Methods: We performed a retrospective analysis comparing outcomes, and the incidence, timing, and severity of histologic recurrence of HCV following transplantation in patients who underwent living donor liver transplant compared to recipients of cadaveric organs. Local liver immune responses are thought to play a major role in chronic autoimmune diseases directed at biliary epithelium.Using the apical sodium dependent bile acid transporter (ASBT) promoter to drive biliary epithelial cell -specific expression of a membrane form of ovalbumin (OVA), we have previously developed OVA-BIL transgenic mice. Thus, our AIM was to ascertain whether Kupffer cells express death ligands and contribute to hepatocyte apoptosis and liver fibrosis in the bile duct ligated mouse, an animal model of cholestasis. Control experiments confirmed that Y2 protein inhibited IFNa-induced ISRE-mediated signaling in Huh-T7 cells; relative luciferase activity was reduced from 653 (pH771 IFNP nAb increased HCV core Ag replication by 42% and 23% compared to no treatment (p=O.O1).
cord-023049-fio7cjj5	2017	Clinical efficacy (Medical Research Council sum score, 10-m walk, modified Inflammatory Neuropathy Cause and Treatment score, Overall Neuropathy Limitations Scale, Romberg test) and patient-reported outcomes (36-item Short Form Health Survey , Life Quality Index [LQI] ) were assessed at baseline and at regular intervals until the final visit (10-14 months after switching). To explore the issue of early biomarkers in FAP, we performed skin biopsy and compared IENF density with parameters of nerve conduction studies (NCS) and quantitative sensory testing (QST) on 36 subjects (23 men, aged 55.1 ± 11.1 years) with genetic confirmation of TTR-A97S: 17 patients and 19 carriers. Results: The Gly112Ser mutation causing CMT1C is a mild form of CMT, as patients walked on time, had less weakness than those with Charcot-Marie-Tooth Disease type 1A (CMT1A), had a Charcot Marie Tooth neuropathy score (CMTNS) indicative of mild disease, and had faster ulnar and median motor nerve conduction velocities compared to those with CMT1A.
cord-023157-0lqlx2rv	2013	The patients revealed the increase of free fatty acids level (2.19 AE 0.10) mmol/l/ml, that meaningfully differed from such indexes in the control group (P < 0.001) and low level of adiponektin (3.70 AE 0.70) mg/ml that confirms their role in development of NAFLD even for persons with normal body weight after the presence of abdominal type of adipose tissue distribution. Results: This study has shown effectiveness in reduction in fasting blood glucose (P < 0.01), systolic blood pressure (P = 0.03), diastolic blood pressure (P = 0.01), weight (P = 0.03), added sugar (P = 0.03) and fat consumption (P < 0.01) while improving physical activity (P < 0.01) and insulin sensitivity (P < 0.01) in the intervention group when compared with the control group at follow up assessment. Conclusion: Our study shows that infiltration of macrophages in human adipose tissue, estimated by the expression of macrophage markers, is increased in subjects with obesity and diabetes and associated with insulin sensitivity and serum lipid levels independent of BMI.
cord-023168-cd7adns8	2013	The most useful laboratory measure of iron status Low value is diagnostic in the presence of anaemia Very high values (>100 µg/L) usually exclude iron deficiency'' Being an acute-phase protein, it increases in inflammatory conditions, and certain malignancies, making it unreliable Also increased in tissue damage especially of the liver Levels are falsely decreased in vitamin C deficiency and hypothyroidism Erythrocyte zinc protoporphyrin An intermediate in haem biosynthesis and elevated concentrations indicate interrupted haem synthesis due to iron deficiency when zinc is incorporated in place of iron Can be measured on a drop of blood with a portable haematofluorometer Small sample size makes it very useful as a screening test in field surveys, particularly in children, and pregnant women where inflammatory states may not co-exist Red cells should be washed before measurement (serum bilirubin and fluorescent compounds like some drugs can give falsely high values) although not often done Lead poisoning can give falsely high values Rarely acute myeloid leukaemia and sideroblastic anaemia give slightly high values Useful in that it is not increased in thalassaemias WHO recommends normal level >70 µmol/mol haem Iron studies Serum iron concentration represents the iron entering and leaving the circulation.
cord-023169-obupqcua	2013	The severe illness, characterized by febrile illness with jaundice, acute renal injury and bleeding, is recognized as Weil''s disease, though many different local names have been used such as Fort Bragg, mud, swamp and sugar cane fevers. Complications such as cholestatic jaundice, aseptic meningitis, acute renal injury, haemorrhage especially in the lung and myocarditis can occur and lead to a fatal outcome. 24 Complications such as jaundice, acute renal injury, haemorrhage, especially pulmonary haemorrhage, aseptic meningitis, myocarditis, shock, occur early during the course of illness. Acute pancreatitis has been reported rarely, although serum amylase may be raised in up to 60% of patients with severe disease due to renal impairment. Nowadays, the term ''Weil''s syndrome'' usually refers to the extremely severe form of leptospirosis, characterized by the combination of jaundice, renal dysfunction, and haemorrhagic diathesis, especially pulmonary haemorrhage. Acute febrile illness accompanied by jaundice and renal failure should always include leptospirosis in the differential diagnosis.
cord-023186-gqltd6u0	2019	Methods: This is a one-year retrospective study that was conducted in our pediatric intensive care unit (PICU) comparing the intervention failure rate of three different Noninvasive respiratory support modalities (bi-level positive airway pressure (BIPAP), continuous positive airway pressure (CPAP) and HFNC) for infants and young children between the ages of 1 month and 2 years admitted with the diagnosis of bronchiolitis. The aim of the study was to determine the association between Methods: Ninety children aged between > 28 days to < 5 years hospitalized with diagnosis of severe CAP in the Pediatric Department of West Nusa Tenggara Province General Hospital from January to October 2018 were enrolled. Arterial blood gases, respiratory rate, peak inspiratory pressure (PIP) and mean airway pressure (MAP) of rat lung during respiratory support, wetto-dry lung weight ratio, lung homogenate and/or bronchoalveolar lavage fluid tumor necrosis factor-α, macrophage inflammatory protein-2, interleukin-6 and total protein levels were measured and compared among groups after study completion.
cord-023211-kt5gt26t	2007	Previous studies performed using fluorescence halide efflux measurements and short-circuit current voltage clamp have shown that treatment with PPARγ (peroxisome proliferator activated receptor gamma) agonists, such as pioglitazone and FLL (FMOC-L-leucine), resulted in an increased biosynthesis and trafficking of ∆F508-CFTR to the cell surface. Physiology, School of Medical Sciences, University of Bristol, Bristol, United Kingdom Recent progress in the development of small molecule correctors and potentiators capable of restoring CFTR function have increased the need for pre-clinical test models including cultured airway epithelial cells from human CF patients as well as CF mouse models. Clinical studies have linked increased sputum and peripheral blood neutrophil MPO activity with increased airflow obstruction in cystic fibrosis (CF) patients of the same age, gender, airway bacterial flora, and CFTR genotype. Because patients expressing low levels of normal CFTR mRNA (5-20%) have mild disease symptoms, these studies demonstrate that the incorporation of the ciliated cell-specific FOXJ1 promoter into gene therapy vectors may be useful for treatment of CF.
cord-023216-avn8f2w3	2004	• relevant past history • recently recommended home physiotherapy program including inhalation therapy (agents, order and timing), airway clearance therapy (ACT) and physical exercise program and adherence • the possibility of gastroesophageal reflux 5 in relation to physiotherapy • clinical status including subjective and objective measures of the following -amount, color, consistency and ease of expectoration of sputum -oximetry/pulmonary function tests/peak expiratory flow rate -breath sounds on auscultation, respiratory rate and pattern of breathing -exercise tolerance (current activity & incidental exercise/ exercise tolerance tests) -musculo-skeletal problems (posture, pain, muscle tightness/weakness, oedema) -urinary incontinence during coughing and forced expirations Assessment of health related quality of life (HRQOL) in children and adolescents with cystic fibrosis (CF) is important to better understand disease and treatment-related factors that impact function and well-being, and to evaluate the effectiveness of therapies and methods of drug delivery.
cord-023239-06a03o14	2016	The basics of inhaler technique / device / adherence / allergen exposure are all being maintained A retrospective analysis of follow-up of children with difficult asthma for up to six years revealed that those in whom underlying modifiable factors were identified and addressed had an improvement in lung function and reduction in exacerbations over time, while being able to reduce maintenance dose of inhaled steroids such that the majority fell below the threshold for problematic severe asthma 4 . Long-term follow up of children investigated in infancy and reassessed in later childhood have so far showed that reduced baseline lung function in symptomatic infants was significantly associated with subsequent respiratory morbidity as well as with the need of anti-asthma medication at the age of 3 years.
cord-023288-sqr33y72	2008	Results Data indicate splice variant expression in dendritic cells from asthmatic patients is influenced by asthma severity. Methods Randomized controlled trials (RCTs) of GORD treatment in adults or children that reported asthma health outcomes and had symptomatic GORD were included and assessed in accordance with the standard Cochrane systematic review process. Results 11 male (44%) and 14 female (56%) patients with moderate to severe persistent asthma (mean age 44 years, SD = 11) participated. Methods A comprehensive range of intracellular T-cell and monocyte proand anti-inflammatory cytokines/chemokines was investigated in peripheral blood from 5 OSA patients and 5 aged-matched control subjects (with no evidence of sleep problems) using multiparameter flow cytometry. Methods Following completion of a 12-month exercise study, which included a supervised program (Intervention, n = 18) and control group (Control, n = 17), COPD subjects [mean age (SD): 66 (8); mean FEV1 (% predicted) = 56% (19)] were asked to complete a questionnaire.
cord-023298-ysur3sjq	2011	
cord-023302-p9pxz44a	2011	Expression of MR, CD91 and CD31 were decreased in patients with NEA or COPD, but not signifi cantly changed in EA Conclusion Impaired sputum-macrophage phagocytosis of apoptotic cells in NEA is associated with reduced expression of key macrophage recognition molecules. Conclusions Subjects with severe persistent asthma have an eating pattern of lower diet quality with higher intakes of fat and lower intakes of fi bre than healthy controls, which is related to lower lung function and increased airway infl ammation. Support and Confl ict of Interest Nil. Methods We performed a retrospective chart review of all adult patients who had an ICC over a 24-month period within a tertiary hospital respiratory service. The objectives of our study were to (1) determine the point prevalence and identify viruses associated with exacerbations and (2) evaluate clinical and investigational differences between viral infection positive and negative exacerbations in children with non-CF bronchiectasis.
cord-023303-fxus38mp	2008	Results Data indicate splice variant expression in dendritic cells from asthmatic patients is influenced by asthma severity. Methods Randomized controlled trials (RCTs) of GORD treatment in adults or children that reported asthma health outcomes and had symptomatic GORD were included and assessed in accordance with the standard Cochrane systematic review process. Results 11 male (44%) and 14 female (56%) patients with moderate to severe persistent asthma (mean age 44 years, SD = 11) participated. Methods A comprehensive range of intracellular T-cell and monocyte proand anti-inflammatory cytokines/chemokines was investigated in peripheral blood from 5 OSA patients and 5 aged-matched control subjects (with no evidence of sleep problems) using multiparameter flow cytometry. Methods Following completion of a 12-month exercise study, which included a supervised program (Intervention, n = 18) and control group (Control, n = 17), COPD subjects [mean age (SD): 66 (8); mean FEV1 (% predicted) = 56% (19)] were asked to complete a questionnaire.
cord-023305-5lb9kho6	2011	
cord-023306-3gdfo6vd	2010	Conflict of Interest No. Purpose We examined age trends in the distribution of stage at diagnosis in patients presenting with non-small cell lung cancer (NSCLC) at tertiary hospitals. Methods Eleven healthy male subjects, aged 28(8) (SD) years completed separate visits with (a) no restriction and (b) chest wall strapping to reduce FVC by 30 (7) Introduction Glossopharyngeal breathing (GPB) is used by competitive breath-hold divers to increase lung gas content above TLC to improve performance. Our DC culture results showed that both MHC-I and MHC-II expression on DCs from COPD were significantly down regulated compare to healthy controls, which could affect MHC restricted Ag presentation, and lead to a failure to activate responder T cells.
cord-023308-af5nihyi	2008	Results Data indicate splice variant expression in dendritic cells from asthmatic patients is influenced by asthma severity. Methods Randomized controlled trials (RCTs) of GORD treatment in adults or children that reported asthma health outcomes and had symptomatic GORD were included and assessed in accordance with the standard Cochrane systematic review process. Results 11 male (44%) and 14 female (56%) patients with moderate to severe persistent asthma (mean age 44 years, SD = 11) participated. Methods A comprehensive range of intracellular T-cell and monocyte proand anti-inflammatory cytokines/chemokines was investigated in peripheral blood from 5 OSA patients and 5 aged-matched control subjects (with no evidence of sleep problems) using multiparameter flow cytometry. Methods Following completion of a 12-month exercise study, which included a supervised program (Intervention, n = 18) and control group (Control, n = 17), COPD subjects [mean age (SD): 66 (8); mean FEV1 (% predicted) = 56% (19)] were asked to complete a questionnaire.
cord-023311-7wqdlha4	2010	Methods We determined the usefulness of preoperative lung function by spirometry in predicting regression of pulmonary hypertension after surgical correction of mitral stenosis among 20 patients who underwent mitral valve surgery at Philippine Heart Center from July to December 2009. Elderly patients exhibited a signifi cantly higher mortality rate that was independently associated with the following: age; residence status; confusion, urea, respiratory frequency and blood pressure (CURB) score; comorbid conditions; and failure of initial therapy. Methods A total of 40 patients (Male: 50%; Female: 50%) admitted and diagnosed with HAP at our Center were followed up to investigate the rate of adherence of physicians on the diagnosis and treatment of HAP based on Level I and II ATS/IDSA 2008 recommendations and to determine its association with outcome (mortality, mechanical ventilation, ICU stay, hospital stay).
cord-023314-rwjxk8v4	2011	Expression of MR, CD91 and CD31 were decreased in patients with NEA or COPD, but not signifi cantly changed in EA Conclusion Impaired sputum-macrophage phagocytosis of apoptotic cells in NEA is associated with reduced expression of key macrophage recognition molecules. Conclusions Subjects with severe persistent asthma have an eating pattern of lower diet quality with higher intakes of fat and lower intakes of fi bre than healthy controls, which is related to lower lung function and increased airway infl ammation. Support and Confl ict of Interest Nil. Methods We performed a retrospective chart review of all adult patients who had an ICC over a 24-month period within a tertiary hospital respiratory service. The objectives of our study were to (1) determine the point prevalence and identify viruses associated with exacerbations and (2) evaluate clinical and investigational differences between viral infection positive and negative exacerbations in children with non-CF bronchiectasis.
cord-023331-jrvmgnu3	2008	
cord-023333-b7w9zrl6	2011	Expression of MR, CD91 and CD31 were decreased in patients with NEA or COPD, but not signifi cantly changed in EA Conclusion Impaired sputum-macrophage phagocytosis of apoptotic cells in NEA is associated with reduced expression of key macrophage recognition molecules. Conclusions Subjects with severe persistent asthma have an eating pattern of lower diet quality with higher intakes of fat and lower intakes of fi bre than healthy controls, which is related to lower lung function and increased airway infl ammation. Support and Confl ict of Interest Nil. Methods We performed a retrospective chart review of all adult patients who had an ICC over a 24-month period within a tertiary hospital respiratory service. The objectives of our study were to (1) determine the point prevalence and identify viruses associated with exacerbations and (2) evaluate clinical and investigational differences between viral infection positive and negative exacerbations in children with non-CF bronchiectasis.
cord-023343-y17z9w2x	2011	
cord-023346-8sqbqjm1	2005	• enhancement of automation/computerisation; • process control to provide an ''error-free pathway''; • (national) surveillance and trend analysis of results, preferably based on national working standards; • significantly increased sensitivity, especially from development of antigen/antibody ''combi'' assays (e.g. for HIV, and recently, for HCV); • awareness of HBsAg vaccine-escape mutants and design of assays to cope with this; • extension of range of agents and markers tested for (varies in different countries); • increasing range of assays available for testing donors with a relevant history of exposure to malaria or Chagas'' disease infection (for retrieval of otherwise wasted blood); • European Union''s in vitro diagnostics directive: this has caused some problems and reduced flexibility.
cord-023354-f2ciho6o	2005	• enhancement of automation/computerisation; • process control to provide an ''error-free pathway''; • (national) surveillance and trend analysis of results, preferably based on national working standards; • significantly increased sensitivity, especially from development of antigen/antibody ''combi'' assays (e.g. for HIV, and recently, for HCV); • awareness of HBsAg vaccine-escape mutants and design of assays to cope with this; • extension of range of agents and markers tested for (varies in different countries); • increasing range of assays available for testing donors with a relevant history of exposure to malaria or Chagas'' disease infection (for retrieval of otherwise wasted blood); • European Union''s in vitro diagnostics directive: this has caused some problems and reduced flexibility.
cord-023364-ut56gczm	2005	• enhancement of automation/computerisation; • process control to provide an ''error-free pathway''; • (national) surveillance and trend analysis of results, preferably based on national working standards; • significantly increased sensitivity, especially from development of antigen/antibody ''combi'' assays (e.g. for HIV, and recently, for HCV); • awareness of HBsAg vaccine-escape mutants and design of assays to cope with this; • extension of range of agents and markers tested for (varies in different countries); • increasing range of assays available for testing donors with a relevant history of exposure to malaria or Chagas'' disease infection (for retrieval of otherwise wasted blood); • European Union''s in vitro diagnostics directive: this has caused some problems and reduced flexibility.
cord-023483-owgs4syo	2020	
cord-023509-tvqpv6fp	2011	As a general rule, exposure to silica dust extends over many years, often 20 or more, before the symptoms of silicosis first appear: by the time the disease becomes overt clinically, much irreparable damage has been inflicted on the lungs. Confusingly, the term ''acute silicosis'' has since been applied to a further effect of heavy dust exposure in tunnellers, sand blasters and silica flour workers, namely pulmonary alveolar lipoproteinosis (see below), 71, 72 whilst the terms ''accelerated silicosis'' or ''cellular phase silicosis'' have been substituted for ''acute silicosis'' in referring to the rapid development of early cellular lesions. Asbestosis is defined as diffuse interstitial fibrosis of the lung caused by exposure to asbestos dust. The finely divided fume of several metals is highly toxic to the lungs and capable of producing severe acute and chronic damage to both the conductive airways and the alveoli, resulting in acute tracheobronchitis and bronchiolitis, diffuse alveolar damage, obliterative bronchiolitis and pulmonary fibrosis.
cord-023592-w96h4rir	2015	Conclusions: Although the risk of developing more serious gastric lesions increased as the number of virulence factor genes are accumulated in a given Hp strain, we did not find any significant differences or relationship in the cagA, vacA or babA2 status between the Hp isolates from patients with gastritis or peptic ulcer in this study. pneumophila at the serogroup level, it was used in two different outbreaks to demonstrate rapidly the identity of the sequences between strains responsible for severe human infection and those isolated in the hot water reservoir, suggesting a common origin. To determine the antimicrobial resistance in Salmonella and Shigella strains isolated from stool specimens during a 2-year period, from patients admitted to our clinics with a diagnosis of diarrhoea. In our study the susceptibility of 65 bacterial strains isolated in hospital environment (colonising or infecting patients or carried by German cockroaches) to antibiotics and chemical disinfectants was determined.
cord-023622-tul7bonh	1975	Certainly bacterial pathogens may cause both sporadic and epidemic gastroenteritis in children, but they cannot be isolated in up to 75% of cases.2, 3 Whilst it is true that some investigations suggest that enteroviruses or adenoviruses may occasionally cause localised outbreaks of gastroenteritis,4-7 others have shown that these viruses may be detected almost as frequently in controls as among patients. Employing negativestaining techniques on fsecal extracts, FLEWETT and his colleagues found similar particles in children with gastroenteritis in Birmingham 13; indeed, if virologists had only looked at such simply prepared specimens, there is no technical reason why these viruses could not have been detected, say, 15 years ago. Thus, existing evidence suggests that rotaviruses are the most important cause of infantile gastroenteritis throughout the world, but as yet only a limited number of specimens have been examined from those tropical areas where mortality-rates are particularly high.
cord-023669-3ataw6gy	2009	As the population of patients with cancer, organ transplants, vasculitides, and human immunodefi ciency virus (HIV) infection has grown, intensivists are seeing more and more patients with altered immunity. For instance, if a patient presents with severe hypoxemia and diffuse pulmonary infi ltrates, a health care provider who recognizes a prior splenectomy as the major predisposition to infection would focus the diagnostic evaluation and the empiric therapy on Streptococcus pneumoniae and Haemophilus infl uenzae. Patients with HIV infection develop clinical disease as a result of three basic processes: the direct effect of HIV on specifi c organs (e.g., cardiomyopathy, enteropathy, dementia); immunologically mediated processes (e.g., glomerulonephritis, thrombocytopenia); or opportunistic infections and tumors that are enabled by HIV-induced immunosuppression. For instance, if a patient with HIV infection and a CD4+ T lymphocyte count of 700 cells/µL presents with diffuse pulmonary infi ltrates, the diagnostic evaluation and empiric antimicrobial regimen should focus on S.
cord-023729-dipjubn7	2009	
cord-023833-xpfibjh2	2014	Embracing a safety culture, limiting the number of steps (''less is more''), enhancing and prompting clear prioritized information, patient-and familycentered care delivery (integration of values, beliefs and advanced directives), improved communication and coordination (hand-offs, physician extenders) are all needed for safe and efficient critical care delivery. The advances in information technology, medical informatics and human factors engineering, have provided a tremendous opportunity for the development of novel and user-friendly checklists and decision support tools that can be widely applied in a complex and busy acute care settings [9] . To be successful, these applications need to reduce information overload and the potential for error, facilitate adherence to practice guidelines and enable clear communication and collaborative decision Fig. 3 Outline of the structured approach to early recognition and treatment of acute illness. A structured, reliable and error-free approach to the management of acutely ill or injured patients during the early, most vulnerable period is facilitated by point-of-care checklists and algorithms containing brief prioritized information.
cord-023873-fidpskcs	2009	Finally, to date, the diagnostic utility of recently available non-culture based microbiological tools, including the detection of fungal antigens and the detection of Aspergillus-specific DNA through polymerase chain reaction (PCR) techniques, has not been properly validated in the non-haematology ICU population. In addition, typical ICU patients such as those with chronic obstructive pulmonary disease (COPD) or liver disorders were not considered amongst hosts at high risk for IA in the recently updated EORTC/MSG guidelines [2] . In a recent study published by our group [10] , patients with fever new lung infiltrates were screened for IA using galactomannan testing in bronchoalveolar (BAL) fluid. The concept that increasing fungal burden due to specific ICU treatments for other diseases than IA (e.g. steroids for septic shock) parallels the progression from subclinical to clinical aspergillosis, needs to be explored with more sensitive markers (e.g. PCR). Corticosteroid treatment as a risk factor for invasive aspergillosis in patients with lung disease
cord-023913-pnjhi8cu	2011	So while there has been no shortage of effort paid to improving Medicare, the one common theme in all of the recent initiatives is that dental care has been conspicuously 1 A new study by Hedlund, Jeffcoat, Genco and Tanna funded by CIGNA of patients with Type II diabetes and periodontal disease found that medical costs of patients who received maintenance therapy were $2483.51 per year lower than patients who did not. Examples of integrated care models do exist, such as that presented by (Heuer 2007 ) involving school-linked and school-based clinics with an "innovative health infrastructure." According to Heuer, "Neighborhood Outreach Action for Health (NOAH)" is staffed by two nurse practitioners and a part-time physician to provide "primary medical services to more than 3,200 uninsured patients each year" in Scottsdale, Arizona.
cord-024073-243addff	2020	All of the patients had deteriorated despite routine therapies in the previous week, and the agent is now listed as a treatment option for severe or critical cases with elevated IL-6 in the National Health Commission of the People''s Republic of China COVID-19 Diagnosis and Treatment Guide.(35) A very recent case study has described the successful use of Tmab in a patient on maintenance therapy for multiple myeloma who had received bortezomib, thalidomide and dexamethasone therapy approximately 4 years previously and had been on thalidomide maintenance since then. A systematic review of observational studies of corticosteroids administered to patients with SARS-CoV-1 reported no survival benefit and possible harm and increased mortality and secondary infections were noted with severe influenza A; however, the evidence quality was low.(43) A subsequent study noted in the WHO guidelines found no effect on mortality. Clinical course and outcomes of critically ill patients with SARS-CoV-2 pneumonia in Wuhan, China: a single-centered, retrospective, observational study
cord-024120-3eemj37r	2020	[10] [11] [12] I also worked on early efforts to leverage health information technology (IT) by linking lab and pharmacy data, 13, 14 demonstrate the value of integrating drug indication into computerized physician order entry (CPOE), 15 identify safety vulnerabilities in current CPOE systems, 16, 17 and conceptualize ways redesigning electronic clinical documentation redesign could prevent diagnostic errors. I believe we have squandered much of its potential to help us achieve the World Health Organization (WHO) Global Patient Safety Challenge aim of "Medication without Harm." 26 These areas of failure include poorly designed decision support, introduction of new types of errors associated with using CPOE systems, frustratingly inefficient work-flows and screens that lead to dangerous workarounds, suboptimal linkages between prescribing systems and pharmacy dispensing databases resulting in prescribers not knowing what drugs have actually been dispensed by pharmacies and pharmacies not knowing when drugs are discontinued by physicians, inadequate monitoring of patients prescribed medications (including adverse effects and adherence), and failure of prescribing systems to help prescribers know the drug-of-choice for a particular indication.
cord-024130-kgzegwon	2020	Conjunctival secretions from patients and asymptomatic contacts of COVID-19 cases may also spread the disease further into the community. In view of the presence of coronavirus in body fluids of patients, and SARS-CoV-2 being similar to SARS-CoV, the risk of transmission through conjunctival secretion and tear cannot be neglected. Patients with conjunctivitis may initially report to an ophthalmologist, possibly making the eye care physician to first suspect a case of COVID-19 (Lu et al. According to a recently published literature on COVID-19 conjunctivitis, tear sample and conjunctival swab are reported to be positive for the novel coronavirus. As per recent AAO guidelines, as a response to the state of national emergency due to COVID-19, eye care practitioners should reduce the number of outpatient The following preventive measures should be taken by the ophthalmologist in the outpatient clinic for general patients (Group 1 and 2) during such outbreaks: Evaluation of coronavirus in tears and conjunctival secretions of patients with SARS-CoV-2 infection
cord-024189-t7mbsr25	2008	A relatively disease-specifi c manifestation of GCA that is present in about half of the patients is jaw claudication: pain in the masseter or temporalis muscles caused by compromised blood fl ow in the extracranial branches of the carotid artery. Although a high erythrocyte sedimentation rate (ESR) is usually considered a hallmark of GCA, in a recent study 25% of all patients with positive temporal artery biopsies had normal ESRs before the initiation of glucocorticoid therapy (16) . Upregulation of acute phase reactants is helpful in distinguishing PMR from other pain syndromes, yet (as in GCA and TA) not all patients with active disease have elevated markers of infl ammation within their serum. Kawasaki''s disease (KD), once known as mucocutaneous lymph node syndrome, is a systemic infl ammatory disorder occurring in children that is accompanied by vasculitis and a risk of coronary artery aneurysms.
cord-024233-hrzpxdh0	2020	Circulating tumor DNA analysis to assess risk of progression after long-term response to PD-(L)1 blockade in NSCLC Optimal treatment duration of immune checkpoint inhibitors (ICI) in non-small-cell lung cancer (NSCLC) is not well established. Hellman and colleagues evaluated blood samples using Cancer Personalized Profiling by Deep Sequencing (CAPP-Seq) of 31 advanced NSCLC patients with baseline detectable ctDNA and experiencing long-term benefit to PD-(L)1 blockade (defined as progression-free survival-PFS 12 months) in surveillance. Baseline plasma tumor mutation burden predicts response to pembrolizumab-based therapy in patients with metastatic non-small cell lung cancer The phase III KEYNOTE 010 trial demonstrated survival improvement with pembrolizumab as compared with docetaxel in previously treated PD-L1 positive (cut-off 1%) advanced non-small-cell lung cancer (NSCLC) patients. Following this decision, brigatinib is now indicated as monotherapy for the treatment of adult patients with Anaplastic Lymphoma Kinase (ALK) positive advanced non-small-cell lung cancer previously not treated with ALK inhibitors.
cord-024614-6bu3zo01	2020	Based on the transmission characteristics of SARS-CoV-2 and the requirements for prevention and control of COVID-19, the authors proposed some concrete measures and practical strategies of managing emergency, limited-term, and elective pediatric surgeries during the epidemic period. Based on the transmission characteristics of SARS-CoV-2 and the requirements for prevention and control of COVID-19, the authors proposed some concrete measures and practical strategies of managing emergency, limited-term, and elective pediatric surgeries during the epidemic period. Based on the "Technical Guidelines for the Prevention and Control of New Coronavirus Infection in Medical Institutions (First Edition)," 17 "Diagnosis and Treatment Plan on the New Coronavirus inflicted pneumonia (Sixth trial edition, revised)" 2 (both released by the National Health Commission of China), "Recommendations for the Prevention and Control of General Surgery in the Background of New Coronavirus Outbreak," 6 and other relevant latest reports, we propose the following control measures and practical strategies for pediatric surgery practice during the COVID-19 epidemic.
cord-024651-578c9ut5	2020	Abstract/Case Report Text Introduction: Mutations in the gene encoding signal transducer and activator of transcription 3 (STAT3) cause autosomal dominant hyperimmunoglobulin E syndrome (AD-HIES) characterized by recurrent skin and sinopulmonary infections, atopic dermatitis, and elevated serum immunoglobulin E (IgE) levels. Objective: The purpose of this study is to increase awareness and improve diagnosis of primary immune deficiency (PID) in the heterogenous group of patients with autoimmune cytopenia (AIC) by identifying clinical characteristics and laboratory biomarkers that distinguish those with underlying PID, disease activity and guide mechanism-based targeted therapy. 7 Chief, Laboratory of Clinical Immunology and Microbiology/National Institute of Allergy and Infectious Diseases, NIAID/National Institutes of Health, NIH Abstract/Case Report Text We have previously used the artificial thymic organoid (ATO) system, based on the 3D aggregation and culture of a delta-like canonical Notch ligand 4-expressing stromal cell line (MS5-Dll4) with CD34+ cells, to study T cell differentiation from CD34+ cells obtained from patients carrying defects that are intrinsic to hematopoietic cells (RAG1-2, AK2, IL2RG) or that affect thymus development (DiGeorge syndrome).
cord-024795-xa7ke70d	2020	
cord-024833-e6vcf4un	2019	Approximately 80% of US hospitals rely on data and recommendations from the ECRI Institute to protect patients from unsafe practices and ineffective products, while the ISMP''s efforts to improve safety in patients have resulted in changes to clinical practice and public policy, including improvements in drug labelling, packaging, preparation and administration. The FDA has now announced the availability of a draft document entitled "Best Practices in Drug and Biological Product Postmarket Safety Surveillance for FDA Staff", which outlines the agency''s approach to timely postmarketing analyses of drugs and biologics, and "includes a high-level overview of tools, methods, and signal detection and evaluation activities, using varied data sources, for drug safety surveillance to provide a broader context and a general overview of our overarching effort and commitment in this area", says Woodcock. Analysis of spontaneous ADR reports to the European Medicine Agency''s EudraVigilance database has identified new safety signals for asthma drugs in paediatric patients, say authors of a study published in Drug Safety.
cord-024893-pd67o7l8	2020	
cord-024956-oht0v33s	2020	title: Thin-section Chest CT Imaging of Coronavirus Disease 2019 Pneumonia: Comparison Between Patients with Mild and Severe Disease The purpose was to compare radiological characteristics of COVID-19 pneumonia on thin-section CT upon admission between patients with mild and severe disease. Thus, the purpose of our current study was to compare radiological characteristics of COVID-19 pneumonia on thin-section CT between patients with mild and severe disease. We studied the findings on chest CT at hospital presentation in patients diagnosed with COVID-19 pneumonia, focusing our comparisons between the patients with mild and severe disease. As for characteristics in CT images, COVID-19 pneumonia seems to be more extensive in the severe form of disease, involving a larger number of lung segments. Clinical characteristics of 138 hospitalized patients with 2019 novel coronavirus-infected pneumonia in wuhan, china
cord-025157-7b3v5yct	2020	In the multivariate analysis, seven parameters were significantly associated with early intubation and ranked as follows by decreasing weight: Glasgow score, center effect, use of accessory respiratory muscles, lactate level, vasopressor dose, pH and inability to clear tracheal secretions. Several arguments have been put forward in favor of early ventilatory support in septic shock patients, as part of the bundle that should be introduced in the first hours Open Access *Correspondence: nicolas.lerolle@univ-angers.fr 31 Medical Intensive Care Unit, Angers University Hospital, Angers, France Full list of author information is available at the end of the article of care together with antibiotic, fluid, and vasopressor use. To assess use, timing and factors associated with tracheal intubation in septic shock patients, we conducted a multicenter observational prospective study in 30 intensive care units (ICUs) in France and Spain.
cord-025164-hqj22yxe	2020	ACh: Acetylcholine; AMG: Acceleromyography; ARDS: Acute respiratory distress syndrome; ASA: American Society of Anesthesiologists; CIM: Critical illness myopathy; CINM: Critical illness neuromyopathy; CIP: Critical illness polyneuropathy; DVT: Deep venous thrombosis; ED95: Effective dose that decreases the twitch by 95% from baseline; EEG: Electroencephalography; EMG: Electromyography; GRADE: Grading of Recommendations Assessment, Development, and Evaluation; ICP: Intracranial pressure; ICU: Intensive care unit; ICUAW: Intensive care unit-acquired weakness; KMG: Kinemyography; nAChR: Nicotinic acetylcholine receptors; NAP4: 4th National Audit Project; NMBA: Neuromuscular blocking agent; NMJ: Neuromuscular junction; OR: Operating room; OSA: Obstructive sleep apnea; PaO 2 /FiO 2 : Partial pressure of oxygen to fraction of inspired oxygen; pEEG: Processed electroencephalography; PNS: Peripheral nerve stimulator; RSII: Rapid sequence induction and intubation; SCCM: Society of Critical Care Medicine for all aspects of the work.
cord-025170-dtbm4ue1	2020	Resuscitation fluids are used to correct an intravascular volume deficit or acute hypovolemia; replacement solutions are prescribed to correct existing or developing deficits that cannot be compensated by oral intake alone [6] ; maintenance solutions are indicated in hemodynamically stable patients that are not able/allowed to drink water in order to cover their daily requirements of water and electrolytes [10, 11] . Despite the unexpectedly low volume of crystalloids, the authors found a small difference in the primary outcome, i.e., the incidence of major adverse kidney events within 30 days (composite of death, new renal replacement therapy or persistent renal dysfunction) in favor of balance solutions. Effect of a buffered crystalloid solution vs saline on acute kidney injury among patients in the intensive care unit: The SPLIT randomized clinical trial Effects of fluid resuscitation with colloids vs crystalloids on mortality in critically ill patients presenting with hypovolemic shock: the CRISTAL randomized trial
cord-025172-qg3jxgch	2020	We hypothesized mortality and rates of infectious and inflammatory complications would be higher in HIV positive (HIV+) trauma patients. We hypothesized that a HIV+ trauma cohort would have increased mortality rates, infectious complications (i.e., pneumonia, urinary tract infection (UTI), and sepsis), and inflammatory complications [i.e., acute respiratory distress syndrome (ARDS) and acute kidney injury (AKI)], compared to a propensity-matched HIV− group. TQIP patient inclusion criteria consists of age ≥ 16, presence of at least one valid trauma International Statistical Classification of Diseases and Related Health Problems (ICD) diagnosis code, blunt or penetrating mechanisms of injury, Abbreviated Injury Scale (AIS) score ≥ 3, and having data for hospital or emergency department disposition [13] . Using seven years of data derived from the TQIP database, we demonstrated no differences in mortality or rates of infectious complications between HIV+ and HIV− trauma patients.
cord-025176-f0frlpwh	2020	15 Most recommendations from public health officials have suggested that a steady decrease in the number of new COVID-19 cases over a period of 14 days (decreased incidence), associated with a similar trend in hospital and ICU admission, is necessary to consider resuming elective surgery (box 1). However, it is important that a staged system be implemented with partial reopening followed by interval full reassessment of the system, as the incidence of COVID-19 infection may have decreased further, allowing the opening of more operating rooms, increasing the overall number of procedures performed. After a functional period in stage 1, a reassessment of the COVID-19 infection in the community and in the hospital should occur to determine if adding operating room capacity and increasing the number of surgical cases is warranted.
cord-025666-u8w4sk07	2020	These surveys provide us with an important view of an individual''s health across multiple domains which go beyond any pathophysiological measure and there is substantial literature validating PROMs in particular, for use after burn injuries [6, 7] . Notwithstanding, the availability of computerised adaptive testing, the instruments established and emerging include: a) Medical Outcome Study Short Form -36 item (SF-36) [9] for generic QoL measurement in adult burn patients. The SF-36 is a widely applied instrument and the most often used generic instrument to assess QoL in burns [8, 10] , it is validated for use in the adult burn patient population [11] , and it covers many domains that are also covered by the most applied burn specific QoL measure [12] . A systematic review of patient-reported outcome measures used in adult burn research Demonstration of the validity of the SF-36 for measurement of the temporal recovery of quality of life outcomes in burns survivors
cord-025749-mip9mkef	2020	
cord-025990-nj4ah2yz	2020	OBJECTIVES: To investigate the antimicrobial resistance patterns of multidrug-resistant Acinetobacter baumannii (MDRAB) in patients in pediatric intensive care units (PICU) in order to determine a guide for the empirical antibiotic treatment of MDRAB. Thus, in order to determine a guide for the empirical antibiotic treatment of MDRAB, the authors investigated the antimicrobial resistance patterns of MDRAB in patients in pediatric intensive care units (PICUs). In 2016, the isolates were found to have a resistance rate of above 90% against all antibiotics except for colistin and trimethoprim/sulfamethoxazole (Table 3 ). In a worrying study of MDRAB antibiotic susceptibility, it was reported that the colistin resistance rate increased to 35.7% in Iran [19] . A 5-year surveillance study on antimicrobial resistance of Acinetobacter baumannii clinical ısolates from a tertiary Greek hospital Antimicrobial susceptibility patterns of an emerging multidrug resistant nosocomial pathogen: Acinetobacter baumannii
cord-026025-xqj877en	2009	
cord-026031-hnf5vayd	2009	Fresh whole blood Coagulopathy with active hemorrhage (disseminated intravascular coagulation, thrombocytopenia; massive acute hemorrhage; no stored blood available) Stored whole blood Massive acute or ongoing hemorrhage; hypovolemic shock caused by hemorrhage that is unresponsive to conventional crystalloid and colloid fluid therapy; unavailability of equipment required to prepare blood components Packed red blood cells Nonregenerative anemia, immune-mediated hemolytic anemia, correction of anemia before surgery, acute or chronic blood loss Fresh frozen plasma Factor depletion associated with active hemorrhage (congenital: von Willebrand''s factor, hemophilia A, hemophilia B; acquired: vitamin K antagonist, rodenticide intoxication, DIC); acute or chronic hypoproteinemia (burns, wound exudates, body cavity effusion; hepatic, renal, or gastrointestinal loss); colostrum replacement in neonates Frozen plasma Acute plasma or protein loss; chronic hypoproteinemia; (contains stable colostrum replacement in neonates; hemophilia B and clotting factors) selected clotting factor deficiencies Platelet-rich plasma* Thrombocytopenia with active hemorrhage (immune-mediated thrombocytopenia, DIC); platelet function abnormality (congenital: thrombasthenia in Bassett hounds; acquired: NSAIDs, other drugs) Cryoprecipitate
cord-026392-cvb44v5v	2020	RESULTS: Among 279 eligible critically ill patients, 204 (73%) were omitted from the study due to challenges and barriers in the inclusion process. Previous studies have identified obstacles when performing research in critically ill patients at intensive care units (ICU) related to challenges in the recruitment process [1] [2] [3] [4] . The legislation and clinical practice vary across the world, and a prior PubMed search did not disclose any resent Scandinavian research covering the overall barriers and challenges in the process of including critically ill patients in clinical studies. The purpose of this study was to identify practical, medical, legal or ethical barriers and challenges in the process of including critically ill patients in the Norwegian Intensive Care Unit Dalteparin Effect (NORIDES) study. The study revealed that most critically ill patients at ICU were unable to provide written, informed consent for study participation.
cord-026653-094bk0t0	2020	This review will evaluate reports of allergic and substance-specific infusion reactions (IR), injection-site reactions (ISR), hypersensitivity reactions (HSR), urticaria, and anaphylaxis caused by BSs. The most common indications for the use of biologics in lung diseases are allergic and severe uncontrolled asthma. The Australian Public Assessment report and the FDA label did not observe an increase in the incidence of severe immunological and anaphylactic reactions related to the use of nintedanib [25, 26] . According to the recent BCCA Drug Manual, it was reported that HSR including anaphylaxis can develop in ≤ 1 % (severe < 1 %), IRs in 1 % (severe ≤ 1 %), and immune-mediated rash in 8-18 % ( severe ≤ 1 %) of patients [58] . The FDA''s 2019 label reported infusion-related reactions in 11-24 % of patients (placebo 7-18.0 %), acute urticaria in 1-2 %, acute HSRs in 1.5 %, pruritus in 4 %, and serious IRs and anaphylaxis in < 1 % [159] .
cord-026846-3u3x52f8	2020	The authors pooled data on 19,833 patients from 18 randomized trials evaluating outcomes after percutaneous coronary intervention, categorized according to the presence of angiography core laboratory-confirmed moderate or severe coronary artery calcification in any target lesion. This has resulted in an inability to care for patients with valvular and structural heart disease in a timely fashion, potentially placing these patients at increased risk for adverse cardiovascular complications, including CHF and death. In this document, the authors suggest guidelines for how to triage patients in need of structural heart disease interventions and provide a framework for how to decide when it may be appropriate to proceed with intervention despite the ongoing pandemic. In particular, the authors address the triage of patients in need of transcatheter aortic valve replacement and percutaneous mitral valve repair. The authors also address procedural issues and considerations for the function of structural heart disease teams during the COVID-19 pandemic.
cord-026868-z9gozm2w	2020	This high prevalence of simulation practices in nursing programs has led to opportunities to research this topic from various angles, including its impact on students'' skill performance, self-efficacy, self-confidence, self-satisfaction, and clinical knowledge acquisition. Results: The analyses revealed various training and communication issues including the lack of harmony among the team members (e.g., regarding understanding and performing their assigned roles as well as delegating and conducting delegated tasks) and the students'' inability to effectively communicate with the patient as a valuable source of information and to make appropriate and timely clinical decisions regarding patient assessment. 2 This widespread use of simulations in nursing programs has led to opportunities to research this topic from many angles, including its impact on students'' skill performance, 6, 7 self-efficacy, [8] [9] [10] self-confidence and satisfaction, [11] [12] [13] and, most importantly, clinical knowledge acquisition.
cord-026879-gwzrdeb1	2020	CASE PRESENTATION: In the present case report, we discuss two patients who presented with mild symptoms and CT imaging not suggestive of COVID-19, but subsequently had a rapid deterioration, with severe involvement happening in CT imaging. A chest CT scan was obtained from the patient which showed nonspecific findings (few linear and subsegmental atelectasis at lower lobes) which were not suggestive of COVID-19. The patient again presented to the emergency Fig. 1 The first and second rows show the chest CT scan which was obtained at the emergency department, which shows no significant findings consistent with COVID19 except some linear atelectasis. In conclusion, the clinical course of COVID-19 may not follow that of which is presented in available scientific literature, and more attention should be paid to patients not being treated in hospitals, as they can present severe symptoms without any prior radiologic signs.
cord-026991-75sbxnsc	2020	This retrospective study aims to determine and compare the pulmonary changes in Iraqi patients with COVID-19 disease across the first two weeks after onset of symptoms using computerized tomography (CT) scan. With the continuing COVID-19 pandemic and the increasing number of patients suspected or confirmed with the disease, the radiologists are facing more and more cases because of the paramount role of imaging, particularly chest CT scans in the workup algorithm. In the current study, we compared the pulmonary radiological features associated with COVID-19 infection between two groups of patients, who underwent chest CT scans after different durations from initial clinical presentations. In conclusion, there is a significant difference in the pulmonary manifestations associated with COVID-19 infection when CT scan conducted earlier or later after the clinical presentation, with alteration, on one hand in the proportion and combination of GGO (becoming less) and consolidation (getting more) and, on another hand, more diffuse and multilobar distribution at the second week.
cord-027259-f4sgobcz	2020	On the basis of the analysis of 12 modern prognostic models from 10 countries we can identify some of the most stable (main) predictors for the causes of intra-hospital mortality: age [16, [20] [21] [22] [23] [24] ; type of stroke [25] ; lesion location [25] ; level of consciousness [11, 20, 23, 25, 26] upon admission; NIHSS stroke severity [10, 21, 22, 24] ; comorbidity [22, 27] , Charlson comorbidity index [23] , Atrial fibrillation [11, 22] , case history Transitor ischemic attack (TIA) [31]; hospital complications (high intracranial pressure) [16] , pneumonia, seizures, anxiety/depression, infections, limb pains and constipation [22, 27] . Early mortality in each subgroup was associated with a number of demographic, clinical, and instrumental-laboratory characteristics based on the interpretation of the results of calculating the significance of predictors of binary classification models by machine learning methods from the Scikit-Learn library 2 .
cord-027266-jdti1pwa	2020	In the first approach, the authors study risk factors for atrial fibrillation, predicting the probability of AF development for a specific period using regression analysis. Using the system for ranking we need to create an easy-to-use and interpretable model for assessing the risk of developing atrial fibrillation in patients with thyrotoxicosis. The main objective of the study is to create a practical method for assessing the risk of developing atrial fibrillation in a patient with thyrotoxicosis. The age and heart rate detected at the first examination also increase the probability of atrial fibrillation in patients with thyrotoxicosis and supraventricular extrasystole. This decision tree is a fairly simple and well-interpreted method that can be useful as part of a support and decision-making system for medical professionals working with patients The Atrial Fibrillation Risk Score for Hyperthyroidism Patients with thyrotoxicosis.
cord-027551-a92lv4sh	2020	We have therefore hypothesized that, similar to what was observed with the sleep impairment [16] , the early postoperative HRQL could be improved by ameliorating the quality of nutrition and respiration after esophagectomy and designing a randomized control trial to assess if the adoption of nutritional and respiratory counseling may be effective in enhancing the quality of postoperative QoL after esophagectomy for cancer. This randomized controlled trial aimed to assess the effectiveness of nutritional counseling and/or respirology counseling on postoperative quality of life after esophagectomy for cancer. Thus, the aim of this study was to evaluate the effect of the nutritional and respiratory counseling on quality of life after esophagectomy for cancer. However, nutritional counseling did not influence appetite loss, global quality of life, or eating issues at 3 months after surgery, and receiving nutritional counseling did not result in any significant changes in additional nutritional measures (PA, FFm, Kcal, prot, BMI). Feb-Mar) Longterm nutritional outcome and health related quality of life of patients following esophageal cancer surgery: a meta-analysis
cord-027677-fc410vto	2020	Acute retroviral syndrome, a manifestation of acute HIV infection, typically has an incubation period that ranges from 3 to 5 weeks with symptoms that include fever, nonexudative pharyngitis, lymphadenopathy, arthralgia, myalgia, and lethargy. haemolyticum pharyngitis include peritonsillar abscess (PTA) similar to that of GA␤HS infection (see later). Periodic fever associated with aphthous stomatitis, pharyngitis, and cervical adenitis (PFAPA) typically occurs in patients younger than 5 years of age. GA␤HS requires antimicrobial therapy in order to prevent the development of acute rheumatic fever (ARF) and to reduce the risk of suppurative complications such as PTA, retropharyngeal abscess, cervical adenitis, sinusitis, mastoiditis, otitis media, and bacteremia leading to metastatic infection. It usually occurs in older school-age children, adolescents, and young adults as a complication of recurrent bacterial tonsillitis or a secondary bacterial infection following viral pharyngitis.
cord-027678-k64whepc	2020	
cord-027805-p0bhju1s	2020	
cord-027860-s97hdhh6	2020	Although common upper respiratory bacterial pathogens, such as Moraxella (Branhamella) catarrhalis, Streptococcus pneumoniae, and Haemophilus influenzae, may be isolated from patients with acute bronchitis, their relevance is questionable because these bacteria can be present in the respiratory tract of healthy individuals. In the treatment of Bordetella pertussis, early administration of a macrolide antibiotic and patient isolation will likely decrease coughing paroxysms and limit spread of disease (Braman, 2006) (SOR: A). Risk factors for Pseudomonas infection include severe structural lung disease (e.g., bronchiectasis) and recent antibiotic therapy, health care-associated exposures or stay in hospital (especially in the ICU). Patients who present with severe infection or whose infection is progressing despite empiric antibiotic therapy should be treated more aggressively; the treatment strategy should be based on results of appropriate Gram stain, culture, and drug susceptibility analysis. For suspected MRSA skin infections, oral treatment options include trimethoprim-sulfamethoxazole, clindamycin, and doxycycline of purulent material when performing incision and drainage in the event that the patient fails to improve and antibiotic coverage becomes necessary.
cord-028260-mja2jrgm	2020	
cord-028285-n4dommet	2020	With there being a short interval from the time of the first COVID-19 case presentation, to the development of a global pandemic, validated management algorithms to support changes in operative strategies are lacking. The key components of NHS preoperative patient screening for COVID-19 are: structured questionnaires with temperature monitoring, viral real-time polymerase chain reaction (RT PCR) for SARS-CoV-2, and chest imaging. Full PPE (fluid resistant gown, double gloving, visor or goggles, fit-tested FFP3 mask or respirator, disposable hat, shoe covers) should be worn in the operating rooms for any suspected or positive COVID-19 case, for AGP 38 (Table 3) , and for procedures for which the risk is unknown. All surgical cases require a discussion about the patient''s COVID-19 status, the degree of aerosol risk for each part of the procedure (induction of anaesthesia, extubation, and for all operative phases), with PPE requirement stated for each stage.
cord-028328-5lews3uw	2020	
cord-028379-ghudhac6	2020	
cord-028557-68jypaaw	2020	The possible reasons for the virus transmission to the healthcare worker could be due to (1) lack of sufficient quantity of personal protective equipment (PPE) at the most infected places; (2) PPE provided not meeting the quality standard requirements; (3) inadequate or unsuitable isolation chambers for testing of suspected patients; and (4) prevailing unhygienic conditions in the facilities where COVID-19 positive patients are treated. The healthcare worker who is standing outside the chamber inserts his hands through the long cuff gloves and collects the sample from either nose or throat of COVID-19 patient. At the deployed hospital, the first prototype COVSACK unit stands to be highly effective in preventing the transmission of COVID-19 virus to healthcare workers during sample collection from suspected persons, due its in-built features such as air tightness, use of long cuff gloves and automatic disinfectant spraying followed by thorough water flushing after each patient exits the kiosk.
cord-028590-rw0okd0p	2020	''Many hospitals have had to adapt to become urgent dental care hubs during the peak of the pandemic, with both the hospitals I work in beginning to start to resume some '' According to a new poll by the mental health charity Mind, many people who were previously well will develop mental health problems as a ''direct consequence of the pandemic and all that follows'', with the worst yet to come.'' routine services. '' As always, the impact will be greatest on the most vulnerable of the profession: new graduates, many of whom have lost their part-time jobs; young dentists leaving dental foundation training and potentially struggling to find their first associateship; and dental care professional colleagues who are significantly affected by the closure of practices and the expected lengthy return to the provision of dentistry over the coming months.
cord-028709-r1inj3ra	2020	
cord-028721-x6f26ahr	2020	Congenital decrease of germ cells occurs in numerous conditions, including trisomies 13, 18, and 21, some forms of primary hypogonadism such as Klinefelter''s syndrome, anencephaly, many cryptorchid testes, and in patients with posterior urethral valves and severe obstruction of the urinary ducts. 728, 729 Leydig cell hypoplasia This variant of male pseudohermaphroditism is defi ned by insuffi cient testosterone secretion 422 and the following characteristics: predominance of female external genitalia; absence of male secondary sex characteristics at puberty; absence of uterus and fallopian tubes and the presence of epididymis and vas deferens; 46XY karyotype; lack of response to human chorionic gonadotropin stimulation; absence of an enzymatic defect in testosterone synthesis; and small undescended testes that are gray and mucous on section.
cord-028907-m9psxg1f	2020	BACKGROUND: Dual antiplatelet therapy (DAPT) with aspirin and a P2Y12 inhibitor is the cornerstone for prevention ischemic events in patients with acute coronary syndromes (ACS) and undergoing percutaneous coronary intervention (PCI). J o u r n a l P r e -p r o o f 3 / 21 Background Dual antiplatelet therapy (DAPT) with aspirin and a P2Y12 inhibitor is the cornerstone to prevent stent thrombosis and atherothrombotic events in patients with acute coronary syndromes (ACS) and/or undergoing percutaneous coronary intervention (PCI) [1] [2] [3] . In order to test this hypothesis, we designed the Optimal antiPlatelet Therapy for high Bleeding and Ischemic RISK patients (OPT-BIRISK) trial, to determine if extended clopidogrel monotherapy will be superior to DAPT with clopidogrel and aspirin following completion of 9 to 12 months DAPT for ACS patients who received drug eluting stent (DES) implantation and possess both high bleeding and high ischemic characteristics.
cord-028982-kkzpqbry	2020	
cord-029112-u507i0t0	2020	Study ALXN1210-COV-305 is a multicenter Phase 3, open-label, randomized, controlled study designed to evaluate the safety and efficacy of intravenous (IV) ravulizumab + best supportive care (BSC), compared with BSC alone in patients with a confirmed diagnosis of SARS-CoV-2 infection, and a clinical presentation consistent with COVID-19 severe pneumonia, acute lung injury, or ARDS.
cord-029150-e242o2ml	2020	In early 2020, the COVID-19 outbreak complicated the diagnosis, treatment and rehabilitation of patients with substance use disorders and increased the risks of substance abuse and addictive behaviours, such as online gaming disorders, in the general public. It also adversely impacts the mental state of the general public in several ways and leads to broader symptoms, including anxiety, tension and insomnia, that may increase the risk of alcohol abuse, sedative and hypnotic drug abuse, and other addictive behaviours. 2 3 It is also of utmost importance to ensure the continuous, regular and effective treatment of existing patients with addiction problems, reduce the risk of drug relapse and prevent new cases of addiction during the pandemic. The screening of addictive substance use, prevention and education for clinic patients, as well as the timely identification, diagnosis and treatment of related mental and behavioural problems may all occur under stressful conditions.
cord-029183-3aotgq6m	2020	
cord-029211-6o7qn2y2	2020	In this study, we aimed to report the 5-year oncological outcomes, including local recurrence, metastatic disease, and survival. Patients age 18 years and older with T2T3 low rectal cancer, of maximum size 4 cm, who were clinically good responders after chemoradiotherapy (residual tumour ≤ 2 cm) were randomly assigned before surgery to either local excision or total mesorectal excision. The primary objective of this study was to assess the 5-year oncological outcomes of local recurrence, metastatic disease, disease-free survival, overall survival, and cancer-specific mortality, which were the secondary endpoints of GRECCAR 2. After 2 years, overall and disease-free survival tended to be improved in simultaneous as compared with delayed-resection groups (P 0.05), a tendency which persisted for OS after a median follow-up of 47 months. This retrospective monocenter study analyzed the shortand long-term outcomes of pancreatectomies associated with arterial resection for patients with either borderline (27%) or locally advanced (73%) pancreatic adenocarcinoma.
cord-029332-yn603pvb	2020	
cord-029466-9sy6icrm	2020	In the first 2 weeks, the meetings were focused on ensuring the availability of personal protective equipment (PPE), the shutting down of all neurology outpatient and most inpatient activities, establishment of virtual care activity and seeking volunteers for redeployment openings listed by Incident Command on the daily leadership calls. In order to expand the number of ICU beds, the larger unit, consisting of 18 beds, became an extension of the medical ICU (MICU) for patients with confirmed or suspected COVID-19 and was staffed by internal medicine (IM) physicians and residents. Neurological checks and National Institutes of Health Stroke Scale assessments were performed using video devices to limit exposure to HCPs. Consensus was reached between the stroke team, neurointerventional team and radiology on an amended policy to manage patients receiving thrombectomy during the pandemic. Several neurology residents were redeployed to provide care for patients admitted to the COVID-19 unit under the supervision of an IM staff.
cord-029547-9ei1ram3	2020	
cord-029606-2z1tw4xo	2020	An intensive community management strategy, including outreach to high-risk patients, dedicated telephone triage, and a respiratory clinic, can reduce hospitalizations and improve outcomes for Covid-19. Our model spans the continuum of care and includes six key components: high-risk outreach, telephonic primary care, a phone triage system, a community management group, a respiratory clinic, and integrated emergency room/hospital care ( Figure 1 ). The triage center is a dedicated group of nurses supported by onsite physicians who (1) determine whether patients'' symptoms are clinically consistent with Covid-19 using a symptom checklist, (2) risk-stratify patients for severe disease complications using risk stratification criteria (Table 1) (3) determine whether patients meet criteria for testing, (4) conduct robust education (about 10-15 min) on home care with attention to self-isolation and selfquarantine and (5) evaluate patients for symptoms requiring urgent in-person assessment at the respiratory clinic based on identification of potential pulmonary involvement.
cord-029609-zh2ah34g	2020	
cord-029612-cts1al9z	2020	
cord-029615-x498xj3m	2020	The first step in effective deployment was for the Department of Medicine (DOM) Chair to name the decision makers and establish a command structure with formalized roles and responsibilities.1 Anticipated responsibilities were divided and delegated based upon those individuals'' strengths and networks.2 DOM Vice Chairs were delegated specific responsibilities related to the build-out of the inpatient service (Table 1) , which required full-time commitment and temporary suspension of all non-Covid research and clinical activities. Additional DOM vice chairs coordinated personal protective equipment (PPE) needs with hospital administration, provided education regarding PPE use, onboarded outpatient physicians and facilitated their inpatient electronic medical record (EMR) access and training, and created teaching modules on treatment of the acutely ill Covid patient. In addition, volunteers and locum tenens providers were rapidly onboarded and integrated into teams and schedules.13 All remaining medicine divisions and other departments were asked to identify nurse practitioners (NPs), physician assistants (PAs), residents, and fellows eligible for deployment to the surge medical teams.
cord-029626-j6b59y7a	2020	
cord-029770-72ncfyc5	2020	
cord-029848-dj5xqlz1	2020	Telemedicine is defined as the delivery of health care services, where distance is a critical factor, by all healthcare professionals using information or communication technology. Telemedicine aims to ensure equitable services to everyone, is costeffective, provides safety to both patient and doctors during pandemics, and offers timely and faster care. Telemedicine can be classified on the basis of mode of communication as (i) audio, video or text-based (video mode is preferred as it allows limited examination as well); (ii) timing of information transmitted as real time or asynchronous exchange; (iii) purpose of consult as first time or follow up (in non-emergent cases or emergency consultation); and (iv) according to individuals involved as patient to medical practitioner, caregiver to medical practitioner, medical practitioner to medical practitioner or health worker to medical practitioner [2] . Doctors should avoid giving advice in such cases and the patient must be referred for an urgent in-person visit to the nearest hospital.
cord-029859-fhm0d9t9	2020	
cord-029884-zl0uqmfi	2020	This step explores the patient''s beliefs, goals, ideology, narrative, hopes, fears, and communication, informational and decision-making preferences in the context of the now-understood medical situation. An effective SIC requires the clinician to honor patient and family autonomy and personhood by: ensuring their assent to answer questions and receive information; tailoring that information to their needs, abilities, and preferences, as well as the situational urgency; valuing and learning their history and experience; informing them to the extent possible, reasonable and desired; and ensuring their centrality to the shared decision-making process. �I admire your courage in discussing this hard stuff.�Now that I understand your values, I''d like to offer a recommendation, okay?�If your breathing deteriorates I suggest we� (ex.,take resuscitation off the table, and treat your symptoms at home�OR�offer a time-limited ventilator trial�OR�)�Does this make sense?
cord-029991-0sy417j0	2020	BACKGROUND: Besides airway suctioning, patients undergoing invasive mechanical ventilation (iMV) benefit of different combinations of chest physiotherapy techniques, to improve mucus removal. The presence of an endotracheal tube impairs the bronchial mucus velocity transport in anaesthetized dogs [2] ; in critically ill patients undergoing invasive mechanical ventilation (iMV), it seriously impairs cough reflex and mucociliary escalator function [3, 4] , promoting the accumulation of tracheobronchial secretions, leading to sequestration and densification of secretions in the lower airways and increasing the risk of pneumonia [5] and lung atelectasis [6] . The aim of this pilot randomized physiological study is assessing the effects of HFCWO on lung aeration and ventilation distribution, as assessed by EIT, in normosecretive and hypersecretive mechanically ventilated patients. Our study shows that chest physiotherapy by HFCWO may improve lung aeration of hypersecretive mechanically ventilated patients, without affecting gas exchange.
cord-030149-hkpjnqm9	2020	Therefore, we have developed a series of practical recommendations that may guide physical therapists throughout the use of technology for the treatment of their patients (Table 1 ). 5, 6 Best practice for chronic musculoskeletal pain includes provision of education/information about the patients'' condition and management strategies and encouragement to pursue physical activity or exercises. 7, 19 Previous studies showed barriers to development of therapeutic alliance related to lack of visual cues and misunderstanding, therefore requiring advanced communication skills from clinicians to ensure best telerehabilitation practice. 17 The evidence on acceptability of remote delivery of interventions for a diverse range of medical conditions (eg, pain management, post-surgery, cardiac and pulmonary conditions) 12,29---31 indicate mostly positive findings, including a feeling of closeness despite the distance, 11 ongoing support from health professionals, 32 and continuous motivation for learning. Presenting clear and practical recommendations for telerehabilitation may empower clinicians to better use technology as an alternative mode of delivering physical therapy.
cord-030216-l38i06v2	2020	METHODS: This study analyzed data from the National Health Insurance Research Database in Taiwan for patients who were diagnosed with ESRD and received CABG (ICD-9-CM codes 585 or 586) between January 1, 2004, and December 31, 2009. There have been limited studies investigating the prognosis, risk factors and hospital costs of CABG between ESRD and non-ESRD patients. Thus, the aim of our study was to assess whether ESRD patients on hemodialysis who received CABG experienced higher hospital costs and perioperative and postoperative mortality than CABG patients without ESRD and to evaluate the factors related to outcomes between the two groups. Second, the risk factors for mortality after CABG were hypertension, diabetes, myocardial infarction history, stroke and COPD in ESRD patients compared with non-ESRD patients. ESRD patients with regular hemodialysis, old age, diabetes, and hypertension are at increased risk of stroke [23] [24] [25] , but our study found that these factors were not significantly associated with mortality among ESRD patients after CABG.
cord-030254-eevqclsy	2020	A suspected case has been defined as a patient with acute onset respiratory infection with fever, cough, sore throat, and an epidemiological link in the form of a history of travel 14 days prior to the onset of symptoms to countries afflicted with COVID-19, or a close contact with a confirmed or probable case of COVID-19 14 days prior to symptom onset, or some acute respiratory infection requiring hospitalization with no other etiology fully explaining the clinical presentation, as per WHO guidelines. • In patients with severe COVID-19 infection requiring supplemental oxygen, lopinavir/ritonavir combination plus hydroxychloroquine plus favipiravir 1,600 mg (eight tablets) twice daily as a loading dose followed by 600 mg (three tablets) every 8 hours for 14 days is being used. Clinical characteristics of 138 hospitalized patients with 2019 novel coronavirus-infected pneumonia in Wuhan, China Clinical management of severe acute respiratory infection when COVID-19 disease is suspected.
cord-030256-muah207b	2020	The marked elevation of IL-6 in patients with cytokine release syndrome (CRS) led to the institution of successful targeted therapy for the treatment of CRS using IL-6 receptor blockade (tocilizumab). It is widely acknowledged that the majority of COVID-19 patients, especially those with severe disease, are characterized by lymphocytopenia. Where extracorporeal life support (ECLS) expertise is available, it should be considered according to the standard management algorithm for ARDS in supporting patients with viral lower respiratory tract infection. Although there are no published outcomes, early experience in Wuhan, China, indicates that prone position was widely used in patients with COVID-19 related severe ARDS and had possible benefits. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China High risk of thrombosis in patients with severe SARS-CoV-2 infection: a multicenter prospective cohort study United States Center for Disease Control interim guidance for clinical management of COVID-19 patients with and without acute respiratory distress syndrome
cord-030361-0tepkjdl	2020	In a study conducted by Foster and colleagues, data was combined from nine phase 2 and phase 3 clinical trials to evaluate efficacy and safety outcomes in HCV patients ≥ 65 years old treated with the pan-genotypic regimen, glecaprevir/pibrentasvir, for 8, 12, or 16 weeks [28] . Shiffman and colleagues reported outcomes of 123 patients aged 65 years or older enrolled in three phase 3 studies who received sofosbuvir/velpatasvir, a pan-genotypic DAA, for 12 weeks for the treatment of chronic HCV [29] . Safety and efficacy of sofosbuvir/ velpatasvir for the treatment of chronic hepatitis C in patients aged 65 years or older: a retrospective analysis of phase 3 studies The efficacy and safety of direct acting antiviral treatment and clinical significance of drug-drug interactions in elderly patients with chronic hepatitis C virus infection
cord-030369-4dn02a35	2019	Once pulmonary infection is present, the disease condition will likely deteriorate, directly causing death; (3) a majority of infections are nosocomial infection, and pathogens are usually resistant to common antibiotics, making therapy challenging; (4) the pathogens causing infection are diverse but mainly Gram-negative bacteria, although the incidence of Gram-positive and fungal infections is increasing; (5) infection is closely related to the prognosis for liver failure patients. Although their clinical manifestation differ significantly, the "coexistence of acute and chronic failures" is shared by failures of all those organs; (2) CLF classification has been generally recognized at home and abroad, and the necessity of classification are further proved by the difference between CLF and the other three types; (3) CLF cases are relatively large in proportion (nearly 30%), which is still increasing (since the proportion of ALF/SALF are lowering); (4) Complications of CLF are common and are found in various forms, with bad prognosis; (5) In CLF patients with correlation to HBV, virus replication are commonly found, which is closely related to decompensation.
cord-030370-89n13hml	2019	Epidemiological factors Considerations for screening for general populations Early: fever, profound weakness or malaise, headache, myalgia, arthralgia, conjunctivitis, nausea or anorexia, throat pain or difficulty swallowing, abdominal or epigastric pain, diarrhea (bloody or nonbloody) Exposure/Contact: infected animals, bushmeat or fruit also fed on by bats, healthcare workers/ traditional healers also treating EVD, items soiled or touched by positive EVD patient, deceased EVD bodies Sexual intercourse with EVD-positive male or EVD survivor Late: confusion and irritability, hiccups, seizures, chest pain, diarrhea (watery or bloody), vomiting (with or without blood), skin rash, internal or external bleeding, shock, respiratory distress Additional considerations for screening obstetric population Vaginal bleeding of unknown origin, spontaneous abortion, premature labor and/or rupture of membranes, preterm labor, antepartum and postpartum hemorrhage, intrauterine fetal demise, stillbirth, loss of consciousness Exposure to products of conception or deceased fetus of EVD positive patient Being a pregnant woman with history of contact with confirmed EVD patient, recent EVD survivor with an intact pregnancy, newborn of an EVD positive mother, infant breastfed by a recent EVD positive mother WHO Library Cataloguing-in-Publication Data [55] setting, women were often left untreated or were provided minimal intervention by frightened medical staff working in an overwhelmed, under resourced health care system in crisis.
cord-030380-okue1kso	2020	Conceptually, with informed and motivated professionals as their agents, patients effectively become discerning consumers capable of driving healthy competition in health care markets where extrinsic pressure may be needed to encourage highquality care (e.g., primary care physicians [PCPs] directing patients to the safest hospitals or surgeons selecting the best devices). (This article focuses largely on physician agency as an instructive case, but other health care professionals act as agents, too, presenting analogous issues that are no less important.) Potential refinements notwithstanding, the dissatisfying pace of quality improvement over the last 2 decades should tell us that measure-reliant approaches are unlikely to deliver on their promise." As the concept of quality is reduced to that which is measured, improvement redefined as higher scores, extrinsic judgments elevated above unseen efforts, and time for patients and colleagues hijacked by box-checking, demoralization sets in.17 , 18 Purpose is undermined as demands on physicians diverge from their values, professional identity is lost, and intrinsic motivation gives way to a self-fulfilling prophecy that physicians care only about financial incentives.
cord-030502-mvlib8ol	2020	CONCLUSIONS: We did not observe the effectiveness of early steroid pulse therapy on patient outcomes among children with IAE in our study population including all clinical subtypes of IAE. In this study, we aimed to assess the effectiveness of early steroid pulse therapy on patient outcomes among children with all subtypes of IAE using a nationwide database in Japan. We observed no significant difference in patient outcomes between the propensity score-matched patients with and without early steroid pulse therapy in our study population, including all clinical subtypes of IAE. In our study population including all clinical subtypes of IAE, after adjusting for the factors in Table 1 , we did not observe a significant difference in the proportions of unfavorable outcomes or in-hospital mortality between the patients with and without early steroid pulse therapy within 2 days.
cord-030531-4uucx9ss	2020	All drugs in use for treating plague are registered based on experimental data and anecdotal evidence, and no regimen currently recommended is supported by a randomized clinical trial. The primary endpoint of the trial is to assess the proportion of patients with bubonic plague who have a therapeutic response to treatment (defined as alive, resolution of fever, 25% reduction in the size of measurable buboes, has not received an alternative treatment and no clinical decision to continue antibiotics) as assessed on day 11. The secondary objective is to collect data on the effectiveness of ciprofloxacin in the treatment of pneumonic plague, although the trial is not able to formally assess the non-inferiority of ciprofloxacin monotherapy compared to streptomycin and ciprofloxacin combination therapy in pneumonic plague, Considering the operational and practical complexities of a plague RCT, the study also has additional exploratory objectives to optimize investments: to evaluate the level and kinetics of anti-Y.
cord-030897-c88tjrai	2020	PURPOSE: Combined immunodeficiency (CID), due to mutations in TFRC gene that encodes the transferrin receptors (TfR1), is a rare monogenic disorder. Nevertheless, the high rate of consanguineous marriages in the Saudi population [7] and the availability of advanced molecular genetic testing provided us with the opportunity to identify and review a relatively large number of patients with combined immunodeficiency due to mutated TFRC in great detail. The observed neurological involvement in some of the patients in the form of developmental delay, milestone regression, and optic atrophy could be related to recurrent infections and prolonged hospitalization, or it could be part of the disease itself, as mitochondrial iron supply may be affected by this mutation [11] [12] [13] [14] [15] [16] . Patients with WAS and TFRC gene mutations tend to have recurrent infections and thrombocytopenia. The lymphocyte requirement of transferrin and impaired TfR signaling role impaired lymphocyte proliferation to PHA in patients with TFRC gene mutations [4, 17] .
cord-030918-0w327dgj	2020	At present, the functional organization of paediatric care in PCTs includes health prevention and promotion activities through healthy child (HC) and school-based health programmes, on-demand visits for management of acute diseases, scheduled appointments for follow-up of chronic diseases and coordination of care delivery by different providers: nurses, midwives, dentists, physical therapists, psychologists, social workers and family physicians. Another high-priority organizational change is the participation of paediatric nurses in the care of the paediatric population, both in the form of on-demand nursing visits for follow-up of patients with acute diseases and, especially, the management of patients with SHCNs through scheduled nursing visits for health education and follow-up of patients with asthma, obesity, diabetes and other chronic diseases requiring nursing care and healthy child programme services.
cord-030927-wo8r8zny	2020	
cord-030962-2xem8inu	2020	Reference centers, which have a greater number of cases, have had to vacate wards and intensive care units to make room for patients infected with the coronavirus, so the impossibility of transferring surgical patients from regional to tertiary hospitals to receive specialized care and the waiting list delays caused by the suspension of scheduled operations will soon have an impact on patients with lung cancer (LC) not infected by this virus. The American College of Surgeons (ACS), 1 in their recently published guidelines on the management of patients scheduled for thoracic surgery, categorize the general status of hospitals into 3 phases according to the number of COVID-19 patients admitted: phase 1 -preparation; phase 2 -urgent setting; and phase 3 -ଝ Please cite this article as: Isea de la Viña J, Mayol J, Ortega AL, Alcázar Navarrete AN.
cord-031129-wqkdug42	2020	RECENT FINDINGS: Evidence shows that patients with SSc demonstrate an increased risk for perioperative myocardial infarction, high rates of interstitial lung disease, pulmonary arterial hypertension, neurological disease, gastric dysmotility disorders, and challenging airway management, all findings that may result in suboptimal perioperative outcomes. Optimal perioperative management and risk stratification should expand beyond the well-described airway challenges and consider numerous systemic manifestations of systemic sclerosis such as pulmonary arterial hypertension, interstitial lung disease, and cardiac sequelae. Separately, pulmonary hypertension related to ILD or SScrelated cardiac involvement may increase both morbidity and mortality in the perioperative period and may be present in 8-12% of SSC patients [23, 25•] . Microstomia is likely a prominent physical feature of challenging airway management in the patient with SSc supported by a meta-analysis of 15 studies that examined risk factors for intensive care unit-related mortality in a mixed ILD population and found a strong correlation between mortality and the application of invasive mechanical ventilation [69] .
cord-031130-xvkyt3l3	2020	RECENT FINDINGS: Heparin-induced thrombocytopenia (HIT) occurs more frequently in surgical patients compared with medical patients due to the inflammatory release of platelet factor 4 and perioperative heparin exposure. Heparinoid exposure by syringe flush, subcutaneous prophylaxis, or therapeutic anticoagulation is common in the operative room (OR) and ICU environments [5] .Only a fraction of those with low platelet counts will develop HIT, which presents in approximately 0.3-0.5% of critically ill patients exposed to heparin [6] . Although HIT is less frequent in cardiac surgical patients compared with orthopedic patients, cardiac surgical patients have a higher frequency of HIT immunization (positive antibody formation) [15] , potentially due to the high intraoperative UFH doses required for anticoagulation on cardiopulmonary bypass [7, 17] . Antibodies from patients with heparin-induced thrombocytopenia/thrombosis are specific for platelet factor 4 complexed with heparin or bound to endothelial cells
cord-031191-63xtga7h	2020	title: Recurrence of atrial fibrillation following non-cardiac surgery or acute illness: A common but rarely detected complication These devel-opments create opportunities for early detection of recurrent AF in patients with transitory AF events during acute illness or following non-cardiac surgery, enabling subsequent initiation of anticoagulation and other therapies. Patients without a history of AF and who reverted to sinus rhythm before discharge were included in the study and used a handheld single-lead ECG device for self-monitoring of AF recurrence 3 times per day for 4 weeks. [17] supports the notion that AF recurrence in patients with secondary AF in the setting of non-cardiac surgery or acute illness is common and has potentially important clinical consequences. Self-monitoring for atrial fibrillation recurrence in the discharge period post-cardiac surgery using an iPhone electrocardiogram Selfmonitoring for recurrence of secondary atrial fibrillation following noncardiac surgery or acute illness: a pilot study
cord-031256-4mxt501d	2020	Our study shows that the maximal non-irritant concentration (NIC) for ceftazidime and for aztreonam 32 is as high as 20 mg/mL for immediate readings of intradermal skin tests (IDT). (1) 42 This study aims at assessing the NIC for ceftazidime, a third generation cephalosporin, and 43 aztreonam, a synthetic monobactam, both potential safe alternative β-LABs in patients with a 44 documented hypersensitivity reaction to penicillin G, amoxicillin (+/-clavulanic acid) or cefazolin. Diagnosis of their Penicillin G, amoxicillin (+/-clavulanic acid) or cefazolin 52 hypersensitivity was based upon a history complemented by positive STs (immediate and delayed 53 readings), drug-reactive sIgE antibodies, a sIgE-to-tIgE ratio ≥ 0.002, or a graded drug challenge (DC). Our results show that the NICs for ceftazidime and aztreonam, as recommended in the ENDA/EAACI 102 Drug Allergy Interest Group position paper (3) and its update by Romano et al (8) , can further benefit 103 from an assessment in patients who experienced an IDHR or NIDHR to penicillin G, amoxicillin (+/-104 clavulanic acid) or an IDHR to cefazolin.
cord-031497-pp0p3en6	2020	Various authors and scientific societies have recommended limiting the number of airway procedures and manipulations and introducing stringent protection measures for health personnel in order to minimize the risk of infection. [2] [3] [4] We report 2 cases of patients diagnosed with SARS-CoV-2 infection and tracheal iatrogenic rupture following airway manipulation. She required OTI + MV for respiratory failure, and during the procedure she incurred a tracheal lesion confirmed by computed tomography and fiberoptic bronchoscopy to be a rupture of the pars membranacea measuring approximately 2 cm. To minimize the risk of aerosols, the patient was maintained in complete muscle relaxation throughout the procedure; preoxygenation and ventilatory pauses-apneas-were performed (as far as possible) in accordance with the recommendations described for tracheotomy. Emergency tracheal intubation in 202 patients with COVID-19 in Wuhan, China: lessons learnt and international expert recommendations Tracheal trauma after difficult airway management in morbidly obese patients with COVID-19
cord-031544-clzt6kyg	2020	Thus, owing to the lack of physical exposure to clinical settings, it is likely that our patients with sexual dysfunction, with or without infertility, who stand to benefit the most from our taking a potential risk of prescribing medications after virtual care. Overall, the availability of prescription medications with well-defined risk profiles to patients through virtual sources is only likely to enhance the access to care for sexual and reproductive health conditions by easing the pain of embarrassment some patients may experience. In light of the current situation of the COVID pandemic along with the boom of telemedicine, physicians should consider incorporating home-based kits for both male and female fertility testing with the caveats that even though we may not get accurate data all the time, data from these kits can be used to guide care. Although physical examination and in-office diagnostics are paramount for the evaluation of both female and male fertility, an initial telehealth visit can uncover pertinent history, identify risk factors, and establish the physician-patient relationship.
cord-031558-8wysernx	2020	
cord-031710-1xl2isee	2020	title: Successful treatment of pulmonary haemorrhage and acute respiratory distress syndrome caused by fulminant Stenotrophomonas maltophilia respiratory infection in a patient with acute lymphoblastic leukaemia – case report CASE PRESENTATION: We present the rare case of successful outcome in a 61-year-old female who developed alveolar haemorrhage and acute respiratory distress syndrome 8 days after a chemotherapy session for her acute lymphoblastic leukaemia, in the context of secondary bone marrow aplasia. We report the case of successfully treated severe Stenotrophomonas maltophilia respiratory infection complicated with pulmonary haemorrhage in a chemotherapyinduced pancytopenia patient diagnosed with acute lymphoblastic leukaemia. To our knowledge, this is the first reported case of pulmonary haemorrhage and ARDS caused by a fulminant Stenotrophomonas maltophilia respiratory infection in Eastern Europe, and it seems to be a rare case of positive outcome in a patient with haematological malignancy.
cord-031734-5wnvuk2n	2020	PURPOSE: The aim of the study was to identify solution strategies from a non-governmental (NGO) hospital in a war region for violence-related injuries and to show how high-income countries (HIC) might benefit from this expertise. Apart from surgical wound care and debridements, which were performed on every wound in the operation theatre, laparotomy was the most common surgical procedure, followed by installation of a chest drainage and amputation. The lack of surgical experience might not be relevant as long as a hospital provides a specialist for every probable pathology, but in cases of a sudden high volume of causalities like in a terror attack or train accident, adequate treatment of the injured could get difficult [7, 8] . As much as medical standards in LIC and war zones lag behind, there might be a potential knowledge of primary injury treatment and basic surgical techniques, expectable injury patterns, and experience in dealing with mass causalities by fast decision-making.
cord-031821-rywdkqcd	2020	In relation to the data we have on the behaviour of the coronavirus pandemic in cancer patients, there are many studies that are being carried out and few already published. The symptomatology has been the usual one observed in the general population with coronavirus infection, highlighting dyspnoea as the main symptom that defines seriously ill patients. The low percentage of the population of cancer patients must be taken into account in most studies, limiting the interpretation that can be made of these data. We hope that clinical and therapeutic studies of coronavirus infection will soon emerge, to shed light on the health crisis we are experiencing. Clinical characteristics of COVID-19-infected cancer patients: A retrospective case study in three hospitals within Wuhan Clinical characteristics and prognosis in cancer patients with COVID-19: A single center''s retrospective study A Practical Approach to the Management of Cancer Patients During the Novel Coronavirus Disease 2019 (COVID-19) Pandemic: An International Collaborative Group
cord-031907-ilhr3iu5	2020	L.M., and the National Institutes of Health (R35GM119623) to T.R.G. The addition of a size exclusion chromatography step to various urinary extracellular vesicle concentrating methods reveals differences in the small RNA profile Introduction: Urinary extracellular vesicles (EVs) and their RNA cargo are a novel source of biomarkers for various diseases, however non-vesicular RNA (e.g. associated with proteins) is also present within urine. We then evaluated efficiency of heart targeting for eAAV9 or eAAV6 and standard AAV9 or AAV6 encoding for EGFP, mCherry or firefly luciferase in different human cell lines in vitro, in black mouse and in passive immunity nude mouse model in vivo using flow cytometry, confocal microscopy, Langendorff perfusion system and Methods: HLHS patients (n = 3) after Glenn procedure and swine (n = 3) after PAB were given RV injections of allogeneic/xenogeneic MSCs. Donor-specific, HLA-I+, exosomes were isolated from plasma.
cord-032181-gmcugd8h	2019	3. Hepatorenal syndrome, which is characterized by renal failure, hemodynamic changes in arterial circulation and abnormalities in the endogenous vascular system, is a common clinical complication of end-stage liver disease, and one of the important indicators for the prognosis of patients with severe hepatitis. The latest report indicated that basic laboratory examinations for coagulation function testing in common use at present, such as PT, APTT, international normalized ratio (INR) etc., have little correlation with occurrence of gastrointestinal bleeding in these patients, thereby revealing the importance to search and pay close attention to those complicating disease upregulating bleeding risk, such as bacterial infection, renal failure, hemodynamic change after portal hypertension, dysfunction of endotheliocyte as well as macrophagocyte and so on [107] .
cord-032183-yqqqe325	2019	Patients awaiting liver transplantation because of HBV-related end-stage liver disease or liver cancer should be given nucleoside analogues with strong HBV inhibition and low drug-resistance, or nucleotides analogues combination treatment, in order to reduce viral load and prevent graft re-infection. The objective of antiviral treatment for HBV-ACLF is to reduce viral load at an appreciably high rate, thereby promoting reduction in hepatocyte cell death and improved survival outcomes by prevention of decompensation related multiorgan complications in this group of severely ill patients. Response-Guided Therapy 4006 study [126] suggested continuous treatment with LAM (10 years) delayed clinical progression in patients with chronic hepatitis and advanced fibrosis by significantly reducing the incidence of the risk of hepatocellular carcinoma and hepatic decompensation.
cord-032244-s7t5u9lf	2020	The aim of this document is to propose algorithms for the management of cardiovascular diseases during COVID-19 emergency with the objective of providing patients with optimal care, minimizing contagion risk and appropriately managing personal protective equipment. 9, 10 The objective of this document is to propose management algorithms for cardiovascular disease during the COVID-19 emergency, in order to optimize cardiological assistance for the benefit of patients by minimizing the possibility of contagion, safeguarding healthcare personnel, and rationalizing the use of personal protective equipment (PPE). • angina pectoris • heart failure • arrhythmia In the case of a suspected COVID-19 patient, it is always necessary to try to postpone the medical exam or the appointment (if a cardiac patient cannot wait, refer them to the emergency room which has appropriate access points and safety procedures in place) or manage with the available PPE according to the risk of contagion following specific safety procedures, remembering to disinfect spaces and equipment after the exam/appointment according to local protocols.
cord-032335-6c9gt7t9	2020	In a recent editorial, published in The New England Journal of Medicine, the authors address the problem of having to choose between 2 or more patients for the assignment of resources, such as ICU admission. This real situation that arose during the Covid-19 pandemic underlines the need to develop fair resource allocation procedures that include all the stakeholders involved in patient care, and the patient and family themselves, in order to develop prioritization criteria for decisionmaking in times of adversity, without transferring this burden to a single healthcare professional in a specific situation. Among the many changes that will emerge after the Covid-19 pandemic, we believe that one of the most relevant will surely be the expansion of RICUs and the leadership of respiratory medicine in decision-making on borderline patients, such as the elderly, unifying selection criteria, clarifying the concept of frailty, and integrating its use into our clinical practice.
cord-032392-ex3s8evv	2020	Interpretative phenomenological analysis (IPA) provided the theoretical framework to examine semistructured interviews exploring participants'' lived experiences of the breaking bad news process, and then to directly compare patients'', caregivers'', and HCPs'' accounts that were linked to the same patient''s case. The current study sample was determined by the number of linked cases that were able to be formed from the data collected for a larger doctoral study exploring the perspectives of 4 different groups involved in the bad news process: patients, caregivers, surgeons, and nurses. In linked cases that included the bad news deliverer and receiver perspective, the direct comparison highlighted the importance of HCPs recognizing and attending to patients'' and caregivers'' specific emotional needs ("noticing and meeting emotional needs") and delivering information in the way that suited each patient ("reading different informational needs").
cord-032544-2yrqjw1o	2020	title: Treatment to reduce vascular calcification in hemodialysis patients using vitamin K (Trevasc-HDK): A study protocol for a randomized controlled trial DISCUSSION: Evidence of successful regression or retardation of vascular calcification will support the conduct of larger and longer-term trials aimed at reducing cardiovascular disease mortality and major adverse cardiovascular events in this high-risk population using a safe and inexpensive strategy TRIAL REGISTRATION: ClinicalTrials.gov NCT02870829. [27] A recent randomized trial reporting 1-year outcome of vitamin K2 supplementation in hemodialysis patients found no effect on aortic calcification despite reduction in dp-ucMGP. The proposed "Treatment to Reduce Vascular Calcification in Hemodialysis Patients Using Vitamin K" (Trevasc-HDK) study is therefore timely. Our trial is important even if the study is negative as we will have more insight into the baseline level and role of vitamin Kin Asian patients as well as provide us with the magnitude and progression of calcification in our multiethnic HD population. The effect of vitamin K2 supplementation on vascular calcification in haemodialysis patients: a 1-year follow-up randomized trial
cord-032588-8bfl2qy1	2020	Conclusion: In hospitalized patients CoV is associated with a longer LOS, higher number of complications and much higher in-hospital mortality rates compared to influenza virus infections even in a population with less comorbidities. Women with acute heart failure or >75 years have an increased risk of influenza associated in-hospital mortality, while ICU admission and any malignancy are predictors for male patients. Die Eingriffssicherheit wurde anhand der dokumentierten peri-und postinterventionellen Komplikationen bewertet.Ergebnisse: Von April 2019 bis Februar 2020 wurden 14 Patienten mit NYHA II (33 %) oder III (67 %) aufgrund einer TI Grad III-V mittels Implantation eines oder mehrerer MC an der Trikuspidalklappe behandelt. Pro Patient wurden zwischen 1 und 4 Clips an der Trikuspidalklappe implantiert ( Grundlagen: Roxadustat ist ein oraler "Hypoxia-induceable factor"-Prolyhydroxylase-Inhibitor zur Behandlung von Patienten mit Anämie bei chronischer Niereninsuffizienz (CNI). Der vorliegende Abstract zeigt die Resultate einer Interimsanalyse.Methodik: Die Studie schließt Patienten mit NDP-CNI im Stadium 3 bis 5 mit begleitender Anämie ein und hat sie zu Roxadustat-oder DA-Therapie randomisiert.
cord-032928-m0awip9y	2020	Coronavirus disease 2019 (COVID-19) is caused by a novel single-strand ribonucleic acid (RNA) coronavirus known as severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). SARS-CoV-2 primary attacks the lower respiratory system causing viral pneumonia, but it may also affect the heart, gastrointestinal system, liver, kidney, and central nervous system leading to multiple organ failure [3] . Other researchers found elevated serum troponin levels in many patients infected with COVID-19, and it was associated with more severe disease and poor prognosis [21] . The mechanism behind acute myocardial injury caused by SARS-CoV-2 infection might be related to human angiotensin-converting enzyme 2 receptor (ACE2) [20] which are highly expressed in the heart [11] . The results of previous reports indicate that cardiac injury, arrhythmia, and venous thromboembolism should be considered in any suspected or confirmed COVID-19 case and the patient should undergo a prompt clinical evaluation.
cord-032930-ohsh46l2	2020	Hepatorenal syndrome (HRS) occurs in patients with cirrhosis or fulminant hepatic failure and is a kind of pre-renal failure due to intense reduction of kidney perfusion induced by severe hepatic injury. Hepatorenal syndrome occurs in patients with cirrhosis or fulminant hepatic failure and is a kind of pre-renal failure due to intense reduction of kidney perfusion induced by increasingly severe hepatic injury. The persistence of these conditions may cause cardiac dysfunction and decreased kidney function, Legend: SNS, sympathetic nervous system; ADH, antidiuretic hormone; NO, nitric oxide; CO, carbon monoxide; PI 2 , prostaglandin I 2 ; EET, epoxyeicosatrienoic acid; CE, endogenous cannabinoids; Ang I, angiotensin I; Ang II, angiotensin II; Ang-(1-7), angiotensin (1) (2) (3) (4) (5) (6) (7) subunit) in cirrhotic rats as a response to CO stimulation was also reported [16] .
cord-033019-4eo037jp	2020	Indeed, the transition, even partial, from in-face to teleconsultation must be prepared and a minimum of prerequisites are necessary, such as: the availability of high-performance computer equipment; the availability of a secretariat to organise the call planning and the sending before the teleconsultation of the documents to be prepared by the patient; the use of secure applications to preserve the confidentiality of the medical data exchanged; or the training of anaesthetists in the institutional tools made available. As this PCR must be carried out as close as possible to the surgery, we agree that the result cannot be available at the time of the anaesthetic consultation. In other cases (i.e. non-aerosol-generating care and no prolonged contact within one metre), the wearing of a simple surgical mask is recommended, including for the care of a proven COVID-19 patient.
cord-033135-cxsmxk3b	2020	1 During the lockdown, primary care professionals reorganized to attend to mild cases at home and actively follow up people with greater vulnerability by phone, caring for their health and avoiding the complications that would require hospital admission. The current situation of the health crisis provoked by COVID-19 and the isolation measures imposed by the state of alarm decreed on 14th March led to the break-down of a series of routines and actions upon which the care of these patients was based, with their continued application being lost. An evaluation (Table 1 ) aimed at determining the functional, mental and social health situation of patients is therefore a way to detect possible changes or delays which occurred throughout lockdown and it is the necessary step before establishing new healthcare interventions, or the assignment of new resources and social-health resources and re-assessment.
cord-033247-2cbslnb7	2020	
cord-033279-bcf9568a	2020	Levels of PCT and CRP were significantly increased in patients with positive blood cultures, the infection caused by Gram-negative microorganism regardless of disease severity and pneumonia with complications. In the critical care setting, published studies differ greatly considering patient case mix [3] [4] [5] [6] [7] , the source of infection [3, 4, [6] [7] [8] [9] [10] [11] [12] [13] , the severity of the disease [4, 5, [10] [11] [12] 14] , exclusion criteria as well as cut-offs and laboratory methods for PCT measurements [3, 11, [13] [14] [15] . The PCT and CRP levels were significantly increased in patients with positive blood cultures, the infection caused by Gram-negative microorganism regardless of disease severity (no difference in SOFA and APACHE II scores), and pneumonia with complications (Table 3) .
cord-033327-yi1tvsh4	2020	
cord-033574-4y53ryoa	2020	On serum cytokine and chemokine analyses, the overweight asthma group included significantly more patients with a lower level of tissue growth factor α (TGF-α) (1.1 pg/mL) and higher levels of hsIL-6 (2.5 pg/mL), RANTES/CCL5 (298.5 pg/mL), and vascular endothelial growth factor A (VEGF-A) (63.7 pg/mL), than the non-overweight asthma group (p=0.02, p<0.01, p=0.02, p=0.01, respectively). CONCLUSION: The present study showed that overweight patients with adult-onset asthma were characterized by a higher rate of annual exacerbations and worse lung function despite treatment with high-dose inhaled corticosteroids and lower blood eosinophil counts than non-overweight patients with asthma. 7 Thus, the present study focused only on adult-onset asthma and showed that blood eosinophil counts were significantly lower in overweight patients with asthma than in non-overweight patients with asthma (Table 1) , and they were negatively correlated with BMI (Figure 1 ), consistent with low type 2 inflammation, as described in previous reports.
cord-033778-u2r0neyc	2020	Flexible fibreoptic bronchoscopy (FFB) has been used for years as a diagnostic and therapeutic adjunct for the diagnosis of potential airway obstruction as a cause of acute respiratory failure or in the management of hypoxaemia ventilated patients. To evaluate the use of FFB as a rescue therapy in mechanically ventilated patients with severe hypoxaemic respiratory failure caused by COVID-19. Patients with severe COVID-19 pneumonia who have persistent hypoxaemia despite the resolution of inflammatory parameters may respond to FFB with removal of mucus plugs. These patients had severe COVID-19 pneumonia with the following characteristics: severe refractory hypoxaemia despite maximal mechanical ventilatory support, including proning and significant deterioration from previous minimal ventilator settings. We have demonstrated that some patients with severe COVID-19 pneumonia and persistent hypoxaemia despite resolution of inflammatory parameters may respond to FFB following removal of mucus plugs.
cord-033965-c1i7dnnt	2020	
cord-034036-1wigu3i3	2020	
cord-034157-uif9xtvl	2020	
cord-034185-e0am7pa6	2020	We do not recommend the routine use of either continuous positive airway pressure (CPAP) or non invasive ventilation (NIV) to prevent postoperative pulmonary complications, prolonged length of stay, and mortality (both in ICU and in hospital) in patients undergoing major thoracic surgery. Level of evidence: Fair Strength of recommendation: C A meta-analysis of 45 studies including almost 5800 patients showed that a single perioperative dose of intravenous dexamethasone resulted in significant reductions in pain scores and opioid use, and was associated with shorter stays in the post-anesthesia recovery room, compared with placebo or antiemetic treatment (Waldron et al. Level of evidence: Fair Strength of recommendation: A Multiple clinical trials have shown that, in patients undergoing open thoracotomy or other major surgical procedures, thoracic epidural analgesia (TEA) is superior to intravenous opioid administration in terms of postoperative pain relief, length of hospital stay, and incidence of postoperative complications (Hazelrigg et al.
cord-034257-kl2ccmz5	2020	title: PRECIOUS: PREvention of Complications to Improve OUtcome in elderly patients with acute Stroke—statistical analysis plan of a randomised, open, phase III, clinical trial with blinded outcome assessment AIMS AND DESIGN: PREvention of Complications to Improve OUtcome in elderly patients with acute Stroke (PRECIOUS) is an international, multi-centre, 3 × 2 factorial, randomised, controlled, open-label clinical trial with blinded outcome assessment, which will assess whether prevention of aspiration, infections, or fever with metoclopramide, ceftriaxone, paracetamol, respectively, or any combination of these in the first 4 days after stroke onset improves functional outcome at 90 days in elderly patients with acute stroke. The primary objective is to assess whether prevention of aspiration, infections, or fever with metoclopramide, ceftriaxone, paracetamol, or any combination of these in the first 4 days after stroke onset improves functional outcome at 90 days in older patients with acute stroke.
cord-034286-m1c98nv7	2020	One starting point for those practicing acute neurology and neurocritical care is a new mnemonic TELL ME (Time course, Essence, Laboratory, Life-sustaining interventions, Management, Expectation), which will assist physicians in standardizing their communication skills before they start a conversation or pick up a phone. These include knowing the time course (new and "out of the blue" or ongoing for some time); extracting the essentials (eliminating all irrelevancies); communicating what tests are known and pending (computerized tomography and laboratory); relaying how much critical support will be needed (secretion burden, intubation, vasopressors); knowing fully which emergency drugs have been administered (e.g., mannitol, antiepileptics, tranexamic acid), when transport is anticipated, and what can be expected in the following hours. In any case, improved provider perceptions of transfer workflow efficiency and patient safety may not be enough; communication must also include solutions for active medical problems and an outline of anticipatory guidance ("what if-what then" scenarios) in the event an acute change in clinical condition occurs.
cord-034303-kcu9guxa	2020	The objective of this study was to detect the validity of serial measurements of arterial lactate level in differentiating hospital mortality and neurological outcome after VA-ECMO support for adult patients with cardiogenic shock. The non-survivors and the patients with acute cerebral strokes had significantly higher arterial lactate levels at pre-ECMO initiation, post-ECMO peak and after 24 h of ECMO support compared to the survivors and those without strokes, respectively. CONCLUSION: Progressive hyperlactatemia after VA-ECMO initiation for adult patients with cardiogenic shock is a sensitive and specific predictor of hospital mortality and acute cerebrovascular strokes. The objective of this study was to detect the validity of serial measurements of arterial lactate level in differentiating in-hospital mortality and neurological outcome after VA-ECMO support for patients with cardiogenic shock. Finally, our study revealed that the hospital mortality and neurological outcome of VA-ECMO were significantly associated with the severity of pre-ECMO shock state and the appropriate recovery of organs perfusion after ECMO support as indicated with changes of blood lactate levels.
cord-034340-3ksfpaf7	2020	
cord-034371-j3xxmkjd	2020	
cord-034435-yp0gfl47	2020	
cord-034578-i9rdubix	2020	AIM: We aim at characterising a large population of Coronavirus 19 (COVID-19) patients with moderate-to-severe hypoxemic acute respiratory failure (ARF) receiving CPAP outside intensive care unit (ICU), and ascertaining whether the duration of CPAP application increased the risk of mortality for patients requiring intubation. We designed this retrospective multicentre study to describe the clinical characteristics of patients with laboratory-confirmed COVID-19 treated with CPAP outside ICU, to assess 60-day in-hospital mortality, and hospital length of stay (LOS), and to ascertain whether the duration CPAP application prior to CPAP failure affects outcome in patients requiring endotracheal intubation. This multicentre retrospective observational study on 537 patients hypoxemic ARF secondary to laboratory-confirmed COVID-19 infection, shows that CPAP applied to different therapeutic goals i.e., candidate to intubation in the case of CPAP failure and do-not-intubate in which CPAP is considered the ceiling of treatment, is feasible outside ICU.
cord-034690-x8lkngra	2020	Qualitative and quantitative analysis of perfused blood volume (PBV) maps recorded: i) perfusion defect ''pattern'' (wedge-shaped, mottled or amorphous), ii) presence of PT and CT obstruction index (CTOI) and iii) PBV relative to pulmonary artery enhancement (PBV/PAenh); PBV/PAenh was also compared with seven healthy volunteers and correlated with D-Dimer and CTOI. Accordingly, in the present study we aimed to evaluate the relationships between a quantitative measure of perfusion on DECTPA (relative perfused blood volume, PBV/PAenh) (22) , and i) disease duration, ii) right ventricular dysfunction on echocardiography iii) Ddimer levels and (iv) obstruction score (23) in patients with severe COVID-19 pneumonia. This early data demonstrated perfusion defects on perfused blood volume (PBV) maps, when available, as well as the presence of vascular dilatation on conventional CT, hypercoagulability and an increased dead space in 39 patients suggesting that pulmonary angiopathy was accountable for hypoxia observed in patients requiring mechanical ventilation for severe COVID-19 pneumonia.
cord-034746-uxhpufnv	2020	We therefore analyzed standard markers of glomerular proteinuria (e.g. immunoglobulin G [IgG]), urinary nephrin excretion (podocyte injury) and serum levels of the soluble urokinase plasminogen activator receptor (suPAR), a proposed pathomechanically involved molecule in INS, in PUUV-infected patients. On admission, patients suffering from hantavirus infection showed significantly increased urinary nephrin, IgG, α1-MG and serum suPAR levels compared to healthy controls (Fig. 3A ). Though, urinary biomarker levels decreased in both groups over time, patients with severe PCR showed significantly higher levels of nephrin, IgG, ACR and PCR during the first 48 h after admission ( Table 2 ). Our data show a strong association between urinary nephrin levels and the extent of (non-selective) glomerular proteinuria, suggesting that hantavirus infection causes a pronounced podocyte damage and subsequent impairment of the GFB. To date, one other study showed significantly elevated blood suPAR levels and their association with hantavirus disease severity but did not include nephrinuria and the extent of proteinuria in their analysis 19 .
cord-034898-zjfhpum2	2020	title: Veno-arterial extracorporeal membrane oxygenation: Special reference for use in ''post-cardiotomy cardiogenic shock'' — A review with an Indian perspective Veno-arterial extracorporeal membrane oxygenation (VA-ECMO) is an important modality of managing post-cardiotomy cardiogenic shock with variable outcomes which would otherwise be universally fatal. Veno-arterial extracorporeal membrane oxygenation (VA-ECMO) has gained popularity over the years as a ''bailout'' option after conventional circulatory support methods have proved refractory in the operating room (OR)/intensive care unit (ICU). Long-term survival and major outcomes in post-cardiotomy extracorporeal membrane oxygenation for adult patients in cardiogenic shock Usefulness of cardiac biomarkers to predict cardiac recovery in patients on extracorporeal membrane oxygenation support for refractory cardiogenic shock Nosocomial infections in adult cardiogenic shock patients supported by venoarterial extracorporeal membrane oxygenation Clinical outcomes in patients after extracorporeal membrane oxygenation support for postcardiotomy cardiogenic shock: a single-centre experience of 92 cases
cord-035024-kx9jfssi	2020	INTRODUCTION: The predominant coagulation abnormalities in patients with coronavirus disease 2019 (COVID-19) suggest a hypercoagulable state and are consistent with uncontrolled clinical observations of an increased risk of venous thromboembolism. CONCLUSION: Our results showed that use of prophylactic dose of enoxaparin might have some benefits compared to the therapeutic dose in terms of less duration of ICU and hospital stay, duration of oxygen support, need and duration of MV, and normalization of inflammatory markers. There was a significant difference between both study groups in enoxaparin duration, time to ferritin and Ddimer improvement, and the duration of MV and O 2 support duration, with longer duration among group 2 cases (therapeutic dose) compared to group 1 (prophylactic dose) in all the above-mentioned variables. Our study compared the effect of different dose regimens of the anticoagulant enoxaparin (prophylactic and therapeutic) that was administered to patients with severe COVID-19 infection, and we compared the clinical outcome as well as improvement in laboratory parameters in both groups.
cord-035026-2qcsfd87	2020	The effect of glucocorticoids and catecholamines, invasion of the pancreatic islet cells, drugs used in the treatment of COVID-19, and the lockdown policy may impact negatively on glycemic control of diabetic patients. [40] showed that the clinical outcomes in COVID-19-positive patients with coexisting diabetes and hypertension who use ACE inhibitor or angiotensin II receptor blocker were comparable to those not using the drugs. A clinical trial (NCT04318418) was designed to determine the effect of ACE inhibitors and angiotensin II type 1 receptor blockers on the severity of COVID-19 infection [41] . Some authors have considered the rapidity of worsening glycemic control in stable diabetic patients with CO-VID-19 requiring the use of high insulin dose and suggested the possibility of pancreatic invasion by the SARS-CoV-2 [57, 58] . Once the entry of the virus is established, there is a downregulation of ACE2 receptor and a corresponding Ugwueze/Ezeokpo/Nnolim/Agim/ Anikpo/Onyekachi Dubai Diabetes Endocrinol J 6 DOI: 10.1159/000511354 activation of renin-angiotensin-aldosterone system, which is responsible for the cardiac and pulmonary complications of COVID-19 infection [75] .
cord-035030-ig4nwtmi	2020	
cord-035067-ic843wr9	2020	Those infected may be asymptomatic, present typical symptoms (fever, dry cough and dyspnea), gastrointestinal symptoms (diarrhea, nausea, vomiting and abdominal pain) and viral RNA in stools. Information on country of origin, mean age, different comorbidities, typical symptoms (fever, cough, and dyspnea, among others), gastrointestinal symptoms (diarrhea, nausea, vomiting, and abdominal pain), and the presence of viral RNA in feces, when cited, were included in this study for analysis. (19) According to the descriptive, cross-sectional, multicenter study (three hospitals in Hubei, China) by Pan et al., with 204 patients, in which 107 were male, mean age of 52.91±15.98 years, 103 (50.5%) reported some gastrointestinal symptom, such as lack of appetite (81; 78.6%), diarrhea (35; 34.0%), vomiting (4; 3.9%), and abdominal pain (2; 1.9%). (26) Cipriano et al., conducted a systematic review with six studies of patients from China, which points to the possibility of SARS-CoV-2 infection in the gastrointestinal tract and fecal-oral transmission.
cord-035070-drt6esrk	2020	
cord-035090-gnfeyddv	2020	
cord-035182-ax6v3ak5	2020	To enhance the effect CME may achieve in improving community health the authors suggest a kick-off/keep-on continuum of medical competence, and integration of aspects of public health at all levels from planning to delivery and outcomes measurement in CME. Continuing medical education (CME) should not be an end in itself, but as expressed in Moore''s pyramid [1] , help to improve both individual patient and ultimately community health. Continuing medical education (CME) should not be an end in itself, but as expressed in Moore''s pyramid [1] , help to improve both individual patient and ultimately community health. On the one hand there is some evidence for the impact of this strategy on physician performance and patient outcomes [82] , but on the other hand this is not the appropriate strategy to address gaps in community health, and tends to create an attitude of unbalanced activism. The impact of CME on physician performance and patient health outcomes: an updated synthesis of systematic reviews
cord-035315-j5mknuv5	2020	
cord-035316-l4qbiuuu	2020	
cord-035396-lg7m9xzs	2020	A command center for coordinating discharges and a streamlined process for arranging home oxygen helped a New York hospital significantly speed up discharges during the Covid-19 pandemic with no negative impact on readmissions. Our second step was to have our Social Work and Case Management departments work closely with our largest DME vendor (who provides over 90% of all oxygen and medical equipment for our patients) to streamline the process for discharging patients home with supplemental oxygen, a process that has historically extended hospitalizations by an entire day or more. We attribute this improvement to: better communication between unit managers and discharge control center; earlier identification of barriers; on-site representative for home oxygen; streamlining of the documentation and authorization processes; providers learning how to optimize documentation; and time saved by many patients not requiring home delivery.
cord-048343-nzk8m912	2006	A large number of pathophysiologic mechanisms are thought to underlie critical illness-associated cognitive dysfunction, including neuro-transmitter abnormalities and occult diffuse brain injury. Markers that could be used to evaluate the influence of specific mechanisms in individual patients include serum anticholinergic activity, certain brain proteins, and tissue sodium concentration determination via high-resolution three-dimensional magnetic resonance imaging. Many of the data supporting occult diffuse brain injury as a cause of critical illness-associated CD come from studies of sepsis and septic encephalopathy, a form of delirium. Lending support to the hypothesis that acute inflammation leads to brain injury and subsequent development of delirium, a recent study found that delirium in postoperative hipfractured patients was significantly associated with serum levels of C-reactive protein, an acute-phase protein that is a marker of acute inflammation [55] . Elevated serum S-100β levels were recently demonstrated in critically ill patients with respiratory failure [69] and in porcine models of endotoxic shock [70] and acute lung injury [71] .
cord-048489-ajafw966	2008	
cord-102199-mc6zruyx	2019	title: Hepatotoxicity during 6-thioguanine treatment in inflammatory bowel disease and childhood acute lymphoblastic leukaemia: a systematic review Hepatotoxicity in the form of sinusoidal obstruction syndrome (SOS) occurred in 9–25% of the ALL patients in two of the four included RCTs using 6TG doses of 40–60 mg/m2/day, and long-term hepatotoxicity in the form of nodular regenerative hyperplasia (NRH) was reported in 2.5%. Oral 6-mercaptopurine versus oral 6-thioguanine and veno-occlusive disease in children with standard-risk acute lymphoblastic leukemia: report of the Children''s Oncology Group CCG-1952 clinical trial 6-Thioguanine associated nodular regenerative hyperplasia in patients with inflammatory bowel disease may induce portal hypertension Splitting a therapeutic dose of thioguanine may avoid liver toxicity and be an efficacious treatment for severe inflammatory bowel disease: a 2-center observational cohort study Early nodular hyperplasia of the liver occurring with inflammatory bowel diseases in association with thioguanine therapy
cord-102276-0a8hup5y	2020	title: Development and validation of multivariable machine learning algorithms to predict risk of cancer in symptomatic patients referred urgently from primary care In use-case 1, the algorithms correctly identify 20% of patients who do not have cancer and may not need an urgent 2WW referral. 10 We report the development and validation of a set of machine learning algorithms to provide a calibrated risk probability of cancer (a score between zero and one, higher values indicating greater risk of cancer) for triaging symptomatic patients. Table 6 shows test performance characteristics for use-case 2 (triage), to identify patients at higher risk of cancer who would be considered for priority through the urgent referral pathway. This paper reports the development and validation of a set of statistical machine learning algorithms based on routine laboratory blood measurements that can predict cancer outcomes for symptomatic patients referred urgently from primary care for possible cancer diagnosis.
cord-103214-3lz33pj3	2020	An essential strategic element was a very short-term restructuring of the Emergency Department with the objectives of reducing the number of cases within the clinic, detecting COVID-19 cases as sensitively as possible and separating the patient pathways at an early stage. After establishing a pre-triage with structured algorithms, all confirmed COVID-19 cases were identified before entering the clinic and assigned to an appropriate treatment pathway. . https://doi.org/10.1101/2020.09.07.20185819 doi: medRxiv preprint As of March 27, 2020, a specially developed algorithm for case detection was established, which, in addition to broader range of clinical criteria, focuses on the regionally observable epidemiological events in risk facilities, e. 7%) of the patients, neither direct contact with confirmed COVID-19 cases nor a stay in high-risk areas or facilities could be recorded at the time of pre-triage ( Figure 6 ). At this point, the Emergency Department has the key function of identifying those patients who need treatment with the hospital resources for medical reasons and referring other cases to the outpatient sector.
cord-103659-wpwfqhp2	2020	In order to optimize diagnostic workup of the current severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic, we systematically reviewed neurological and neuroradiological manifestations of SARS-CoV-2 and all other known human coronavirus species (HCoV). . https://doi.org/10.1101/2020.08.26.20182196 doi: medRxiv preprint symptoms/complications, neuropathological findings and/or neuroimaging findings associated to acute or prior coronavirus infection. Several case reports, comprising a total of 11 patients, described neurological complications in SARS-CoV-1, among them critical illness neuro-/myopathy, seizures, persistent sleeping difficulties, persistent anosmia, delirium and generalized pain (Table e-6). Several common neurological symptoms among SARS-CoV-2 patients have been described in these studies, such as fatigue (44 -64% of patients), 42 is the author/funder, who has granted medRxiv a license to display the preprint in (which was not certified by peer review) preprint Retrospective Observational Study of Brain Magnetic Resonance Imaging Findings in Patients with Acute SARS-CoV-2 Infection and Neurological Manifestations
cord-103686-er8llst4	2020	Among the patients hospitalized due to influenza severe respiratory infection, it has been estimated that 29 to 6% require admission to the intensive care unit (ICU). In Argentina, there is a significant absence of data regarding influenza severe respiratory disease and, therefore, a lack of knowledge about the impact of this disease at health institutions, hospital mortality, and the profile of patients requiring ICU. Thus, the objective of this work is to describe the history of comorbidities as well as the clinical, laboratory and imaging findings of patients who required hospitalization in a general ward or ICU during 2019 in a high-complexity care hospital from Buenos Aires, capital of Argentina. In this cohort study, we reported the clinical characteristics and risk factors associated with clinical outcomes in patients with laboratory-confirmed influenza who required hospitalization during 2019.
cord-103807-x4hrwhkz	2020	Patients often present to the intensive care unit with broad phenotypes, including multiple organ dysfunction syndrome (MODS) resulting from infection, trauma, or other disease processes. Using multi-time point whole blood (cellular/acellular) total transcriptomics in 27 patients, we highlight the promise of simultaneously mapping viral/bacterial load, cell composition, tissue damage biomarkers, balance between syndromic biology vs. The power of RNA generated data likely is in its potential to effect therapeutic changes in individual patients with diverse clinical presentations, such as Multiple Organ Dysfunction Syndrome (MODS). Additional insights from the top mapped bacteria include normal flora elevation of Polynucleobacter necessarius and Bordetella parapertussis in patient 24 suggested to have issues in antigen processing and presentation (case study presented below for RNASEH2B), multiple Streptococcus strains (including pyogenes) identified in patients 11 and 5 that were culture positive, Pandoraea faecigallinarum in patient 10, and Cryobacterium arcticum in patient 10 day 0.
cord-104055-47ren7ie	2020	Objective To determine (i) the association between long-term impairment of consciousness after severe brain injury, spontaneous brain oscillations, and underlying subcortical damage, and (ii) whether such data can be used to aid patient diagnosis, a process known to be susceptible to high error rates. Conclusions These results ground, for the first time, electroencephalographic presentation detected with routine clinical techniques in the underlying brain pathology of disorders of consciousness and demonstrate how multimodal combination of clinical, electroencephalographic, and imaging data can be employed in potentially mitigating the high rates of misdiagnosis typical of this patient cohort. Sex, 19 age, time-post-injury, etiology (i.e., TBI vs non-TBI), were included as covariates, 20 along with NBV (to ensure that observed tissue displacement reflect local subcortical 21 shape changes independent of overall brain atrophy ( In this analysis, we related the patients'' behavioral presentation, as captured by the 7 CRS-R subscales, with subcortical atrophy.
cord-104180-f3hoz9bu	2003	They looked at end-organ epithelial cell apoptosis in a rabbit model of ARDS and at the effects of plasma on epithelial cells from recipients of the injurious ventilatory strategy, and analyzed samples from a previous trial into lung protective ventilation [8] . Choosing the right ventilation strategy for ARDS patients has more benefits than just lung protection, and therapeutic targeting of these factors that induce end organ apoptosis may be the next step. Stress doses of hydrocortisone reduce severe systemic inflammatory response syndrome and improve early outcome in a risk group of patients after cardiac surgery Effect of mechanical ventilation on inflammatory mediators in patients with acute respiratory distress syndrome: a randomized controlled trial Dose-response characteristics during long-term inhalation of nitric oxide in patients with severe acute respiratory distress syndrome: a prospective, randomized, controlled study
cord-104404-ytszpa4c	2020	authors: Baig, Muhammad Akbar In wake of the current COVID-19 pandemic, which has taken the world by storm, it is imperative to protect the health and safety of physicians and staff involved in acute management of COVID-19 patients. As of now, it is essential to contain a crashing suspected/confirmed COVID-19 patient within the confines of a negative isolation chamber due to a high risk of aerosolization, with strict adherence to personal protective equipment (PPE), exclusively comprising of N95 or preferably a powered air purifying respirator (PAPR) (1). The ARDSnet (acute respiratory distress syndrome network) protocol should be followed for patient ventilation. Following intubation and initial ventilation, immediately proceed to transfer the patient to intensive care unit, after which, perform decontamination of the initial zone and the equipment used. Interim Clinical Guidance for Management of Patients with Confirmed Coronavirus Disease Prone Positioning in Severe Acute Respiratory Distress Syndrome
cord-104467-elwfz1gk	2020	
cord-104507-xx7t26rl	2020	Based on previous experience of blood purification to treat cytokine storm syndrome (CSS) in severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS), here we aimed to review the current literature on extracorporeal hemoperfusion as a potential therapeutic option for CSS-associated conditions, with a focus on severe COVID-19. To date, various centers in different countries including Italy, China, USA, Germany, and Iran have reported or are investigating the beneficial effects of different hemoperfusion systems, including HA380/HA330 cartridges, CytoSorb, and polymyxin B immobilized fiber column in treatment of critically-ill COVID-19 patients. To date, a large number of experimental and clinical data, mostly from case reports and case series, have introduced CytoSorb as an effective rescue therapy for removal of inflammatory cytokines and achievement of hemodynamic stabilization in critically ill patients with septic shock and kidney failure (47) (48) (49) .
cord-138439-wvynetna	2020	
cord-148109-ql1tthyr	2020	
cord-158252-l43ztxsl	2020	We found that compared to COVIDneg at the time of clinical presentation and diagnostic testing, COVIDpos patients tended to have higher plasma fibrinogen levels and similarly low platelet counts, with approximately 25% of patients in both cohorts showing outright thrombocytopenia. To this end, we instituted a holistic data science platform across an academic health care system that enables machine intelligence to augment the curation of phenotypes and outcomes from 15.2 million EHR clinical notes and associated 3 million lab tests from 1,192 COVID-19positive (COVIDpos) and 47,344 confirmed COVID-19-negative (COVIDneg) patients over a retrospectively defined 2-month observation period straddling the date of the PCR test (see Methods). Conversely, platelet counts were lower in the COVIDpos cohort at the time of clinical presentation but tended to increase over the subsequent 10 days to levels significantly higher than those in COVIDneg patients (Cohen''s D = 0.361, BH-adjusted Mann-Whitney p-value = 0.008, Table 2, Figure 2B ).
cord-184194-zdxebonv	2020	This study used nationwide insurance data, accumulated possible features discussed in existing literature, and used a deep neural network to predict the patients choices of hospital levels. Focusing on the hospital levels of the patients'' choices, this study used explainable artificial intelligence (XAI) methods to interpret the effecting features for the general public and individuals. According to a public opinion poll conducted in 2019 [35] , although 85.3% of the respondents agreed that for a mild condition the patient should go to the primary care service nearby instead of tertiary hospitals, 70% considered institutes with higher levels to possess better professional skills, and 49% expressed having confidence in determining the severity of their own condition. According to our result, three features could interpret the majority of patients'' choices of hospital levels: the MFPC, LFPC, and physician density.
cord-204125-fvd6d44c	2020	Lactate dehydrogenase, neutrophils (%), lymphocyte (%), high sensitive C-reactive protein, and age acquired at hospital admission were identified as key predictors of death by multi-tree XGBoost model. The prognostic model, nomogram and LNLCA score can help in early detection of high mortality risk of COVID-19 patients, which will help doctors to improve the management of patient stratification. [21] reported a machine learning approach to select three biomarkers (lactic dehydrogenase (LDH), lymphocyte and high-sensitivity C-reactive protein (hs-CRP)) and using them to predict individual patients mortality, 10 days ahead with more than 90 percent accuracy. Although several predictive prognostic models are proposed for the early detection of individuals at high risk of COVID-19 mortality, a major gap remains in the design of state-of-the-art interpretable machine learning based algorithms and high performance quantitative scoring system to classify the most selective predictive biomarkers of patient death.
cord-214006-0w6bqrox	2020	
cord-216974-0al3vdh1	2020	title: Reconfiguring health services to reduce the workload of caregivers during the COVID-19 outbreak using an open-source scalable platform for remote digital monitoring and coordination of care in hospital Command Centres Patients answer simple self-reported questionnaires and their data is transmitted, in real time, to a Command Centre in the nearest reference hospital. Data from remote monitoring of patients are transmitted to a Command Centre, in the nearest reference hospital, and automated algorithms triage patients with early warning signs. Patients with confirmed Covid-19 are assessed by clinicians (in hospital or in community) for: 1) absence of initial signs of severity (based on their age, comorbidities, initial presentation of the disease); 2) their ability to be quarantined at home (e.g., absence of a psychiatric disorder or of a loss of autonomy); and 3) their ability to perform the remote monitoring at home (e.g., basic computer literacy, smartphone availability).
cord-217201-lvefk7qx	2020	Based on the HP classification, we systematically analyze three nervous phenotypes (loss of smell, loss of taste, and headache) and four abdominal phenotypes (nausea, vomiting, abdominal pain, and diarrhea) identified in patients, and found that patients from Europe and USA turned to have higher nervous phenotypes and abdominal phenotypes than patients from Asia. First, we analyzed the group of COVID-19-related nervous system phenotypes, which includes loss of smell (anosmia), loss of taste (parageusia), and headache ( Figure 1 ). To further study the relation between different comorbidity phenotypes and disease outcomes, we survey the disease data from the literature and compared the incidences of specific comorbidity phenotypes in severe or non-severe COVID-19 patients. In severe disease patients, the incidence of diabetes or kidney failure was higher than that in non-severe patient groups (The X-axis is country/city, report date, number of cases). Based on the HP classification, we systematically analyzed 17 clinical phenotypes of COVID-19 in case reported.
cord-225218-x32a4sp3	2020	
cord-244388-dxrrpxl7	2020	
cord-251957-luw8m3eq	2020	Here we describe the modifications we have implemented in clinical care provided by the 8 multidisciplinary Aortic Disease Program at our large regional referral institution to address the 9 challenges presented by the COVID-19 pandemic. Unfortunately given the rapid escalation of this worldwide pandemic, we do not 19 have the luxury of waiting for definitive data regarding the effects of COVID-19 on the 20 cardiovascular system-we must proceed in the face of this uncertainty to continue to take care 21 of patients. We have also considered altering our operative plan for patients with aortic disease in need of 13 high-risk operations to take into consideration the current and projected constrained resources of 14 our hospital system due to the pandemic. Cardiovascular Considerations for Patients, Health Care Workers, and Health Systems During 17 the Coronavirus Disease 2019 (COVID-19) Pandemic
cord-252013-ehyuflg3	2020	AIM: Our aim was to report the experience of the Department of Vascular Surgery of Pavia (Lombardy), including the lessons learned and future perspectives regarding the management of COVID-19 patients who developed severe acute ischemia with impending lower limb loss or deep vein thrombosis (DVT). CONCLUSIONS: Our study confirms that critically ill, COVID-19 patients who develop arterial and deep vein thrombosis are at high risk of mortality, but if treated properly, there is an improvement in overall survival rate, especially in patients of 60 years of age or younger. The aim of our analysis was to report our experience of the Department of Vascular Surgery of Pavia (Lombardy), focusing on the lessons learned and future perspectives regarding the management of COVID-19 patients who developed severe acute ischemia with impending lower limb loss or deep vein thrombosis (DVT).
cord-252060-cotsu82v	2020	
cord-252085-8dq3gdo8	2020	title: Chest Drain Insertion following Pneumothorax due to CPR in a COVID – 19 Patient. Chest Drain Insertion following Pneumothorax due to CPR in a COVID -19 Patient. Thus, in patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV2) infection lungs are fragile and especially those with positive pressure ventilations, the dangers of pneumothorax arise, and comprehensive management is warranted. A 42 years old male patient was transferred to our hospital, intubated on mechanical ventilation, he had a 1 week history of fever, cough and shortness of breath, with positive PCR test for COVID-19, and CT scan showing extensive bilateral multiple, multilobed ground glass appearance with areas of consolidation, there was no given history of previous lung diseases or smoking history ( Figure 1 ). A portable chest x-ray was ordered, and the patient was found to have significant amount of left sided -pneumothorax with underlying lung collapse , mild mediastinal shift to the right side, with progressive course regarding the right side opacities (Figure 2 ), compared to previous x-ray.
cord-252101-77lnyjan	2020	
cord-252159-6t35bxwv	2020	PURPOSE: Glucocorticoids (GCs), alone or associated to other drugs, were widely used in the management of patients affected by severe acute respiratory syndrome caused by SARS-CoV-2 infection, during the recent COVID-19 outbreak. RESULTS: GC treatment can cause symptoms of hypercortisolism, especially in patients with individual hypersensibility, or hypoadrenalism after drug withdrawal, due to hypothalamic–pituitary–adrenal (HPA) axis suppression, with consequences in terms of increased morbidity and mortality risk. On the other hand, prolonged steroids treatment can cause symptoms of hypercortisolism, especially in patients with individual hypersensibility, or hypoadrenalism after drug withdrawal, due to hypothalamic-pituitary-adrenal (HPA) axis suppression. This review summarizes the available data on HPA axis impairment in GC-treated Sars-Cov2 patients, focusing on the risk of adrenal insufficiency and on potential drug interactions during concomitant treatments. This review summarizes the available data on HPA axis impairment in GC-treated Sars-Cov2 patients, focusing on the risk of adrenal insufficiency and on potential drug interactions during concomitant treatments.
cord-252243-ua2w6xki	2020	Results: Staff were very aware of common UTI symptoms and nitrofurantoin as first-line treatment, but some were less aware about when to send a urine culture, second-line and non-antibiotic management, and did not probe for signs and symptoms to specifically exclude vaginal causes or pyelonephritis before prescribing. • Clearly outlines how to clinically assess someone with suspected UTI; • Includes prompts/considerations around differential diagnosis, pyelonephritis, and sepsis; • Clearly outlines the steps for clinical assessment of someone with suspected UTI and when a urine dipstick test or culture is needed; • Provides information on the sensitivity and specificity when using urine dipsticks to diagnose a UTI for women under 65 years; • Has been developed as an update to previous guidance; • Links to latest national guidance on antimicrobial prescribing for UTI management (developed since this study was conducted); • Links to UTI leaflets and resources for women under 65 years that explains evidenced-based prevention and self-care recommendations.
cord-252279-0gozdv43	2020	Without a therapeutic vaccine or specific antiviral drugs, and with a desperate attempt to find a cure against novel Corona Virus Disease 2019 (Covid-19) [1] , the limelight was shifted to hydoxychloroquine (derivative of chloroquine that has antimalarial, antiinflammatory, immunosuppressive and antiautophagy activities [2, 3] ; upon a tweet by US president Mr. Donald J. The main aim of this review is to discuss the mode of action of hydroxychloroquine at cellular and molecular levels, that potentially support the clinical efficacy and few adverse side effects observed in Covid-19 patients treated with hydroxychloroquine, which may further help in improving the clinical outcomes by modifying or altering the drug itself or its restricted use in certain individuals by enforcing strict inclusion and exclusion criteria. Due to its cellular and molecular effects as discussed in previous sections, quite a few clinical trials are studying the effectiveness and safety of hydroxychloroquine (also chloroquine) for Covid-19 (https://clinicaltrials.gov/ct2/ results?cond=%22wuhan?coronavirus%22).
cord-252284-cgdcsazr	2020	CONCLUSION: COVID-19 patients may develop severe cardiac complications such as myocarditis and heart failure. Bedside echocardiography showed an enlarged left ventricle (61 mm), diffuse myocardial dyskinesia along with a low left ventricular ejection fraction (LVEF) (32%), pulmonary hypertension (44 mmHg), and no decrease in right cardiac function (Figs. Recently published COVID-19 studies have shown that cardiac complications, including heart failure, arrhythmia and myocardial infarction, are not uncommon, and the proportion of people with increased Trop I in severe cases is higher than other cases [3, 4] . In this case, the patient had the following features: sudden onset, obvious symptoms of viral infection, rapid emergence of severe hemodynamic disorders, severe myocardial injury, and diffuse decreased ventricular wall movement. In this case, the patient had no history of heart disease; therefore, the decreased cardiac function was likely to be caused by COVID-19. COVID-19 patients may develop severe cardiac complications such as myocarditis and heart failure.
cord-252288-klkoerfn	2020	
cord-252368-njlo6g78	2020	
cord-252374-obl6pfpf	2020	
cord-252452-wwkw1uyi	2020	As a further analysis, to investigate whether the intensity of action of statins could influence the risk of mortality, we divided our 42 patients taking statins into two subgroups, based on the drug''s intensity of action, according to the ACC/AHA Classification [5] . The comparison between the survival curves, in contrast to patients who did not take statins, showed no significant differences (Fig. 1b) . The comparison between the survival curves, in contrast to patients who did not take statins, indicated a significant difference between groups. In a recent study, no significant differences in statin chronic assumption were found in COVID-19 patients who developed a cardiac injury, even if this population showed an increased mortality risk in the brief period [11] . The comparison between the survival curves, in contrast to patients who did not take statins, showed no significant differences. The comparison between the survival curves, in contrast to patients who do not take statins, showed a significant differences role against the virus.
cord-252473-i4pmux28	2004	It could be argued that visitation restrictions, in light of a potential outbreak of a contagious disease, are ethically sound because of the compelling need to protect public health. In a health care institution, visitation restrictions not only affect inpatients but also have an impact on ambulatory patients who must come for diagnostic tests or interventions and who, if deprived access, might develop urgent or emergent conditions. Furthermore, to be consistent with expectations of transparency, the criteria by which exceptionality to the rules of visitation restriction exists should also be published openly throughout the organization for staff, patients and visitors. For example, although current policy allows for specific times of visitation and numbers of visitors per day, a sudden outbreak might dictate a quick lockdown of the facility without patients or family members receiving prior notice. It is ethical to accept that public health protection trumps individual rights to liberal visitation.
cord-252506-8u9oiqoc	2020	
cord-252531-i3b647wv	2020	Results Hospital pharmacists shall support pharmaceutical care services by participating in making evidence-based decisions for medication, monitoring and evaluation of medication safety and efficacy, providing strengthened care for special population and patients with combined underlying diseases, monitoring and management of convalescent plasma therapy, providing emotional counselling and psychological support, and providing scientific information about COVID-19 vaccines. For COVID-19 patients receiving centralized hospitalized treatment, pharmaceutical care services are https://doi.org/10.1016/j.sapharm.2020.03.027 Received 31 March 2020; Accepted 31 March 2020 indispensable supplement for clinical treatment and management, which is of great significance for improving the level of drug therapy, improving patient''s outcome and promoting the overall pandemic control. Based on the Chinese perspective of "centralizing COVID-19 patients and centralized inpatient treatment", the paper established a pharmaceutical care framework of COVID-19 hospitalized patients, including participating in making evidence-based decisions for medication, monitoring and evaluation of medication safety and efficacy, strengthened care for special population and patients with combined underlying diseases, monitoring and management of convalescent plasma therapy (CPT), providing emotional counselling and psychological support and providing scientific information about COVID-19 vaccines.
cord-252539-kx8ew3ap	2020	
cord-252617-rqm0p19e	2020	With the deadly and highly transmissible SARS-CoV-2 virus causing the COVID-19 pandemic, there is global concern about the danger of contaminating healthcare workers (HCW), particularly during airway management of infected patients. In this edition of Pediatric Anesthesia, Bryant and Tobias report a laboratory study where there was up to 99.2% decrease of artificial aerosol particles measured outside compared with inside an enclosed clear intubation box using augmented gas flow (suction). 1 At first glance, the concept of a barrier over the patient during airway management seems like a simple and logical option in terms of protecting practitioners from viral infection. Intubation is reported to be a high-risk procedure for aerosol release and transmission of infection to HCWs. Supporting evidence for this comes from a systematic review. The aerosol box for intubation in COVID-19 patients: an in-situ simulation crossover study
cord-252687-7084pfqm	2020	Many clinical studies have shown an association between SARS-CoV-2 infection and hypercoagulability diagnosed on the basis of abnormal coagulation parameters, including activated partial thromboplastin time, prothrombin time, fibrinogen, D-dimer and C-reactive protein level. In this review, the potential mechanism and the effect of the SARS-CoV-2 viral infection on the development of ischemic stroke in COVID-19 patients were carefully studied. study, in which most non-survivor COVID-19 patients'' (71.4%) blood tests showed prolonged prothrombin time and an increased D-dimer levels, which indicated the state after activation of the plasma coagulation system [14] . The accumulation of immune cells in the vascular wall in response to the viral infection, especially among patients with ischemic risk factors, induces endothelial dysfunction, migration and proliferation of cells, activation of coagulation cascade and production of fibrous plaques.
cord-252699-0xw9xvox	2020	Second, we reviewed Hartford HealthCare''s EHR to identify patients with Parkinson disease who were admitted for COVID-19 to any of our six affiliate hospitals across the state as a way to estimate the burden of COVID-19 on the population of patients with movement disorders. Of the patients who died, twelve (92%) were greater than 60 years old, eleven (85%) had parkinsonism, eleven (85%) were from an extended care facility, nine (69%) had comorbid dementia, nine (69%) had at least one high-risk comorbid condition, eight (62%) had alteration in mental status as a presenting symptom, and eight (62%) received a medication with antiviral properties (hydroxychloroquine, oseltamivir, amantadine, and memantine), including three who were on an adamantane prior to contracting COVID-19. Within our cohort of patients with movement disorders, factors related to increased mortality were age over 60 years, PD or parkinsonism diagnosis, residing in an extended care facility, comorbid dementia, and comorbid medical conditions.
cord-252751-prock3co	2020	To be considered eligible for trial inclusion, patients had to meet the following criteria: 1) Currently hospitalized, aged ≥ 18 years, 2) SARS-CoV-2 infection confirmed by PCR test ≤ 4 days before trial enrollment 3) SpO2 ≤ 94% on room air or requiring supplemental oxygen at screening 4) Presence of radiographic evidence of pulmonary infiltrates. For each patient we extracted the following information: age, sex, race, ethnicity, days from onset of symptoms, imaging results, weight, vital signs and laboratory values (both on admission and during hospitalization), preexisting medical conditions, admission to the intensive care unit (ICU), use of mechanical ventilation, use of systemic corticosteroids [12] , hospitalization outcome (death or discharge) and incidence of acute kidney injury (AKI) using the KDIGO criteria [13] . In order to provide a cohesive assessment of the efficacy of remdesivir, we compared the clinical outcomes of patients who were hospitalized with severe COVID-19 (requiring supplemental oxygen and having abnormal imaging findings) and received either remdesivir or supportive care.
cord-252775-faxiem2w	2020	The Cardiac Surgery Departments have to think to a new normal: since the virus will remain endemic in the society, dedicated pathways or even dedicated Teams are pivotal to treat safely the patients, in respect of the safety of the health care workers. Moreover, we need a keen eye on deciding which pathologies have to be treated with priority: Coronary artery Disease showed a higher mortality rate in patients affected by COVID19, but it is, however, reasonable to think that all the cardiac pathologies affecting the lung circulation—such as symptomatic severe mitral diseases or aortic stenosis—might deserve a priority access to treatment, to increase the survival rate in case of an acquired‐Coronavirus infection later on. In epidemiological terms, it would be reasonable to consider a comparison of the age-profile overlap among patients who suffered from more severe COVID-19 with patients who undergo cardiac surgical procedures, since both prevalence of valvular diseases and casefatality rates for COVID-19 increase in the elderly patients.
cord-252829-gn56tsz3	2020	title: Associations between informal care costs, care quality, carer rewards, burden and subsequent grief: the international, access, rights and empowerment mortality follow-back study of the last 3 months of life (IARE I study) Data: ICrs reported hours and activities, care quality, positive aspects and burdens of caregiving, and completed the Texas Revised Inventory of Grief (TRIG). Multivariable logistic regression analysis explored the association of potential explanatory variables, including IC costs and care quality, on three outcomes: positive aspects and burdens of caregiving, and subsequent grief. Therefore, as part of the International, Access, Rights, and Empowerment (IARE I) study of palliative care in three countries, we aimed to determine and compare the informal care (IC) costs and their associations with selfreported caregiver burden, rewards and subsequent caregiver grief, taking account of care quality, as reported by ICrs. We conducted a mortality follow-back postal survey of key informants (normally relatives and informal carers) of decedents identified by palliative care services in participating hospitals.
cord-252890-of29g89s	2020	A plea for avoiding systematic intubation in severely hypoxemic patients with COVID-19-associated respiratory failure Eduardo Villarreal-Fernandez 1 , Ravi Patel 1 , Reshma Golamari 2 , Muhammad Khalid 2 , Ami DeWaters 2 and Philippe Haouzi 1* Indeed, since a profound hypoxemia appears to be the hallmark of COVID-19-associated pneumonia, the initial consensus [2] was to start invasive mechanical ventilation as soon as possible due to the overwhelming number of patients in respiratory failure presenting at the same time in a hospital and to prevent the risk of hypoxic cardiac arrest; (2) avoidance of high-flow nasal cannula (HFNC) to reduce respiratory droplet aerosolization for healthcare workers [3] in what was seen as "inevitable" intubations. After an initial increase in oxygen requirement through day 6, patients in this group were all able to be discharged at a time when most of the early-intubated patients were still mechanically ventilated (Fig. 1) .
cord-252981-hywvmdjb	2020	The public health campaign encouraging social distancing must also provide tips for remaining safe from physical harm. The public must consider 2 important consequences of a trip to the emergency department in today''s climate in addition to the harm created by the injury itself: (1) as the virus spreads, they are putting themselves at risk of exposure as providers triage and care for those with the disease; and (2) the time and resources it takes to care for injuries will create additional strain on our hospital system. With more than 25,000 orthopaedic surgeons in practice in the United States 1 caring for patients of all ages and demographics, there are specific steps we can take in order to help the public prevent hospital visits and take extra precautions to remain safe while social distancing.
cord-253077-61fmul8c	2020	Lastly, Nonhuman primate (NHP) studies and patient data on SARS-CoV-1 have also shown that virus spike-specific IgG responses can exacerbate acute lung injury due to repolarization of alveolar macrophages into pro-inflammatory phenotypes and enhanced recruitment of inflammatory monocyte via CCL2 and IL-8 (Clay et al., 2012; Liu et al., 2019) . Collectively, these data suggest that cross-talk with monocytes might impair NK cell recognition and killing of SARS-CoV-2infected cells, and antibodies targeting IL-6 and TNF-signaling may benefit enhanced NK cell functions in COVID-19 patients ( Figure 2 ). However, these CD4 T cells lacked phenotypic markers of activation and were specific for C-terminal S protein epitopes that are highly similar to endemic human coronaviruses, suggesting that crossreactive CD4 memory T cells in some populations (e.g., children and younger patients that experience a higher incidence of hCoV infections) may be recruited into an amplified primary SARS-CoV-2-specific response (Braun et al., 2020) .
cord-253129-v5lck9l7	2020	BACKGROUND: Positive end-expiratory pressure (PEEP) at minimum respiratory elastance during mechanical ventilation (MV) in patients with acute respiratory distress syndrome (ARDS) may improve patient care and outcome. The Clinical utilisation of respiratory elastance (CURE) trial is a two-arm, randomised controlled trial (RCT) investigating the performance of PEEP selected at an objective, model-based minimal respiratory system elastance in patients with ARDS. Secondary outcomes include length of time of MV, ventilator-free days (VFD) up to 28 days, ICU and hospital length of stay, AUC of oxygen saturation (SpO(2))/FiO(2) during MV, number of desaturation events (SpO(2) < 88%), changes in respiratory mechanics and chest x-ray index scores, rescue therapies (prone positioning, nitric oxide use, extracorporeal membrane oxygenation) and hospital and 90-day mortality. Following the study, a phase-2 randomised controlled trial (RCT) was designed to assess mechanical ventilation at minimal elastance PEEP in patients with ARDS versus standard practice of care in a single-centre hospital.
cord-253148-3t4o27xp	2008	STUDY DESIGN: From October 2005 through October 2006, we screened respiratory samples from children and adults negative for common respiratory pathogens for HBoV by PCR. CONCLUSIONS: HBoV circulates in Cleveland, OH, in children and adults with similar frequencies, and can warrant hospitalization and intensive care. We sought to further define the clinical and epidemiologic characteristics of HBoV in adult and pediatric patients in Cleveland, OH. Isolates positive for HBoV were screened for common respiratory viruses by RT-PCR with published primer sets. Forty samples (2.2%) tested positive for HBoV by PCR: 36 (90%) pediatric patients and 4 (10%) adult patients. Of pediatric patients who screened positive for HBoV, 27 (84.4%) were admitted to the hospital, including 9 (28.1%) who required intensive care. However, this report suggests that clinical disease associated with HBoV alone may be severe enough to require admission to the hospital in both adults and children and to the intensive care unit in children.
cord-253168-b095rq5i	2020	OBJECTIVE: The aim of this study was to evaluate the results of a follow-up protocol established in an advanced heart failure unit at a single center in Spain during the coronavirus disease 2019 (COVID-19) pandemic. RESULTS: When compared to the preceding months, during the COVID pandemic there was a 56.5% reduction in the ER visits and a 46.9% reduction in hospital admissions, without an increase in mortality (9 patients died in both time periods). CONCLUSION: Our study suggests that implementing an active-surveillance protocol in acutely decompensated heart failure units during the SARS-CoV-2 pandemic can reduce hospital admissions, ER visits and, potentially, viral transmission, in a cohort of especially vulnerable patients. Our study suggests that implementing an active-surveillance protocol in HFUs during the SARS-CoV-2 pandemic can reduce hospital admissions, ER visits and, potentially, viral transmission, in a cohort of especially vulnerable patients.
cord-253189-uba6dy08	2020	There has been a major expansion of scribe programs in the United States of America (USA) both in terms of their employment locations, now moving outside the emergency department (ED), and numbers, despite attempts to streamline documentation in electronic health records (EHRs) so that clerical support is no longer required. Many studies note that physicians go home soon after completion of their shift when working with a scribe but can''t report the magnitude of the impact. Impact of COVID19 on scribe programs 2020 has provided significant challenges for EM and for all other medical settings as well. In summary, there is now some limited economic evidence for using scribes, with small improvements seen in physician productivity and increased per-patient revenue in the USA, but not patient flow. Impact of scribes on emergency medicine doctors'' productivity and patient throughput: multicentre randomised trial An economic evaluation of the costs of training a medical scribe to work in Emergency Medicine
cord-253256-909chgl0	2020	
cord-253295-82ydczid	2020	Patient workup uses present illness history with reference to past medical history, review of other organ systems for other abnormalities, review of family history, physical examination, radiographic studies, clinical laboratory studies (for example, peripheral blood or CSF specimens), and anatomic pathology laboratory studies (for example, tissue biopsy or pleural fluid cytology specimens). Obviously, arrival at the correct diagnosis is a function of the examining physician and pathologist (fund of knowledge, experience, alertness), the prevalence of the disease in question in the particular patient (age, race, sex, site), and the sensitivity/ specificity of the screening tests used (physical exam, vital signs, blood solutes, tissue stains, genetic assays). However, understanding the molecular and cellular pathogenesis of a disease allows development of screening methods to determine risk for clinically unaffected individuals, as well as mechanistic approaches to specific therapy.
cord-253375-m3qjj7r4	2020	
cord-253402-6sgeraws	2020	There is now grave concern regarding the Italian national health system''s capacity to effectively respond to the needs of patients who are infected and require intensive care for SARS-CoV-2 pneumonia. At present, our national health system''s capacity to effectively respond to the needs of those who are already infected and require admission to an intensive care unit for ARDS, largely due to SARS-CoV-2 pneumonia, is a matter of grave concern. Given that the mortality of patients who are critically ill with SARS-CoV-2 pneumonia is high and that the survival time of non-survivors is 1-2 weeks, the number of people infected in Italy will probably impose a major strain on critical care facilities in our hospitals, some of which do not have adequate resources or staff to deal with this emergency. We predict that if the exponential trend continues for the next few days, more than 2500 hospital beds for patients in intensive care units will be needed in only 1 week to treat ARDS caused by SARS-CoV-2-pneumonia in Italy.
cord-253417-ihi67m1u	2020	title: Rapid implementation of an evidence‐based remote triaging system for assessment of suspected referrals and patients with head and neck cancer on follow‐up after treatment during the COVID‐19 pandemic: Model for international collaboration The aim of this study is to demonstrate a rapid implementation of an evidence-based, structured, remote triaging system for assessment of suspected referrals and patients with cancer who are on regular follow-up after treatment for HNC in the United Kingdom (UK). Primary care practitioners'' views (12 general practitioners in the North East were interviewed face to face between June 14, 2019 and December 5, 2019) discussing the head and neck cancer risk calculator (version 1) as a means to drive more confidence in the triage of patients to suspected cancer clinics was met with enthusiasm. Rapid implementation of an evidence-based remote triaging system for assessment of suspected referrals and patients with head and neck cancer on follow
cord-253456-u9num2o9	2020	Suspected patients with clinical and/or radiological features of pneumonia were quarantined prior to SARS-CoV-2 nucleic acid detection according to WHO guidelines for cases with suspected infection [8] as well as the instructions from the Pediatric Branch of the Hubei Medical Association for pediatric cases [9] . Specifically, suspected cases of SARS-CoV-2 infection should meet 1 of the following criteria [10] : (1) at least 1 clinical symptom, including fever, expectation, tachypnea, lethargy, poor feeding, cough, vomiting, and diarrhea; (2) chest radiologic abnormalities consistent with viral pneumonia. Patients were discharged when all the following criteria were met [10] : (1) fever had recovered for at least 3 days; (2) upper respiratory symptoms were alleviated; (3) the exudative lesion was alleviated significantly according to radiological evidence; (4) negative results were obtained for SARS-CoV-2 nucleic acid detection in 2 consecutive tests performed with an interval of 24 hours.
cord-253638-5f9ofdsc	2020	Given the increased risk for severe COVID‐19 observed in adults with underlying cardiac involvement, there is concern that patients with pediatric and congenital heart disease (CHD) may likewise be at increased risk for severe infection. In this review, we describe the effects of COVID‐19 in the pediatric and young adult population and review the cardiovascular involvement in COVID‐19 focusing on implications for patients with congenital heart disease in particular. 4-Cardiac care team members are at risk for acquiring COVID-19 and may play a role in spreading the disease between patients and in the society at large. It is important to know that 3.8% of the cases reported from China were of healthcare team members suggesting that health care providers are at a significantly increased risk of contracting COVID-19 11, 83 .
cord-253704-y0t30xw3	2020	Even though severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has been observed to principally affect the respiratory system, neurological involvements have already been reported in some published work. Neurological manifestations can further be subdivided into the central nervous system (headache, dizziness, alteration of the sensorium, ataxia encephalitis, stroke, and seizures) and peripheral nervous system (skeletal muscle injury and peripheral nerve involvement including hyposmia and hypogeusia) symptomatology. Even though severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has been observed to mainly affect the respiratory system, neurological involvements have already been reported in some published work. In the present paper, we have reviewed the recently published or pre-print original articles, case reports, and existing open-source data-sets in order to delineate the spectrum of neurological disorders in SARS-CoV-2 positive cases. Another report from China describes a case of acute myelitis, possibly affecting the cervical spinal cord, as evidenced by the clinical features, in a known patient of SARS-CoV-2 infection [22] .
cord-253730-cdkzvfib	2020	OBJECTIVE: The aim of this study was to describe the clinical characteristics of coronavirus disease (COVID-19) patients, including risk factors for deep vein thrombosis and pulmonary embolism, and to evaluate the need for rehabilitation to prevent pulmonary embolism. The clinical characteristics and blood test results of patients with no history on admission of oral anticoagulant use were evaluated to assess the importance of inflammation and clotting function as risk factors for pulmonary embolism. 8) Because hypercoagulability and hyperinflammation have been reported in patients with COVID-19, we compared coagulability and inflammation by sex and the severity of COVID-19 to identify risk factors for PE that can be used to determine the necessity of early rehabilitation intervention to prevent PE. Considering the high risk of hospital-acquired infections and the worldwide shortage of medical resources, including not only PPE but also physicians, nurses, and rehabilitation therapists, it is understandable that the guidelines for physiotherapy do not recommend affirmative intervention for patients with moderate to severe COVID-19.
cord-253746-15w4gquq	2020	As therapeutic interventions in the early phase of the disease are attracting more and more interest, we argue that now is the time to involve patients'' organizations in the design of clinical protocols in order to define the most relevant end-points and assess the risk-benefit balance of new therapies. In this editorial perspective, we argue that patients'' voice will be essential to ensure uptake in the wider public of new therapies and vaccines resulting from these initiatives. Therefore, it is essential that trials are designed to include sufficient numbers of patients within the period of time during which the pandemic is expected to be active. Furthermore, patient reported outcomes are essential to assess the impact of therapeutic interventions on the long-term consequences of COVID-19 (13) . It is therefore important that patient organizations are involved early on in the design of clinical trials.
cord-253862-jl1zhg13	2020	Although this novel virus is less severe than the first SARS-CoV outbreak, human-to-human transmission remains very high and the number of cases continues to rise exponentially in major urban areas, highlighting the urgent need to develop new containment, diagnostic, and treatment protocols. In the case of SARS-CoV-2, viral evasion of the innate immune system leads to an increase in cytokine production and late CD4+/CD8+ response, which then leads to pathogenic inflammation in patients with high viral loads. (ChiCTR2000029308), involving severe SARS-CoV-2 cases, compared lopinavir/ritonavir treatment with standard care alone, and they showed that the antivirals yielded no clinical benefits. In an open-label control study conducted by Cai et al., the antiviral activity of favipiravir + IFN-α was compared to that of lopinavir/ritonavir + IFN-α in patients with confirmed SARS-CoV-2 infection.
cord-253886-4b3i30hi	2015	The foundation of safe care for patients with confirmed or suspected Ebola virus disease is effective infection control practice, which requires implementation of appropriate administrative policies, work practices, and environmental controls, accompanied by focused education, training, and supervision. However, the transport of the first patient with confirmed Ebola virus disease to the United States (Atlanta, GA), the transport of the first US-diagnosed Ebola virus disease case (Dallas, TX), and the first transmission of Ebola virus disease to health care workers in the United States understandably raised anxiety in the EMS community about the appropriate education and training, policies, and procedures, as well as supervision required, to be best prepared for transporting patients with serious communicable disease in the United States. The objectives of these hospital and out-of-hospital collaborations were to close education, training, and practice gaps to best facilitate the care for patients with serious communicable disease while ensuring the safety of the medics and the general public through meticulous implementation of infection control practices as recommended by CDC.
cord-253962-ug7yflxh	2020	title: A novel risk score to predict diagnosis with Coronavirus Disease 2019 (COVID‐19) in suspected patients: A retrospective, multi‐center, observational study BACKGROUND: The aim of the study was to explore a novel risk score to predict diagnosis with COVID‐19 among all suspected patients at admission. We found nine independent risk factors for diagnosis with COVID‐19 at admission to hospital: epidemiological exposure histories (OR:13.32, 95%CI 6.39‐27.75), weakness/fatigue (OR:4.51, 95%CI 1.70‐11.96), heart rate <100 beat/min (OR:3.80, 95%CI 2.00‐7.22), bilateral pneumonia (OR:3.60, 95%CI 1.83‐7.10), neutrophil count ≤6.3×10(9)/L (OR: 6.77, 95%CI 2.52‐18.19), eosinophil count ≤0.02×10(9)/L (OR:3.14, 95%CI 1.58‐6.22), glucose ≥6 mmol/L (OR:2.43, 95%CI 1.04‐5.66), D‐dimer ≥0.5 mg/L (OR:3.49, 95%CI 1.22‐9.96), and C‐reactive protein <5 mg/L (OR:3.83, 95%CI 1.86‐7.92). The current study is conducted aiming to explore the potential early risk factors, and to develop a risk score used for predicting the probability of diagnosis among all suspected COVID-19 patients at early stage.
cord-253970-sbj869yy	2020	There is limited knowledge on the neurologic manifestations of COVID-19 at present, with a wide array of neurological complications reported, ranging from ischemic stroke to acute demyelination and encephalitis. The second subset of neurological presentation involves a response to the cytokine storm and multi-system inflammation including acute demyelination, vasculitis, necrotizing encephalopathy, and posterior reversible encephalopathy syndrome. Table 1 provides a summary of the most common (1) vascular complications with stroke secondary to arterial or venous thrombosis, related to the known hypercoagulable state seen in COVID [4, 5, 14] , and (2) much broader gamut including diffuse leukoencephalopathy, acute demyelination, posterior reversible encephalopathy syndrome (PRES), necrotizing encephalopathy, and focal cytotoxic edema, primarily seen as a consequence of systemic inflammation and cytokine storm seen with COVID-19 [6] [7] [8] [9] [10] [11] [12] [13] . The most common neurological presentation reported has been ischemic stroke, secondary to arterial or venous thrombosis, because of the hypercoagulable state associated with COVID-19.
cord-254025-j1l0mder	2020	
cord-254040-s3k51rkk	2020	In this context, patients affected by chronic neurological diseases, such as amyotrophic lateral sclerosis (ALS), are at risk to be lost at follow-up, leading to a higher risk of morbidity and mortality. In this context, patients affected by chronic neurological diseases, such as amyotrophic lateral sclerosis (ALS), are at risk of being lost at follow-up with a consequently higher morbidity and mortality. Neurological examination and ALS Functional Rating Scale revised (ALSFRSr) are the most important tools to monitor disease progression. In a recent randomized trial comparing remote nutritional counseling with or without mobile health technology in ALS patients, Nu Planit application was an acceptable and useful mobile app to check nutritional status [17] . In conclusion, implementing telemedicine services for patients with ALS is necessary to allow direct clinical evaluation during COVID-19 pandemic, in order to plan the appropriate medical and nursing care, avoiding hospitalizations or urgent interventions. Telemedicine for patients with amyotrophic lateral sclerosis during COVID-19 pandemic: an Italian ALS referral center experience
cord-254072-evgw0as5	2003	
cord-254148-wc762p6v	2020	title: Recommendations for Standards of Network Care for Patients with Parkinson''s Disease in Germany Thus, one recommendation for standard of care in the initial phase of the disease course is physician awareness of the first signs of PD (which could be achieved with better information and secondary prevention standards in the network) and early referral of patients to a movement disorder specialist (which could be achieved by specific disease management programmes). For these patients, at the border between inpatient and outpatient care and the need for sophisticated treatment strategies, the new comprehensive, individual, and interdisciplinary concept of a PD day clinic has proven to be effective [25] . In general, a neurologist should be responsible for long-term medical care of patients with PD, and movement disorder specialists should be involved when there is a special issue.
cord-254269-x8vpnhd2	2020	A review of the PubMed Central and Medline provides articles examining the role of telemedicine for preoperative, postoperative, and follow up evaluation of surgical patients encompassing the past two decades. We report the summarized findings of these studies, the financial and HIPAA considerations of using telemedicine, potential benefits, pitfalls and strategies for the utilization of telemedicine into the clinical practice of general surgery and its subspecialties during the COVID-19 pandemic. While surgery may not seem like it would lend itself to telehealth practices, multiple studies have shown it can be a viable modality for safe and effective surgical care as an alternative to in-office visits in the pre and post-operative periods. The implementation of telehealth during the COVID-19 pandemic helps anyone and everyone adhere to policies of social distancing and reduce exposure, particularly patients at high risk Current use of telemedicine for post-discharge surgical care: a systematic review
cord-254357-5s84kimn	2020	Adherence to medication treatment protocols and active participation by individuals in their medical care are important for all patients, but especially for those with chronic conditions such as vision loss. 13 Lack of patient-physician communication can impair treatment effectiveness and result in vision loss since as many as 30% of all prescriptions are never filled 14 and within 6 months, an estimated 50% of prescriptions that are filled are no longer being used; 15 whether cost is a factor in such cases is unknown. 23, 24 For patients with AMD or diabetic eye disease, failure keeps scheduled appointments for intravitreal injections or monitoring undermines treatment efficacy, impairs successful patient outcomes and results in loss of vision that might have been avoided. Active participation by individuals in their medical care is important for all patients, but especially for those with chronic conditions such as vision loss.
cord-254377-j8e8gb0l	2020	However, the risk associated with mild and moderate illness from Covid-19 is unknown, and there is no current recommendation for prophylaxis against thromboembolism in patients after hospital treatment unless there are established thrombophilic risk factors. We report the case of a 52-year old woman, who presented with massive saddle pulmonary embolism after one week of initial hospital discharge, successfully thrombolysed that raises the question of consideration of extended prophylactic anticoagulation even in low risk Covid-19 cases. 3 We report a case of acute massive PE successfully managed by thrombolysis in a patient who was discharged after one week of initial hospital treatment for Covid-19 pneumonia which raises serious concerns about the indication for extended prophylactic anticoagulation in such cases. Emerging data and clinical experience suggest an increased prevalence of venous thromboembolic events (VTE) in COVID-19, especially in patients with severe disease requiring hospitalization, and even among those who are not critically ill.
cord-254382-xy8se56o	2020	In this retrospective cohort pilot study, we determined the incidence and outcomes of COVID-19 in kidney or kidney-pancreas transplant recipients and kidney or kidney-pancreas waitlisted patients in our center. We hypothesize that these patients have an incidence proportion of COVID-19 similar to the general population, but that transplanted patients have greater occurrences of hospitalization, intensive care unit admission, mechanical ventilation and death compared to waitlisted patients due to chronic immunosuppression. Demographic data, vital signs (temperature and body mass index), laboratory results, hospitalization, intensive care unit admission, mechanical ventilation, and death were captured from the electronic datasets, whereas comorbidities, organ type, cause of renal disease, induction and maintenance immunosuppression, presenting symptoms for COVID-19, oxygen supplementation, chest radiographic findings, and treatments tried for COVID-19 were collected by manual chart review. . https://doi.org/10.1101/2020.07.20.20157990 doi: medRxiv preprint Previous epidemiologic studies on COVID-19 in kidney transplant recipients focused on assembling cohorts of patients diagnosed with COVID-19 and describing their clinical features and outcomes.
cord-254419-qw83atrx	2020	
cord-254428-n0uwy77g	2020	Multivariable stepwise Cox regression model showed bilateral pneumonia on CT scan, shorter time from the illness onset to admission, the severity of disease and lymphopenia were independently associated with longer hospitalized duration. In the present study, we reported the retrospective data of 77 hospitalized patient with COVID-19 in Beijing, China, with 64 (83.1%) discharged home alive by the end of follow-up. Previous studies reported that the duration of the illness onset to hospital admission in the early stage of this outbreak was 7 to 12.5 days. Currently, few studies reported the average hospital length of stay of discharged patients COVID-19. Bilateral pneumonia on CT scan, shorter period of illness onset to admission, lymphopenia, severity of disease are the risk factors for longer hospitalization duration of COVID-19. Bilateral pneumonia on CT scan, shorter period of illness onset to admission, lymphopenia, severity of disease are the risk factors for longer hospitalization duration of COVID-19.
cord-254446-yxqbe1dj	2020	The disease name -COVID-19‖ and the associated virus name -SARS-CoV-2‖ were coined by the World Health Organization (WHO) and the Coronavirus Study Group of the International Committee on Virus Taxonomy, respectively, on February 11 1, 2 . Interestingly, pharyngeal swab viral nucleic acid screening results of 2,510 patients between January 23 and February 25 from a hospital fever clinic in Hunan Province (a neighboring province of Hubei) demonstrated that the positive rate of SARS-CoV-2 (1.3%) was lower than that of Influenza A (2.3%) and Influenza B (3.3%) 42 . Clinical characteristics of fatal and recovered cases of coronavirus disease 2019 (COVID-19) in Wuhan, China: a retrospective study Clinical course and outcomes of critically ill patients with SARS-CoV-2 pneumonia in Wuhan, China: a single-centered, retrospective, observational study Effect of High vs Low Doses of Chloroquine Diphosphate as Adjunctive Therapy for Patients Hospitalized With Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Infection: A Randomized Clinical Trial
cord-254478-scc9wee0	2020	title: Temporal profiles of viral load in posterior oropharyngeal saliva samples and serum antibody responses during infection by SARS-CoV-2: an observational cohort study Comprehensive data for serial respiratory viral load and serum antibody responses from patients infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) are not yet available. Nasopharyngeal and throat swabs are usually obtained for serial viral load monitoring of respiratory infections but gathering these specimens can cause discomfort for patients and put health-care workers at risk. We aimed to ascertain the serial respiratory viral load of SARS-CoV-2 in posterior oropharyngeal (deep throat) saliva samples from patients with COVID-19, and serum antibody responses. We present findings of an observational cohort study of the temporal profile of viral load of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) from posterior oropharyngeal saliva samples and serum antibody responses, dated by symptom onset and correlated with clinical findings.
cord-254494-wbfgrez1	2020	RESULTS: Barriers to diabetes self-management identified by patients with diabetes during isolation were categorized into five major themes: inadequate knowledge and behavioral beliefs, shortage of resources, suffering from health problems, negative emotions, and lack of support. Studies in developed countries such as the United States, Canada, the United Kingdom, and Singapore have found that common barriers to self-management include poor communication between patients and healthcare providers, limited accessibility to healthcare facilities, lack of family support, inadequate disease knowledge and limited disease treatment methods, lack of motivation for change, physical and cognitive disorders, limited access to diabetes education, and financial barriers. This study addressed a gap in this field by interviewing patients with diabetes subjected to medical isolation after recovering from COVID-19 to gain a deeper understanding of the barriers to diabetes self-management, and provide new perspectives and approaches for the design of interventions and formulation of policies.
cord-254595-by2j7byz	2020	To help control spread of this pandemic, many centers have boosted telemedicine capability to care for patients who would typically be seen in person in outpatient settings, including total joint arthroplasty clinics. We review key components relevant to the establishment and effective use of telemedicine, focused on patient education, practice logistics, technological considerations, and sensitive patient health information–associated compliance factors, which are necessary to provide care remotely for total joint arthroplasty patients. Orthopaedic surgeons who primarily perform total joint arthroplasty (TJA) of the hip and 41 knee treat a predominantly outpatient population that is at high risk for complications and death 42 from 44, 54] Most patients of adult reconstruction clinics are older than 60 years, 43 and many have comorbidities that put them at high risk of contracting severe acute respiratory 44 syndrome coronavirus 2 (SARS-CoV-2) if exposed. [65] Therefore, an effective and efficient 45 TJA telemedicine practice may enable providers to continue delivering care while preventing 46 unnecessary exposure of at-risk patients to the outpatient clinic during this pandemic.
cord-254777-h8hw4m9f	2020	Cytokine storm syndromes include various entities, depending on the inciting factor: primary Hemophagocytic Lymphohistiocytosis [HLH] in children with specific genetic mutations; secondary HLH due to infection or malignancy, macrophage activation syndrome due to rheumatologic disease and cytokine release syndrome (CRS) when hyperinflammation is due to CAR T-cell therapy. Although still under investigation, ADE has been proposed as a potential mechanism underlying the newly described MIS-C, based on the observation that a majority of the patients have evidence of existing antibodies to SARS-CoV-2 and the inflammatory condition seems to lag behind the COVID-19 infection peak by approximately 4-6 weeks. The rationale for use of IL-6 blockade in serious COVID-19 infections is based on the observation that for the subset of patients with severe manifestations, IL-6 is most likely one of the drivers of the cytokine storm, and elevated levels of IL-6 have been consistently shown [14] .
cord-254852-qr5gdmbc	2018	A 2015 prospective, multi-center study by the Centers for Disease Control and Prevention identified a responsible pathogen in only 38% of cases of community-acquired pneumonia (CAP) in adults requiring hospitalization. 13 However, more extensive diagnostic testing should be considered in patients who are at risk for infection with unusual pathogens, who are not responding to treatment, or when additional testing is likely to change antibiotic management (Table 3) . Their analysis of 13 randomized controlled trials found significantly decreased mortality in severe pneumonia, decreased need for mechanical ventilation, decreased occurrence of acute respiratory distress syndrome, decreased time to clinical stability, and shorter duration of hospitalization. Elderly patients with pneumonia may not exhibit typical symptoms or physical examination findings seen in younger adults, such as pleuritic chest pain, cough, fever, and leukocytosis. Impact of inappropriate antibiotic therapy on mortality in patients with ventilator-associate pneumonia and blood stream infection: a meta-analysis
cord-254990-nrzwn6oz	2020	The purpose of this case report is to highlight the potential role of intensive care unit recovery or follow-up clinics for patients surviving acute hospitalization for coronavirus disease 2019. CASE PRESENTATION: Our patient was a 27-year-old Caucasian woman with a past medical history of asthma transferred from a community hospital to our medical intensive care unit for acute hypoxic respiratory failure due to bilateral pneumonia requiring mechanical ventilation (ratio of arterial oxygen partial pressure to fraction of inspired oxygen, 180). CONCLUSION: We present this case report to suggest that patients surviving coronavirus disease 2019 with subsequent development of acute respiratory distress syndrome will require more intense intensive care unit recovery follow-up. The patient''s family reported no travel history or exposure risk, but, given the Fig. 1 Chest radiograph obtained on day 1 of admission to intensive care unit revealed bibasilar airspace disease patient''s clinical symptoms, a test for COVID-19 was performed.
cord-254993-bndl93qr	2020	To shed light on the regulation of iron metabolism and its impact on monocyte immune effector functions at the cellular level, we investigated the mRNA expression of key mediators of iron homeostasis as well as cytokine expression in PBMCs. In line with serum hepcidin measurements, we also found increased hepcidin mRNA (HAMP, for hepcidin antimicrobial peptide) expression in PBMCs isolated from subjects who previously had severe to critical COVID-19 as compared to those who suffered from milder disease (Fig. 2) . In contrast, the immune effector function of PBMCs was related to COVID-19 severity, as mononuclear cells obtained from patients, who suffered from severe to critical disease, demonstrated higher levels of interleukin 10 (IL10, p = 0.044) and tumour necrosis factor (TNF, p = 0.024) mRNA expression as compared to subjects with a milder course of COVID-19 (Fig. 2) .
cord-255037-i9guxtix	2020	The authors also refer to the recent recommendations for the management of cancer patients in COVID era published by the EHA Infectious Disease Scientific Working Group Executive Committee. On the one hand, CLL is associated with a disease-related disruption of both humoral and cell-mediated immunity, on the other hand, patient-related factors such as age, disease stage, and type of treatment received play an important role [6] . Ibrutinib, an irreversible inhibitor of Bruton''s tyrosine kinase (Btk) currently represents a milestone in the treatment of CLL and has been approved by FDA for the treatment of several B-cell malignancies and chronic graft-versus-host disease (cGVHD). Among 2902 CLL patients, 23 cases of COVID infections have been reported with molecular testing for SARS-CoV-2. In addition to its role on Btk, ibrutinib shows off-target inhibiting activity on IL-2-inducible T-cell kinase (Itk) and is thus capable of rebalancing the disease-inherent Th1/Th2 unbalance toward a Th1 phenotype in CLL patients. CLL and COVID-19 at the hospital clinic of Barcelona: an interim report
cord-255197-79yfslu1	2020	title: Telehealth: "virtual" lifeline for home-ventilated patients during the COVID-19 pandemic Telehealth appears useful to fill in the void for home-ventilated patients to maintain the much-needed connectivity with their healthcare team during the #COVID19 pandemic https://bit.ly/3ftvjxW The emergence of PAP devices also resulted in a higher number of patients requiring long-term medical care and ventilation. HMV support generally comprises a mobile healthcare team (HCT), which delivers services to the patient at their homes or long-term care facility. In contrast, telehealth is an umbrella term that encompasses telemedicine and the distribution of nonclinical services such as medical information and provider training [4] . Through information and communications technology, telehealth provides a network link to enable remote collaboration between the patient or their caregivers and HCTs, who are geographically separated. Technological advances in home non-invasive ventilation monitoring: reliability of data and effect on patient outcomes
cord-255233-rvgj6pvk	2020	Methods: Patients were invited to participate following assessment and treatment at the Westmead Centre of Oral Health Periodontic Clinic, regardless of current disease stage or treatment. Conclusion: Although a small study, this rate of vitamin C deficiency in the periodontal clinic is clinically important and correlations with disease severity and CRP suggests biological importance. Vitamin C deficiency is more common in smokers, the elderly and people of lower socio-economic status, potentially putting those groups at increased risk of periodontal diseases [24, 25] . Patients were eligible to participate in this study if they were an adult attending the Westmead Centre of Oral Health (WCOH) Periodontic Clinic. Patients were eligible to participate in this study if they were an adult attending the Westmead Centre of Oral Health (WCOH) Periodontic Clinic. This study reports that a significant proportion of patients attending the Periodontics Clinic at the Westmead Centre of Oral Health have vitamin C deficiency.
cord-255240-ltatgq3e	2020	
cord-255256-8uckmya4	2020	
cord-255267-o8k5ep9y	2020	
cord-255300-btyth32l	2020	Telemedicine offers distinct benefits to patients, clinicians, and communities during the current crisis: it supports social distancing measures by minimising the need for patients and clinicians to travel to hospitals; it enables continued service delivery at a time when in-person outpatient activity has been severely restricted, supporting patients continued access to medical care, promoting patient confidence and reducing patient and clinician anxiety; and reducing the anticipated surge in demand when normal services resume by allowing existing referral, surgery booking, follow-up and discharge pathways to continue. In response to the Covid-19 pandemic, our institution has rapidly deployed video consultations using Attend Anywhere, a browser-based platform that allows clinicians to work through a list of patients in a virtual waiting room. When greater resolution imaging was required, for example of an eyelid lesion, patients were usually able to take a good-quality photograph themselves using a smartphone camera, and digitally transfer this to the evaluating clinician to review, during the video consultation.
cord-255393-aknebauo	2020	
cord-255435-mr239gai	2020	Delirium, which is highly prevalent in general intensive care unit (ICU) populations, is expected to be frequent and prominent in COVID-19 patients hospitalized with acute respiratory distress syndrome (ARDS) in ICU. Delirium, which is highly prevalent in general intensive care unit (ICU) populations, is expected to be frequent and prominent in COVID-19 patients hospitalized with acute respiratory distress syndrome (ARDS) in ICU. In addition to case presentation, we discuss a proposed delirium pathophysiology in COVID-19 associated delirium and a systematized approach to evaluation and management of such patients. Intravenous valproic acid (VPA; titrated to 1250 mg per day) was also started for management of agitation and symptoms of hyperactive delirium and to facilitate tapering of multiple other sedative deliriogenic medications. At our center, the following medications have been used in management of agitation in patients with COVID-19 ICU-associated hyperactive delirium, including the described patient, with following considerations.
cord-255460-r5p5helx	2019	A phase III clinical trial ''Breast Cancer Trial of Oral Everolimus-2 (BOLERO-2)'' that included everolimus in combination with exemestane was successfully completed in 2012 leading to the approval of everolimus by US FDA for the treatment of HR + , HER2 − advanced metastatic cancers that are resistant to letrozole or anastrazole [125, 126] . Docetaxel and paclitaxel are used as neoadjuvant or adjuvant therapy as single agent or in combination with other chemotherapeutic agents for the treatment of early, advanced and metastatic breast cancer in pre-and postmenopausal women. We thus conclude that comprehensive approach of selecting the most appropriate gene-protein-pathway-target-drug modeling via integration of system biology and bioinformatics holds the high potential of providing more efficient, safer and cost-effective chemotherapeutics for treatment of even the most stringent forms of breast cancer (metastatic and triple negative).
cord-255490-gyq6cpc9	2020	
cord-255519-tcobane8	2020	The population of patients who benefit from both cardiac and pulmonary rehabilitation is increasing as the population ages and heart disease remains a leading cause of global morbidity and mortality. Many patients with stroke, vascular disease, or other conditions can be included in active cardiac and pulmonary rehabilitation programs or benefit from the application of cardiopulmonary rehabilitation principles to their rehabilitation. For secondary prevention in patients with known cardiopulmonary disease, exercise should be at a safe level at 60% or more of the maximum heart rate to achieve a training effect. 82 Rehabilitation is focused on a program that resembles exercise for patients with heart failure, with the addition of close monitoring of oxygen saturation and the use of appropriate levels of supplemental oxygen to prevent hypoxemia. Individuals who are disabled tend to have lower activity levels, which puts them at increased risk of cardiac and pulmonary disease and may present obstacles for a standard rehabilitation program for a person who is newly disabled and who has preexisting cardiopulmonary limitations.
cord-255652-3n2dxljj	2020	title: Screening for COVID-19: Patient factors predicting positive PCR test SARS-CoV-2, the novel coronavirus causing COVID-19, was isolated in patients from Wuhan, China, in December 2019 and sparked a global pandemic in early 2020. At the Mayo Clinic in Rochester, Minnesota, we began screening patients for COVID-19 on a large scale on March 12, 2020, after Minnesota''s first case was reported on March 10, 2020. The COVID-19-negative patients were selected in a random fashion by matching age (±5 years), sex, collection date, and testing location (Minnesota, Wisconsin, or Arizona) with the positive patients. This study investigates the results of testing ambulatory patients in a relatively low prevalence area in early March 2020 and suggests that exposure to the disease is more predictive of a positive test than any examined symptom. In this analysis, exposure to confirmed SARS-CoV-2 and recent travel were both significantly more predictive of a positive test than the presence of any symptoms.
cord-255746-ir73lpi8	2020	
cord-255805-wlr8nod3	2020	The clinical data and the evolution of the disease process of a critical novel coronavirus pneumonia patient who has been successfully treated by mechanical ventilation through tracheal intubation in the intensive care isolation ward of Taihe Hospital in Shiyan City (Hubei Medical College Affiliated Hospital) were analyzed and summarized, to provide a clinical reference for the diagnosis and treatment of critical COVID-19 patients. On March 22, the patient again performed bedside bronchoscopy to clear the airway secretions and successfully removed the tracheal intubation, given nasal high-flow oxygen therapy and continued to anti-infection, airway management, nutritional support, immunity enhancement, and respiratory function exercises treatment. [6] [7] [8] In this case, as the patients condition developed and progressed, the patients diagnosis, which was based on imaging, blood gas analysis and other tests, had been considered secondary bronchial fistula, bacterial lung infection, and acute respiratory distress syndrome (ARDS): persistent carbon dioxide retention and hypercarbonemia after mechanical ventilation by endotracheal intubation.
cord-255807-7goz1agp	2003	By using a nested case-control design, the authors studied the effectiveness of the influenza vaccine in reducing severe and fatal complications in 4,241 and 5,966 primary care, working-age patients aged 18–64 years who had asthma or chronic obstructive pulmonary disease during the 1998–1999 and 1999–2000 influenza epidemics in the Netherlands. The risk of influenza-related morbidity and mortality during influenza epidemics is high (1) (2) (3) (4) , and nonexperimental studies have shown that vaccination against influenza prevents respiratory and cardiac complications during epidemics in elderly patients with chronic obstructive pulmonary disease (COPD) (5, 6) . We determined the occurrence of respiratory and cardiac morbidity during influenza periods and the clinical effectiveness of vaccination in reducing these complications in patients aged 18-64 years who had asthma or COPD by using a prospective, nested case-control design.
cord-255831-nrc35tug	2020	The prolonged lockdown of health services providing high-complexity fertility treatments –as currently recommended by many reproductive medicine entities– is detrimental for society as a whole, and infertility patients in particular. Along these lines, the ART calculator -a clinical predictive model used to estimate the number of mature (metaphase II) oocytes needed to obtain at least one euploid embryo in couples undergoing ARTindicates that 13 (95% confidence interval [CI]: 11-16), 16 (95% CI: [13] [14] [15] [16] [17] [18] [19] [20] , and 19 (95% CI: [15] [16] [17] [18] [19] [20] [21] [22] [23] [24] [25] oocytes are needed for women aged 38, 39, and 40 years, respectively [10, 11] . Based on female age, ovarian reserve, and previous history of ovarian stimulation -if available-, ''low prognosis'' patients were stratified into four specific subgroups, each of which with a distinct prognosis concerning the likelihood of conceiving and delivering a baby with the use of ART (Supplementary Figure 3) .
cord-255905-ti9b1etu	2020	
cord-256011-0cr4ejxu	2020	This paper examines the fairness of recommendations contained in resource allocation guidelines in the Philippines that have implications for the way elderly patients could be treated or excluded from some forms of critical care treatment in the context of the ongoing Corona virus emergency. Anticipating a surge in demand for ventilators and other critical care equipment at the height of the COVID-19 pandemic, many institutions, agencies, and responsible authorities have had to issue guidelines or recommendations for the allocation of scarce medical resources in their respective territories or jurisdictions. After starting with an examination of the principle of net utility, the commentary goes on to explore and clarify what the TFG means by "maximizing prognosis." It emphasizes the importance of invoking short-term-rather than long-term-prognosis as a criterion to determine a patient''s ability to benefit from the use of critical care resources during the period of scarcity.
cord-256030-5xzuilc1	2020	According to the data from the French Biomedicine Agency, during the peak period of the epidemic, between March 1 and June 15, 2020, only 7 of the 423 patients on home hemodialysis in France were diagnosed with COVID-19; the incidence is similar to that observed in patients treated with peritoneal dialysis (1.8%). For instance, in the Ile de France region, one of the most affected by the pandemic, data from the Biomedicine Agency indicate that 930 out of 8,025 patients (11.5%) on in-center hemodialysis were diagnosed with COVID-19, whereas only 4 out of 109 patients on home hemodialysis developed the disease (3.6%) (p = 0.001). Furthermore, globally 52 of our 55 patients later agreed to have a SARS-CoV-2 serology test performed, which was positive in the 2 patients Therefore, within the limits of a small series, and while waiting for additional data, we would like to confirm that our experience underlines the importance of developing an efficient home hemodialysis network, able to patients in a time of epidemic.
cord-256051-87alqfkd	2020	Infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) results in coronavirus disease 2019 (COVID-19), which was declared an official pandemic by the World Health Organization on March 11, 2020. Although SARS-CoV-2 disease (or coronavirus disease 2019 ) primarily manifests as a lung infection, with symptoms ranging from those of a mild upper respiratory infection to severe pneumonia and acute respiratory distress syndrome (ARDS), other multisystemic manifestations of this disease and related complications are becoming more commonly recognized (3) . Thromboembolic complications, including pulmonary embolism (PE), peripheral venous and arterial thrombosis, and acute stroke (seen also in patients older than 50 years without risk factors) have all been reported (50-57). On the basis of the pattern and distribution of the opacities and the presence or absence of certain clinical signs (such as obesity), the authors developed a chest radiography severity scoring system that could be used as a prognostic factor of outcomes in young adult patients with COVID-19 (Fig 3) .
cord-256109-dkp0fwe3	2004	Efforts to contain severe acute respiratory syndrome (SARS) have been limited by the lack of a standardized, sensitive, and specific test for SARS-associated coronavirus (CoV). Efforts to contain severe acute respiratory syndrome (SARS) have been limited by the lack of a standardized, sensitive, and specific test for SARS-associated coronavirus (CoV). All patients who met the current World Health Organization case definition of probable SARS and who underwent a postmortem examination in Canada during the March-April 2003 outbreak were included in this study. The clinical description and RT-PCR results for the 11 patients with probable SARS from whom postmortem lung tissue samples were examined are summarized in Table 1 . By using a standardized RT-PCR assay, SARS-CoV has been unequivocally identified in the lung tissue of all patients who died with probable SARS but not in any of the controls.
cord-256117-t9v1hng5	2020	
cord-256262-lwc4ghj2	2020	Among various causes of morbidity and mortality in COVID-19 patients, the frequency and impact of co-infections has still been poorly studied, particularly in patients with an acute respiratory distress syndrome (ARDS). In France, IFI account for a high risk of mortality in patients with co-morbidities from 9.2% to 40% depending on the fungal disease (8) . Invasive mucormycosis is increasingly reported (thanks to the improvement of diagnostic tools) in susceptible patients such as those suffering from diabetes, hematological malignancies, solid organ transplantation or chronic respiratory diseases and superficial injuries in burned patients or after local traumatism. In case of positivity of any of these tests, a confirmation step with blood biomarkers will be implemented depending on the positive results, with serum galactomannan and/or serum beta-D-glucan and/or cryptococcal antigenemia and/or blood qPCR for Aspergillus or mucorales, -national multicentric studies that aim to explore the risk of fungal co-infection during COVID-19 with joint consortia of ICU and Mycology specialists.
cord-256290-pyrmtps3	2020	Assessment of smell and taste function should be conducted at the point of CoVID19 testing to further investigate their association with disease presence. At the time of our study, The European Centre for Disease Prevention and Control did not specifically delineate taste and smell disturbances as features of CoVID19. As such, our study investigated the prevalence of these features in a cohort of newly diagnosed COVID19 patients triaged to management in an outpatient setting through a telephone clinic. Our study has found that, in a cohort of patients with confirmed mild CoVID19 disease suitable for remote medical management, approximately half of them experienced new onset smell or taste dysfunction. Further work should also investigate the prevalence of olfactory and gustatory disturbance in all patients being tested for CoVID19, in order to evaluate the diagnostic value of these features in predicting the presence of the disease.
cord-256459-6h358si5	1996	
cord-256508-ce59ovan	2020	To date, with the exception of intravenous Remdesivir and dexamethasone, which have modest effects in moderate to severe COVID-19, no strong clinical evidence supports the efficacy and safety of any other drugs against SARS-CoV-2. The current diagnostic strategy to identify patients with COVID-19 is to test samples taken from the respiratory tract to assess for the presence of SARS-CoV-2 specific nucleic acid targets [47] . The neutralization assay is a laboratory-based test that uses live virus and cell culture methods to determine if patient antibodies can prevent viral infection in vitro [72] . A randomized, controlled, openlabel trial involving hospitalized adult patients with confirmed SARS-CoV-2 infection and severe respiratory illness COVID-19 was performed [126] . Viral load dynamics and disease severity in patients infected with SARS-CoV-2 in Zhejiang province, China Targets of T Cell Responses to SARS-CoV-2 Coronavirus in Humans with COVID-19 Disease and Unexposed Individuals
cord-256535-fz5p2u6p	2020	Among the eight patients who survived more than 2 weeks from onset, four patients showed good clinical outcome [modified Rankin Scale (mRS) <2] at 60 days posttreatment and were able to continue treatment for malignancy. The development of endovascular thrombectomy (EVT) is a recent advancement, and numerous randomized clinical trials have proved the efficacy of EVT for the treatment of acute ischemic stroke (AIS) in patients with large vessel occlusion (LVO) (6) (7) (8) (9) (10) (11) . Patient information, including age, sex, location of malignancy, cell type, cancer staging, malignancy treatment before stroke onset, concomitant stroke risk factors (hypertension, diabetes, hyperlipidemia, atrial fibrillation, pulmonary embolism or deep venous thrombosis, and previous history of stroke), premorbid antiplatelet/anticoagulant drug, and blood D-dimer level at admission (17) were obtained from the medical records.
cord-256556-1zea3wa1	2020	The percentage of patients who turned viral negative after 14-day treatment was 70%, 77%, and 100% in the baloxavir marboxil, favipiravir, and control group respectively, with the medians of time from randomization to clinical improvement was 14, 14 and 15 days, respectively. Then, an exploratory single center, open-label, randomized, controlled trial was conducted to evaluate the efficacy and safety of adding baloxavir marboxil or favipiravir to the current standard antiviral treatment in patients confirmed as COVID-19 who are still positive for the SARS-CoV-2 (ChiCTR2000029544). This trial was an exploratory single center, open-label, randomized, controlled trial to evaluate the efficacy and safety of adding baloxavir marboxil or favipiravir to the current standard antiviral treatment in patients confirmed as COVID-19 who are still positive for the SARS-CoV-2 (ChiCTR2000029544). The activity against SARS-CoV-2 was tested in vitro for the antiviral drugs used in this trial, including arbidol, ritonavir, lopinavir, darunavir, baloxavir acid, and favipiravir.
cord-256618-tt3p0tki	2020	They work with pharmacists at SPHCC, having responsibilities that include drug supplies, dispensing, pharmacy intravenous admixture services (PIVAS), prescription audits, medication reconciliations, pharmacotherapy, therapeutic drug monitoring, and patient education. Fangcang, which sounds similar to Noah''s Ark in Chinese, is a large, temporary hospital built by converting public venues, such as stadiums and exhibition halls, into health care facilities to isolate patients with mild to moderate symptoms of an infectious disease from their families and communities, while providing medical care, disease monitoring, food, shelter, and social activities. They work with the 35 pharmacists and 5 clinical pharmacists at SPHCC, having responsibilities over drug supplies, dispensing, pharmacy intravenous admixture services (PIVAS), prescription audits, medication reconciliations, pharmacotherapy, therapeutic drug monitoring (TDM), and patient education. According to the criteria stated in the "Expert Consensus on Comprehensive Treatment of COVID-19 in Shanghai", 4 individuals with an epidemiological history (resided in or visited an epidemic area within 14 days) and clinical symptoms (fever or respiratory symptoms, imaging features, decreased lymphocyte count) are considered suspected cases.
cord-256634-gg8hptfg	2020	Conclusions: While we observed high rates of supportive care for patients with COVID-19, we also found that ADRs were common among patients receiving drug therapy including in clinical trials. The objective of this point-prevalence study was to characterize the drug therapies used in the management of COVID-19, including supportive care and combination therapies, in an attempt to identify safety signals among acutely ill hospitalized patients. Data elements collected included facility demographics, total number of hospital and ICU beds prior to the pandemic, U.S. Census region location, patient populations served, facility type (e.g., academic, community, inpatient rehabilitation), and active clinical trial site status. In addition to whether patients were receiving supportive care or drug therapies targeted at SARS-CoV-2, we collected basic patient demographic information and vital status (e.g., age, sex, comorbidities, oxygen requirement, and ICU status). Patients were significantly more likely to receive COVID-19 directed drug therapy if they were enrolled in a clinical trial (26.9% vs 3.2%; P <0.001).
cord-256639-4e0irb6d	2020	title: Thiopental as substitute therapy for critically ill patients with COVID-19 requiring mechanical ventilation and prolonged sedation The Food and Drug Administration recently issued a midazolam shortage and reported a more than 50% consumption increase for other common sedative drugs such as propofol due to high demand for patients with COVID-19 [3] . For these patients, barbiturate therapy induce deep coma with bispectral index score lower than 20 and, as a result, prolonged MV [4] . Midazolam and propofol were completely stopped one hour after the thiopental loading dose in all patients. Another drug option for sedation of critically ill patients with COVID-19 could be inhaled volatile anaesthetics [9, 10] . Some studies have reported that inhaled agents such as isoflurane and sevoflurane shorten awakening and extubation times in mechanically ventilated patients compared to benzodiazepines or propofol. Thiopental seems to be an acceptable substitute to sedative drugs in this period of high midazolam and propofol demand for ICU patients with COVID-19.
cord-256688-yy7abob9	2020	
cord-256849-8w2avwo2	2015	title: Identify-Isolate-Inform: A Tool for Initial Detection and Management of Measles Patients in the Emergency Department The "Identify-Isolate-Inform" tool will assist emergency physicians to be better prepared to detect and manage measles patients presenting to the emergency department. Emergency physicians must rapidly inform the local public health department and hospital infection control personnel of suspected measles cases. Following a brief review of measles, this paper describes the novel 3I tool, initially developed for Ebola virus disease, 4 as adapted for use in the initial detection and management of measles patients in the emergency department (ED). During a measles outbreak, after donning appropriate respiratory protection, emergency physicians (EP) should carefully assess the oropharynx in patients presenting with non-specific viral syndromes and assess for the presence of Koplik spots. 12 Conversely, patients with signs and symptoms of measles (prodrome of fever, cough/coryza/conjunctivitis, Koplik spots followed by rash), should be immediately masked and isolated using airborne precautions.
cord-256856-jw1d6uig	2020	EP seems uniquely suited to adopt telemedicine as a care delivery platform as an undeniably technical specialty that is increasingly reliant on objective, preacquired data in a manner that does not require the patient to physically interact with a physician to share in clinical decision-making (Figure 1) . 1 A large study using Consumer Assessment of Healthcare Providers and Systems data demonstrated no difference in patient satisfaction when comparing in-person and telehealth visits. These results can then be communicated to the physician via electronic health records, fax, secure messaging, or the telemedicine platform itself, thereby ensuring longitudinal care. Today, however, with the advent of smartphone and smartwatch technologies, consumer electronics have become an attractive modality for ambulatory ECG recording, capable of rapid, high-quality rhythm strip acquisition and transmission, enabling remote physician review. Patient satisfaction management in office visits and telehealth in health care technology.
cord-256864-v3mxcwru	2020	
cord-256888-tdx12ccj	2020	To date, documentation of the histopathological features in fatal cases of the disease caused by SARS-CoV-2 (COVID-19) has been scarce due to sparse autopsy performance and incomplete organ sampling. 8 Post-mortem studies have shown pulmonary, renal, and small vessel injury, with particles resembling virus observed in the kidney by electron microscopy. By electron microscopy, aggregates of uniform, round enveloped particles ranging in size from around 70 nm to 100 nm with peripheral spike-like projections consistent with the morphology described for SARS-CoV-2 were observed in the lung, trachea, kidney, and large intestine of patient 8 and patient 13. [9] [10] [11] [12] We present a case series of autopsy findings in 14 patients who died after SARS-CoV-2 infection. The major histopathological observation in our series of patients who died with COVID-19 was diffuse alveolar damage-type lung injury in the acute or organising phases (12 [86%] of 14 patients).
cord-256893-3sh87h2x	2020	The recent novel coronavirus disease (COVID-19) outbreak, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is seeing a rapid increase in infected patients worldwide. SARS-CoV-2 not only activates antiviral immune responses, but can also cause uncontrolled inflammatory responses characterized by marked pro-inflammatory cytokine release in patients with severe COVID-19, leading to lymphopenia, lymphocyte dysfunction, and granulocyte and monocyte abnormalities. The number of people infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the causative agent of COVID-19, is rapidly increasing worldwide. The effect of elevated cytokine production on clinical manifestations Increasing evidence shows that viral infection can induce severe syndromes of shock and organ failure; 8,57 this phenomenon was also investigated for COVID-19. Treg cell-based therapy The dysregulated inflammatory processes caused by SARS-CoV-2 in patients with severe COVID-19 are partially due to the dysfunction of Tregs, which are responsible for inhibiting inflammation.
cord-257035-ob1xncbs	2020	The recent published literature regarding the occurrence of acute respiratory syndrome (ARDS) in COVID-19 patients have mainly focused attention on the role of computed tomography in evaluating the radiological manifestations and temporal progression of the disease, 2 while few data have been presented regarding the use of lung ultrasonography, 3 especially in the evaluation of the disease course. have recently highlighted that lung recruitability can be effectively assessed bedside in COVID-19 patients with ARDS. The authors did not report data regarding the use of lung ultrasonography for the cited purposes. Since treatment of severe ARDS from COVID-19 is an ongoing challenge, it is important to learn from the patients who have been treated to gain an understanding of the disease''s epidemiology, its biologic mechanisms, and the effects of new pharmacologic interventions. Lung ultrasound can be used to predict the potential of prone positioning and assess prognosis in patients with acute respiratory distress syndrome
cord-257051-ntnfu5ns	2020	Remote working via telemedicine (telephone or video-assisted consultation) displaces the need for face-to-face contact whilst providing care within patients'' own homes [2] . Despite the relative infancy of remote working in physiotherapy, there is an emerging body of evidence that supports its incorporation in clinical practice as both an assessment and rehabilitation tool. However, telemedicine, aided by an ever-increasing number of digital health tools, can significantly increase patients'' confidence in undertaking exercise and improve compliance and adherence to exercise-based rehabilitation programmes, compared to usual physiotherapy care [21] [22] . Digital health tools provide images and videos J o u r n a l P r e -p r o o f of exercises, patient advice and education and include reminders for patients to carry out prescribed exercise programs given by their physiotherapist in a ''virtual'' exercise class, which can be remotely delivered and adherence monitored.
cord-257147-i48qljv6	2020	Clinical information for the 8 patients before and after the Adrecizumab administration was obtained from the hospital information system and included the following: demographic data, including anamnesis and physical examination; treatment and therapies, including mechanical ventilation and antiviral therapies; clinical data, including PaO2/FiO2, the SOFA score (range 0-24, with higher scores indicating a more severe illness), and the SAPS-II score (higher scores indicating a more severe illness); and laboratory data, including bio-ADM, DPP3, the white blood cell count, lactate, the liver and kidney function, and inflammatory factors (CRP, procalcitonin, and interleukin-6). In this preliminary uncontrolled case series of eight extreme-critically ill patients with COVID-19 and ARDS, the administration of the non-neutralizing anti-ADM antibody Adrecizumab was followed by a favorable outcome. In this preliminary uncontrolled case series of eight extreme-critically ill patients with COVID-19 and ARDS, the administration of the non-neutralizing anti-ADM antibody Adrecizumab was followed by a favorable outcome.
cord-257206-av2k44ig	2006	Abstract The aim of this research is to determine the levels of anxiety, depression, and sleep quality a severe acute respiratory syndrome (SARS) nursing staff experienced before and after a SARS prevention program. Using general estimating equations (GEE) statistical analysis to control possible for affecting factors, we found that the nursing staff''s anxiety and depression along with sleep quality started to improve 2 weeks after the initiation of SARS prevention controls. This research is to describe the anxiety level, depression level, and sleep quality of nursing staff who cared for SARS patients during a sweeping epidemic and the effects of a SARS prevention program. Tables 2 and 3 show the effects of the SARS prevention program on nursing staff through their self-reported levels of anxiety and depression as well as sleep quality.
cord-257274-fzyamd7v	2020	
cord-257276-h5542vqg	2020	
cord-257309-sazs5wgh	2020	title: Clinical Outcomes and Features of Covid-19 in Patients with Primary Immunodeficiencies in New York City Main Text: Coronavirus disease 2019 (Covid-19) remains an ongoing pandemic, and data on the clinical impact of SARS-CoV-2 infection in patients with primary immunodeficiency diseases (PIDs) are limited (1) (2) (3) . Here, we report the clinical features and outcomes of Covid-19 in patients from a large PID center in New York City during this period. Twelve out of 16 patients required hospitalization, 5 of which involved intensive care unit In all, 4/16 individuals died (CVID, n=2; hypogammaglobulinemia, n=1; IgA-IgG2 deficiency, n=1) and 12/16 individuals recovered from COVID-19. Lymphopenia in Covid-19 has been associated with disease severity in patients without PIDs (5) . This activity has been planned and implemented in accordance with the Essential Areas and Policies of the Accreditation Council for Continuing Medical Education (ACCME) by the American Academy of Allergy, Asthma and Immunology (AAAAI).
cord-257336-rpx71ww5	2020	Given the rapidly growing number of cases, a detailed report of clinical characteristics recognized in EVALI cases with radiological findings of lung injury will not only provide a better understanding of the natural history of the disease, but also create a strong foundation for the development of evidence-based guidelines for the diagnosis, prognosis, and treatment of this condition. Here, we present data from a series of ten cases that recognize clinical characteristics in hospitalized EVALI patients with radiological findings of lung injury. Our ten-case series data recognized that clinical characteristics in hospitalized EVALI patients with radiological findings of lung injury, may include both respiratory and gastrointestinal or constitutional symptoms and based on the current literature may be misdiagnosed. E-cigarette or vaping product-use-associated lung injury (EVALI): A case report of a pneumonia mimic with severe leukocytosis and weight loss
cord-257344-d13at1y5	2020	Patients with predisposing diseases are highly prone to COVID-19 and manifesting severe infection especially with organ function damage such as acute respiratory distress syndrome, acute kidney injury, septic shock, ventilator-associated pneumonia, and death. Patients with underlying diseases are highly prone to present with severe infection especially with organ function damage such as acute respiratory distress syndrome (ARDS), acute kidney injury (AKI), septic shock, and ventilator-associated pneumonia (VAP) 10, 13 . Results of another systematic review and meta-analysis on 53 randomized clinical trials on administration of hydroxychloroquine in COVID-19 management revealed that hydroxychloroquine administration (case group) was significantly associated with higher incidence of total adverse effects in comparison to placebo or no treatment (control group) in overall population of patients with COVID-19 45 . Almost all of the potential drugs in COVID-19 treatment containing chloroquine, hydroxychloroquine, ribavirin, and lopinavir/ritonavir have hepatic metabolism.
cord-257408-ejhhk1iu	2020	
cord-257433-qgkwylmk	2020	We collected the data on the patients that were referred to our hospital from March 9 to April 19 2020 either for ischemic or hemorrhagic stroke or for intracerebral cerebral hemorrhage (ICH), i.e., a timeframe of 42 days following the promulgation of the decree of the Lombardy Governor for the institution of the hub-and-spoke system. For each patient we acknowledged how he/she had reached the hospital (without or with the regional emergency transportation system AREU), the individual risk factors, the kind of stroke according to the Trial of Org 10172 in Acute Stroke Treatment (TOAST) classification (4), the location of the stroke according to Oxfordshire Classification (OCSP) (5), the therapeutic procedures (IVT, EVT, CEA), and a justification in case no procedure was undertaken, the NIH Stroke Scale (NIHSS) score before and after the procedure.
cord-257467-b8o5ghvi	2010	This article further discusses the risks for HAIs apparent in intravascular cannulation, endotracheal intubation, and the development of surgical site infections, and examines occupational measures to prevent infections in the health care worker. Although endotracheal intubation during surgery is generally a controlled safe procedure, this artificial airway predisposes the body to exposure to respiratory pathogens whether from the health care provider, the environment, or equipment. 12 A recent practice advisory prepared by the American Society of Anesthesiologists (ASA) concurs with the implementation of aseptic technique when handling neuraxial needles and catheters, and states it should include "hand washing, wearing of sterile gloves, wearing of caps, wearing of masks covering both the mouth and nose, use of individual packets of skin preparation, and sterile draping of the patient." The same advisory does not make a specific recommendation regarding the type of skin antisepsis to use.
cord-257504-tqzvdssb	2015	
cord-257600-0plhquk9	2020	Differences in health-care systems, in the incidence and prevalence of SARS-CoV-2 infection by geographic regions, and patient access to intensive support care -including MVand treatment with antivirals or anti-IL6/IL1 agents may ultimately influence outcomes in patients with lung cancer affected by COVID-19. We aimed to describe the clinical characteristics of lung cancer patients with COVID-19 attended in a tertiary hospital in Madrid, one of the most hit regions by coronavirus in the world so far, and analyze factors associated with worse outcome, including type of treatment receiving at the time of COVID-19 diagnosis. We performed SARS-CoV-2 RT-PCR to every suspicious case and included all lung cancer patients attended at our hospital (emergency room, hospitalization, ambulatory office, day care area). Data from Wuhan, in China, showed that active cancer treatment received in the 14 days before SARS-CoV-2 infection had an increase on the risk of severe outcomes of COVID-19 (HR 4.079, 95%CI, 1.086-15.322; p = 0.037) (9) .
cord-257696-ybu772zw	2020	
cord-257717-fbfe5vt4	2020	EVIDENCE ACQUISITION: A collaborative narrative review was conducted using literature published through May 2020 (PubMed), which comprised three main topics: reduced in-person interactions arguing for increasing virtual and image-based care, optimisation of the delivery of care, and the effect of COVID-19 in health care facilities on decision-making by patients and their families. Several themes emerged during the COVID-19 pandemic that would be critical or beneficial to genitourinary cancer care in the future ( Fig. 1) : first, reduced in-person interactions argued for increasing virtual and image-based care; second, optimising the delivery of care to include better triage, understanding and addressing mental health implications due to less in-person care, and maintaining high-quality research and education endeavours are necessary; and third, the presence of SARS-CoV-2 in health care facilities may affect decision-making by patients and their families.
cord-257729-s0vo7dlk	2020	
cord-257732-3xuy6tbn	2020	OBJECTIVES: This study analyzed salivary samples of COVID-19 patients and compared the results with their clinical and laboratory data. At present, Real Time reverse transcription Polymerase Chain Reaction (rRT-PCR) on respiratory specimens represents the gold standard test for detection of SARS-CoV-2 infection. 10 , 11 Sputum and oropharyngeal secretions have recently been suggested as a possible target for the molecular diagnosis of COVID-19, 12 and salivary droplets represent the main source of the human-to-human transmission of the SARS-CoV-2 infection when social distance is less than 2 m. There were not significant differences regarding the clinical and anamnestic history between males and females, with the only exception of the values of serum LDH, which were higher in the female patients'' haematochemical analyses carried out on the day of saliva collection ( p = 0.025).
cord-257781-ybpliz32	2020	IMPORTANCE: Management of severe coronavirus disease 2019 relies on advanced respiratory support modalities including invasive mechanical ventilation, continuous positive airway pressure, and noninvasive ventilation, all of which are associated with the development of subcutaneous emphysema, pneumomediastinum, and pneumothorax (herein collectively termed barotrauma). Barotrauma cases had longer illness duration prior to critical care admission (10 vs 7 d; interquartile range, 8–14 and 6–10, respectively; p = 0.073) and were more often treated with continuous positive airway pressure or noninvasive ventilation as the initial modality of advanced respiratory support (87.5% vs 36.0%; p = 0.007). Subcutaneous emphysema, pneumomediastinum, and pneumothorax-herein collectively termed "barotrauma" (referring to the manifestation, rather than etiologic mechanism, of airway tract damage and resultant extra-alveolar air)-are known complications of all forms of positive pressure respiratory support and are associated with multiple organ failure and death (6) .
cord-257839-kfzc4pwq	2020	We present this case to highlight the extensive COVID-19-associated thrombotic complications that can occur, even despite periods of high-dose prophylactic and therapeutic anticoagulation. In recent case series, elevated D-dimer levels were reported in 43% 6 of the patients and were associated with disease severity and increased mortality. 5 Findings that shed new light on the possible pathogenesis of a disease or an adverse effect Several case series exist which explore the incidence of venous and arterial thrombosis in patients with COVID-19. 10 The latter includes a study of 10 ICU patients with COVID-19 pneumonia in whom D-dimer levels and viscoelastic measures reduced in response to increased prophylactic dosing. [11] [12] [13] Twitter Nathaniel Quail @DrNatQuail and Kevin G Blyth @kevingblyth Acknowledgements Dr Joe Sarvesvaran''s care and compassion were integral to this patient''s journey to recovery and we would like to acknowledge his support with writing this case report, and for selecting the key images to include.
cord-257884-5exwwxin	2020	
cord-258027-f3rr5el1	2013	Our aim was to determine the frequency of 12 common respiratory viruses in patients admitted to intensive care units with respiratory symptoms, evaluate the clinical characteristics and to compare the results to routine microbiological diagnostics. The information included the following: age, gender, underlying comorbidity, use of immunosuppressant drugs, respiratory symptoms, diagnoses on admission, diagnoses on discharge, length of hospital stay, ICU stay and intubation, Simplified Acute Physiology Score II (SAPS II)scores, administration of antibiotics, non-invasive ventilation, chest x-ray, laboratory analyses and results of the physical examination, which included temperature, saturation, stethoscopic findings and clinical signs of respiratory infection or distress. Viruses -Of the 122 patients included in the study group, 19 (16%) were positive for a virus, of which the most frequently detected were influenza A (n = 9) and RSV (n = 3, Fig. 2 ).
cord-258067-par61wwh	2020	Conclusions The patients undergoing the surgical procedures showed high rates of COVID-19 infection and postoperative complications, especially the patients with oncological diseases. The following variables were analysed: age; sex; functional status (defined according to the ECOG scale) (21); personal background; diagnosis; type of surgical intervention; the timing of SARS-CoV-2 infection; the treatment required (Table 1) ; the severity of the respiratory infection (according to the BRCSS) (20) ; and postoperative complications (according to the Dindo-Clavien classification) (19) . Ten (16.9%) of the oncological patients, one (1%) of those operated on electively for benign diseases and four (7%) of the urgent surgery group presented with a SARS-CoV-2 infection, with statistically significant differences in the infection rate of the three groups (p = 0.004) ( Table 2) . Patients undergoing elective surgery before and during the peak of the COVID-19 pandemic showed a high rate of postoperative complications, with a SARS-CoV-2 infection rate of up to 16% in patients undergoing oncologic surgical procedures.
cord-258093-6fn8ei9f	2011	
cord-258113-mnou31j3	2020	
cord-258117-5gpo8smn	2020	10, 58, 59 In this setting, preclinical studies have revealed an interesting paradox: while IDO inhibitors have a negligible effect on established tumors as single-agent, combination of IDO inhibitors and immunotherapies including checkpoint blockers targeting cytotoxic T lymphocyte-associated protein 4 (CTLA4) or PD-1 yields a synergistic effect to control cancer burden and favor survival. 142 These disappointing results suggested that this combinatorial therapy did not improve the clinical outcome of melanoma patients receiving pembrolizumab, confirming that the role of epacadostat (or IDO1 inhibitors in general) in advanced solid tumors with robust PD-1 signaling remains unclear. [210] [211] [212] Along similar lines, the Phase III study NCT03661320 compared the efficacy, tolerability and safety of three therapeutic regimens for MIBC: neoadjuvant standard of care chemotherapy with cisplatin [213] [214] [215] [216] [217] and gemcitabine, 218,219 (NAC) versus NAC combined with nivolumab or nivolumab plus BMS-986205, followed by continuation of adjuvant immunotherapy (nivolumab with or without the IDO1 inhibitor) post radical cystectomy.
cord-258128-qtmjgrml	2020	12 In one case report regarding the successful treatment of a kidney transplant recipient with pneumonia caused by SARS-CoV-2 in China, all the immunosuppressants were stopped and the patient received 5 g intravenous immunoglobulin (IVIG) on the first day and then 10 g/day for the next 11 days, with 40 mg/day methylprednisolone for 12 days and 5 million units/day interferon as atomization inhalation. 17, 18 Considering that adverse clinical outcomes and increased mortality and morbidity following the administration of corticosteroids in patients with respiratory infections caused by respiratory syncytial virus (RSV), influenza, SARS-CoV-1, or MERS-CoV may be due to an increased risk of secondary bacterial infections, their use for the prevention of disease progression or its treatment remains under discussion. So far, few studies have been conducted regarding the use of this drug in liver and kidney transplant patients, but if it is administered to this population, its adverse effects and interactions with immunosuppressants and other medications used in transplant patients, such as fluoroquinolones for the treatment of Gram-negative infections, should be considered.
cord-258133-zsweppku	2020	Here we report the case of a patient with schizophrenia presenting with COVD-19related delusions and hallucinations, illustrating the potential of COVID-19 to precipitate entry into a psychotic phase and impact symptom manifestation. This case report shows the impact of the COVID-19 crisis on the psychopathology of a patient with paranoid psychosis leading to the outbreak of a psychotic phase with paranoid-hallucinatoric experiencing and unrealistic expectations and concerns. This observation may be in line with the previous reports that higher levels of concurrent anxiety in patients with schizophrenia correlated with lower perception of personal risk of infection with swine flu, although the reason for this effect is unclear (Maguire et al., 2019a) . Overall, the current case report illustrates the potential for the psychological context of the COVID-19 emergency to influence emergence and manifestations of symptoms of psychosis, and indicates that measured, balanced and responsible reporting of the COVID-19 crisis in the media will be important to minimize the risk of overreactions in at risk persons and to avoid entry into psychotic episodes.
cord-258278-25rhf91v	2020	Herein, we report a 36-year-old man with no significant past medical history who recently recovered from a mild COVID-19 infection and presented with unusual pattern of arterial macrothrombosis causing AIS. However, most of these patients had significant co-morbidities and established cardiovascular risk factors, making it difficult to confirm COVID-19 as the precipitating cause (3) While coagulopathy and vascular endothelial dysfunction have been widely reported as a consequence of severe COVID-19 infection, these findings are proposed to be directly related to the severity of the respiratory illness, (4) and the prevalence of this prothrombotic state among milder or asymptomatic cases is not yet established. Herein, we report an unusual pattern of arterial macrothrombosis presenting as large vessel stroke in a 36-year-old patient with no prior medical history (PMH) who had recently recovered from a mild COVID-19 infection. In conclusion, we report a young adult with no underlying comorbidities who recently recovered from COVID-19 infection and presented with AIS due to multicentric large vessel occlusion.
cord-258293-7q9zj8c2	2020	with intracranial or spinal oncological pathology (rapidly evolving intracranial hypertension with deteriorating 4 state of consciousness, acute hydrocephalus, spinal cord compression with rapid tetra or paraparesis); Class A + 5 are the patients who requirie treatment within a maximum of 7-10 days, with intracranial tumors with mass 6 effect or with progressive neurological deficit, without deterioration of consciousness and patients requiring 7 treatment within a month, namely Class A, with neurological alteration or suspected malignant lesion, related 8 This resulted in progression of the neurological 4 symptoms, without an early neurosurgical evaluation, until the onset of acute deficit which actually led to the 5 emergency room access. symptoms were consciousness alteration and seizures; in our survey approximately 10,7 % of the acute-onset 0 patients reported to have previously refused the surgical treatment, in the weeks before, correlated to concerns 1 about the hospitalization during the Coronavirus emergency. In conclusion, during the COVID-19 pandemic the neurosurgical urgent and emergency onset of neuro-6 oncological cases increased, in comparison to 2019. Illustrative Table regarding the epidemiological variations in neuro-oncological patients'' onset during the COVID-19 crisis
cord-258315-yt1ytasw	2020	title: Clinical course of 2019 novel coronavirus disease (COVID-19) in individuals present during the outbreak on the Diamond Princess cruise ship Abstract We investigated the clinical course of individuals with 2019 novel coronavirus disease (COVID-19) who were transferred from the Diamond Princess cruise ship to 12 local hospitals. In this study, we describe the clinical conditions, treatment, and the clinical course of the patients positive for SARS-CoV-2 who were transferred from the Diamond Princess cruise ship for further medical care to the participating hospitals in this study. The patients'' vital signs, laboratory data, chest radiographs, or computed tomography (CT) findings at the time of admission and treatment, and the data on the clinical course and prognosis were collected using case report forms. Notably, the severity of this disease in the patients transferred from the cruise ship was very high compared with that previously reported in the general population in China [5, 6] .
cord-258402-9s57thvn	2020	INTRODUCTION: With increasing prevalence of coronavirus cases (including among health care providers), the current advice for orthopaedic surgeons is to favor non-operative management of most injuries and reduce face-to-face follow-up. The standard operating procedures (SOPs) were implemented which were based upon the recommendations of ICMR, Ministry of Health and Family Welfare, GOI and Indian Orthopaedic Association (IOA) [10] , and targeted to provide optimum healthcare at a minimum risk to the treating team as well as other patients admitted to the hospital. Among the non-COVID-19 suspects, who were shifted to non-isolation zone, those who could be managed conservatively were given adequate primary treatment like fluids, analgesics and splintage and were discharged at the earliest so as to minimize the risk of infection transmission to them as well as health care workers.
cord-258416-1jrbu8ox	2020	Following patients with psoriasis on biological therapy, as well as other inflammatory and autoimmune cutaneous disorders such as atopic dermatitis, pemphigus, pemphigoid diseases, and skin cancer provoked the interest of dermatologists. Here, we summarize skin conditions during the COVID‐19 pandemic, patient information, and expert recommendations and give an overview about the registries launched to document skin changes during COVID‐19, as well as details about certain patient groups infected with SARS‐CoV‐2, for example, psoriasis, atopic dermatitis, and autoimmune bullous diseases. 33 In a French prospective study on the incidence and types of COVID-19-associated cutaneous manifestations, skin involvement was reported in only 4.9% (five patients of 103) and presented as erythematous rash (two patients) and urticaria (two patients). Future case-controlled studies may potentially confirm AGA as a predictive factor for increased COVID-19 severity and contribute to the development of antiandrogen therapy for SARSNeonatal rashes Skin rashes in newborns of COVID-19-infected mothers were reported in two boys out of four infants from China.
cord-258498-0mvxwo3w	2020	This review article informs about measures which reduce facility risk, manage symptomatic patients and protect personal health care and management with reference to paediatric dentistry. 5, 6, 7 The risk of SARS-CoV-2 transmission via aerosols generated during dental procedures cannot be eliminated when practicing in the absence of Airborne Precautions (airborne infection isolation rooms or single-patient rooms, respiratory protection program, N95 respirators). 47 Primary prevention encompasses prenatal health care, avoidance of night time bottle feed with sugary drinks or milk, restricting sugar intake and frequency for children younger than 24 months, avoiding frequent/nocturnal breast or bottle feeding after 1 year, exposure to dietary fluoridate (water, milk, salt), use of an age appropriate amount of fluoride toothpaste containing at least 1000ppm fluoride for brushing at least twice a day, dental visit in the first year of life and regular applications of 5% fluoride.
cord-258548-1u7v1nlr	2020	
cord-258576-ywbyflas	2020	
cord-258583-5qdthy0j	2020	We aimed to explore the association between OI and mortality according to the number of affected organs (heart, liver, and kidney) in patients with COVID-19. The primary findings of this investigation were the following: Clinical studies suggested SARS-CoV-2 infection was associated with heart, kidney, and liver injury, which could serve as possible risk factors for increased disease severity. Association of cardiac injury with mortality in hospitalized patients with COVID-19 in Wuhan, China Clinical characteristics of non-ICU hospitalized patients with coronavirus disease 2019 and liver injury: a retrospective study A comparative study of clinical presentation and risk factors for adverse outcome in patients hospitalised with acute respiratory disease due to MERS coronavirus or other causes Association of reninangiotensin system inhibitors with severity or risk of death in patients with hypertension hospitalized for coronavirus disease 2019 (COVID-19) infection in Wuhan, China Multiple organ injury on admission predicts in-hospital mortality in patients with COVID-19
cord-258692-dch1utis	2004	
cord-258708-da6x5rxa	2020	The coronavirus disease COVID-19 is a public health emergency caused by a novel coronavirus named severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). In COVID-19, particular attention has been given to the role of angiotensin-(Ang) converting enzyme 2 (ACE2), and the binding site for SARS-CoV-2 cellular entry (3). One of the clinical features of patients infected with SARS-CoV-2 included abnormal features such as acute cardiac injury (12%) (22) . Significance of the SARS-CoV-2 infection in the CV system is reflected through incidences of acute myocardial injury, arrhythmias, ACS, sepsis, septic shock, viral myocarditis, and heart failure. Coronavirus Disease 2019 (COVID-19) and Cardiovascular Disease: A Viewpoint on the Potential Influence of Angiotensin-Converting Enzyme Inhibitors/Angiotensin Receptor Blockers on Onset and Severity of Severe Acute Respiratory Syndrome Coronavirus 2 Infection 19) and Cardiovascular Disease: A Viewpoint on the Potential Influence of Angiotensin&#x2010;Converting Enzyme Inhibitors/Angiotensin Receptor Blockers on Onset and Severity of Severe Acute Respiratory Syndrome Coronavirus 2 Infection
cord-258727-mhg56j20	2020	It is also worth noting that most of the patients with severe and refractory mood disorders and comorbid anxiety disorders followed in the mood disorders specialized clinic remained stable and well served remotely via telemedicine instead of in-person visits over the last 3-4 months of COVID-19 pandemic. Patients are well supported by their family members who stay at home during the COVID-19 lockdown and this experience of togetherness obviously was beneficial for patients with mood disorders. Finally, many people are working from home during the COVID-19 pandemic. Working from home is beneficial for some patients with mood and anxiety disorders as they are not exposed to social stress at their work place. Psychiatric emergency department volume during Covid-19 pandemic COVID-19 pandemic: impact on psychiatric care in the United States Psychiatrist experience of remote consultations by telephone in an outpatient psychiatric department during the COVID-19 pandemic
cord-258758-sz8chn5e	2020	title: Atypical COVID -19 presentation in patient undergoing staged TAAA repair Patient was tested positive for Covid 19 virus and later during hospitalization developed more typical fever and respiratory symptoms that were managed medically. The 2 typical presenting symptoms in the majority of patients range from common upper respiratory 3 tract signs such as cough, sore throat and fever to more severe shortness of breath and severe 4 respiratory dysfunction. 9 We present a case of COVID 19 infection with atypical debut in a patient having undergone 10 staged, endovascular thoraco-abdominal repair 2 weeks previously. 14 The patient underwent stage 1, percutaneous thoracic endovascular repair (TEVAR) with 15 placement of a thoracic stent-graft from the left subclavian artery to 4 cm proximal to the celiac 16 artery origin (Fig 3) . Short-term outcome of spinal cord ischemia after endovascular repair of thoracoabdominal aortic 3 aneurysms Staged endovascular repair of thoracoabdominal 9 aortic aneurysms limits incidence and severity of spinal cord ischemia
cord-258888-amimzjee	2020	Appropriate protocols for screening, triage and management of non-COVID patients with due precautions and infection control strategies can ensure that emergencies get timely and appropriate attention while preventing spread of infection among patients and healthcare workers. In this article, we describe our experience with the triage and management of ENT & Lakshmi Ananth lakshmiananth@yahoo.com emergencies at a tertiary referral hospital in the setting of a lockdown with limited resources and the protocol followed by us to maximize the safety of health care personnel involved and avoiding the possibility of hospital transmission of infection. In the absence of testing facility, the above suggested protocol will be helpful while performing surgeries even after the lockdown period ends in order to minimize the risk of hospital transmission of infection and increase the safety of patients and healthcare workers.
cord-258916-jbdz1pk0	2020	We report on data and debriefing observations in the context of an immersive simulation conducted to (a) train clinicians and (b) test new protocols and kits, developed in table-top exercises without prior clinical experience to fit anticipated clinical encounters in the setting of the rapidly expanding COVID-19 pandemic. We simulated scenarios with particular relevance for anesthesiology, perioperative and critical care, including (1) cardiac arrest, (2) emergency airway management, (3) tele-instruction for remote guidance and supervision, and (4) transporting an intubated patient. • Immersive healthcare simulation employing anticipated clinical encounters may be useful to test COVID-19 [8, 10, 11] and other airborne contagious disease hospital protocols, developed with limited clinical experience, to detect shortcoming before such gaps become apparent in clinical care and threaten patient or provider safety.
cord-258930-60yn4hg7	2020	All biological and immunosuppressive treatments were discontinued, visits in person were replaced by online consultations, and 318 patients were daily recommended to wash their hands frequently, to reduce the time spent outside the home and to use masks outside the home 7 . It is important to underline that a relevant percentage of evaluated patients had risk factors of infection: chronic diseases (15.4%), immunosuppressive agent therapy (11.0%), elderly (10.4%), high-risk professional categories (7.5%), and biological therapy (6.3%) 7 . Telemedicine has also been associated with a reduction in gastroenterological consultations and hospitalizations and could be a valid alternative to improve the quality of IBD patient care during the COVID-19 outbreak 23 . Comparative Risk of Serious Infections With Biologic and/or Immunosuppressive Therapy in Patients With Inflammatory Bowel Diseases: A Systematic Review and Meta-Analysis Protection of 318 inflammatory bowel disease patients from the outbreak and rapid spread of COVID-19 infection in Wuhan
cord-259073-dixskemz	2020	The elderly are the most vulnerable to significant adverse complications from COVID 19 and AMS should be considered as a possible sign of infection to initiate treatment early in the course of the disease, perhaps before respiratory symptoms are apparent. In this report, we present four patients diagnosed with COVID-19 who initially presented with altered mental status without fever or cough or respiratory distress. Each of the four patients developed AMS without fever or respiratory symptoms and were transferred to the local emergency department and were tested for the COVID-19 virus as part of their medical work up. Recognizing the COVID-19 infection early is especially important in the frail elderly, particularly for individuals in communal living facilities where isolating these patients can help limit the spread of the virus, There is evidence from previous viral epidemics of associated neuropsychiatric symptoms.
cord-259204-27t269pd	2020	Background Limited data are available for antiviral therapy efficacy especially for the most severe patients under mechanical ventilation suffering from Covid-19 related Acute Respiratory Distress Syndrome (ARDS). Methods Observational multicenter cohort of patients with moderate to severe Covid-19 ARDS, comparing antiviral strategies (none, hydroxychloroquine (HCQ), lopinavir/ritonavir (L/R), others (combination or remdesivir). Limited data are available for antiviral therapy efficacy especially for the most severe patients under mechanical ventilation suffering from Covid-19 related Acute Respiratory Distress Syndrome (ARDS). Observational multicenter cohort of patients with moderate to severe Covid-19 ARDS, comparing antiviral strategies (none, hydroxychloroquine (HCQ), lopinavir/ritonavir (L/R), others (combination or remdesivir). In moderate to severe ARDS COVID-19 patients, we did not observe an association between treatment with hydroxychloroquine or lopinavir/ritonavir and ventilatory free days as compared to no antiviral treatment.
cord-259229-e8m8m4ut	2020	Emerging evidence reveals a direct interplay between COVID-19 and dire cardiovascular complications, including myocardial injury, heart failure, heart attack, myocarditis, arrhythmias as well as blood clots, which are accompanied with elevated risk and adverse outcome among infected patients, even sudden death. Respiratory illness and acute cardiac injury are major clinical manifestations observed in patients infected with SARS-CoV-2 during the late stage complications of the disease [38] . Based on the available clinical data, potential myocardial injury is a relevant challenge among hospitalized patients with COVID-19 with increased risk of mortality; therefore, it is essential for multidisciplinary assessment, including blood pressure control in hypertensive patients as well as cardiovascular evaluation and therapy to reduce the morality for COVID-19 infection. Association of Renin-Angiotensin System Inhibitors With Severity or Risk of Death in Patients with Hypertension Hospitalized for Coronavirus Disease 2019 (COVID-19) Infection in Wuhan, China
cord-259329-8pta6o6a	2020	The objective of this study was to derive a risk stratification tool to predict 24 hour respiratory decompensation in admitted patients with COVID-19. 12 Second, to aid healthcare providers in assessing illness severity in COVID-3 19 patients, we present predictive models of early respiratory failure during hospitalization and compare them to three benchmarks accessible using data in the electronic health record: the Elixhauser comorbidity index, 13 the quick sequential organ failure assessment (qSOFA), 14, 15 and the CURB-65 pneumonia severity score. This was a retrospective observational cohort study to develop a prognostic model of early respiratory decompensation in patients admitted from the emergency department with COVID-19. 1Consistent with clinical observations, we noted a significant rate of progression to critical respiratory illness within the first 24 hours of hospitalization in COVID-19 patients.
cord-259411-434acu0h	2020	Here we present a flow chart (figure 1) for the management of diabetes and hyperglycemia in non-critically ill patients as an attempt to standardize a protocol that may be used across different services in the hospital without the need of a diabetes specialist. Experts have suggested that we need to revise guidelines to allow more usage of non-insulin anti-diabetic medications for hospitalized patients (14) . Management of hyperglycemia in hospitalized patients in non-critical care setting: an endocrine society clinical practice guideline Efficacy of basal-bolus insulin regimens in the inpatient management of non-critically ill patients with type 2 diabetes: A systematic review and meta-analysis. Debate on Insulin vs Non-insulin Use in the Hospital Setting-Is It Time to Revise the Guidelines for the Management of Inpatient Diabetes? Randomized study of basal-bolus insulin therapy in the inpatient management of patients with type 2 diabetes undergoing general surgery (RABBIT 2 surgery)
cord-259448-deya8dwn	2020	The expression levels of various miRNAs were detected by high‐throughput sequencing, and correlation analysis was performed on the target genes that are primed by miRNAs. KEY FINDINGS: Compared with the healthy controls, 35 miRNAs were upregulated and 38 miRNAs were downregulated in the human patients with COVID‐19. 16 In this study, to better understand the miRNA expression pattern in peripheral blood collected from human COVID-19 patients and healthy donors, high-throughput sequencing, and bioinformatics analysis were employed. The differential miRNA expression found in COVID-19 patients may regulate the immune responses and viral replication during viral infection. As shown in Figure 3 , there were significant differences in the miRNA expression between the COVID-19 patients and the control group. In the present study, the differential miRNA expression in peripheral blood from COVID-19 patients and healthy donors was observed.
cord-259585-mjtxiu0t	2020	Every possible effort was made to quickly increase the capacity of intensive care units (ICUs) to accommodate the alarming numbers of very sick CoViD-19 patients, including constructing new units in unused areas of the hospital or converting surgical rooms into ICUs. These drastic measures were implemented in a very short period of time, and although necessary to counteract the devastation brought about by the outbreak, they also posed tremendous challenges to the care of patients with GI conditions, including those with inflammatory bowel diseases (IBD). However, for patients on biologic therapies, we have implemented a mandatory phone call-in the day before any planned hospital visit to screen for possible CoViD-19 symptoms or contact with infected individuals and to reassure patients that all possible precautions are being taken by the IBD center to reduce the risk of infection.
cord-259699-48jg7ci7	2020	METHOD: We conducted an observational study of patients undergoing surgical intervention in the operating room assigned as COVID, where we considered age, sex, treating department, type of intervention, and initial biomarkers (first five days of hospitalization), days of hospital stay, days in the Intensive Care Unit and reason for discharge. We conducted an observational study of patients undergoing surgical intervention in the operating room assigned as COVID, where we considered age, sex, treating department, type of intervention, and initial laboratory tests (first five days of hospitalization): ferritin, D-dimer, total leucocyte count, total lymphocyte count, lymphocytes (%), platelets, lactate dehydrogenase, fibrinogen, and procalcitonin; we also considered days of hospital stay (DOHS), days in the Intensive Care Unit (ICU), and reason for discharge. Indeed, it has been decided to reduce elective surgical treatment, we have also observed that patients undergoing emergency surgery with suspicion or confirmation of SARS-Cov-2 infection have significant mortality depending on the performed surgical procedure, without relevant findings regarding biomarkers.
cord-259747-sl9q63oc	2020	BACKGROUND: Post-mortem studies can provide important information for understanding new diseases and small autopsy case series have already reported different findings in COVID-19 patients. IHC revealed positive cells with a heterogeneous distribution in the lungs of 11 of the 17 (65%) patients; RT-PCR yielded a wide distribution of SARS-CoV-2 in different tissues, with 8 patients showing viral presence in all tested organs (i.e., lung, heart, spleen, liver, colon, kidney, and brain). In this post-mortem study, we included the first 17 adult patients (> 18 years) who died in our hospital (either in a COVID-19 unit or an intensive care unit) from March 13, 2020, with confirmed SARS-CoV-2 infection (i.e., positive RT-PCR assay on nasopharyngeal swab and/or bronchoalveolar lavage specimen). This post-mortem study showed several histopathological abnormalities in COVID-19 non-survivors; however, none of the findings was specific for direct viral injury, even though SARS-CoV-2 was detected in all examined organs using RT-PCR.
cord-259767-x9s8qprc	2020	
cord-259801-xuvcrvo2	2020	It starts out with an important article by Hoermann and colleagues underscoring the biochemically heterogeneous expression of thyroid hormone activities in subclinical/overt hyperthyroidism and exogenous thyrotoxicosis (1) . In their study of 461 patients composed of untreated thyroid autonomy, Graves'' disease, and levothyroxine TSH suppressive therapy after thyroidectomy for thyroid carcinoma, they demonstrate that deiodinase activity is markedly reduced in patients with exogenous thyrotoxicosis compared to patients with endogenous hyperthyroidism because of a lack of TSH stimulation, inhibition by levothyroxine, and the absence of a functioning thyroid gland. Cipolla and colleagues share their experience performing total thyroidectomy on 594 patients with Graves'' disease between age 32 y and 56 y underscoring that it is a safe and effective treatment in experienced hands (15) . Zhou and colleagues underscore the important role of neural monitoring during thyroid surgery for Graves'' disease in their retrospective series including 55 thyroidectomies and 82 procedures with intermittent intraoperative neuromonitoring (IONM) and 72 procedures with continuous IONM (19) .
cord-259848-0thzmh7k	2020	
cord-259907-yqmi0cqy	2009	title: Management guidelines for obstetric patients and neonates born to mothers with suspected or probable severe acute respiratory syndrome (SARS) No. 225, April 2009 Labour triage and antenatal hospital admission Actions • Assessment is made as to whether the patient has suspected or probable SARS [1, 14] • Upon arrival in the labour and delivery triage unit, pregnant patients presenting with fever N38°C and respiratory symptoms and one of the associated symptoms (cough, unexplained hypoxia, shortness of breath, or dyspnea) and history of an exposure to an individual with probable SARS are immediately transferred to the designated isolation room, which is equipped with negative pressure ventilation. • Parents and family are counselled to look for symptoms and signs of SARS in the mother and newborn, especially in the first 10 days following delivery, and to report to any findings to the health care team Summary SARS, a life-threatening respiratory illness caused by a novel coronavirus, was responsible for a worldwide outbreak in 2003.
cord-259969-q65k590s	2020	We describe a 43-year-old patient with coronavirus disease 2019 who developed a bullous hemorrhagic rash that progressed to necrotic lesions. Small blood vessel occlusion by microthrombi, which has been described in patients with coronavirus disease 2019 (COVID-19) [1] , could not be demonstrated. Under suspicion of a SARS-CoV-2-induced cutaneous vasculitis, the patient was treated with prednisolone at 0.5 mg per kilogram. Variable and heterogenous skin manifestations in patients with COVID-19 have been described that appear before, during, and after the disease [2] . However, other groups have described skin manifestations in up to 20% of COVID patients [4, 5] . However, our case demonstrates a small/medium-sized vessel vasculitis with involvement of mucous membranes as the cause of skin manifestations in a patient with COVID-19 that appeared late in the disease. Cutaneous manifestations in patients with COVID-19: a preliminary review of an emerging issue
cord-259984-csdf1a69	2020	For emergent/unavoidable case for a known or undetermined COVID-19 patient, the surgeon and all OT personnel in the surgical suite should use PAPR, which filter the air being breathed in addition to face shields and other standard PPE. In routine clinical care of COVID-19 suspected or confirmed infections, surgical masks are acceptable PPE, except in the case of aerosol generating procedures (intubation, high flow nasal cannula, non-invasive ventilation, bronchoscopy, administration of nebulised medications, etc). Hospitals, professional societies and ministries of health could also provide physician and nursing staff with basic ICU and ventilator management refresher education to improve their capacity to care for COVID-19 patients. Designated COVID-19 hospitals may not be able to support all elective cases, in particular those that require post-operative intensive care or significant use of blood and blood products Surgeons, in consultation with anaesthetist, nursing colleagues as well as patients (or legally accepted next of kin), should weigh the risks of proceeding (exposure, lack of resources) against those of deferment, (progression of disease, worse patients outcomes) including the expectation of delay of 2-3 months or more or until the COVID-19 is less prevalent Figure 6 .
cord-260037-ys62jrgw	2015	
cord-260083-c1r9zn43	2020	• Bleeding patients usually require blood transfusion which is in short supply during the Covid pandemic due to the lockdown and fear of entering medical facilities • Biocontainment transfer of Covid-19-positive patients within the hospital is complex and not easy to achieve [5] In view of these considerations, interventional radiology plays a crucial role and a dedicated treatment pathway should be set up. In conclusion, although major bleeding seems to be rare in Covid-19 patients, its management is complex for several reasons: the need to continue anticoagulation, shortage of blood products, multiple sites of haemorrhage and logistic issues. Ethical Approval All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.
cord-260105-ckh8jp9e	2020	
cord-260119-pgu2crhs	2020	Four randomised controlled trials have examined the efficacy of daily home foot temperature monitoring to signal the need for offloading in people at risk of diabetes-related foot ulcers [17] [18] [19] [20] . The previous trials testing home foot temperature monitoring [17] [18] [19] have excluded people with peripheral artery disease (PAD), which is an established risk factor for foot ulceration, thereby limiting the generalizability [20] [21] [22] . The cost-effectiveness and cost-utility of at-home infrared temperature monitoring in reducing the incidence of foot ulcer recurrence in patients with diabetes (DIATEMP): Study protocol for a randomized controlled trial Preventing diabetic foot ulcer recurrence in high-risk patients: Use of temperature monitoring as a self-assessment tool A pilot study testing the feasibility of skin temperature monitoring to reduce recurrent foot ulcers in patients with diabetes-a randomized controlled trial
cord-260180-kojb8efv	2020	METHODS: We report the clinicopathologic findings from 32 autopsy studies conducted on patients who died of COVID-19 including routine gross and microscopic examination with applicable special and immunohistochemical staining techniques. The purpose of this study is to describe clinical and pathologic findings in major organ systems of patients who died from SARS-CoV-2 infection. In this study, we described the unique and multisystem clinical and pathologic findings in 32 autopsies of patients who died from the novel coronavirus, SARS-CoV-2. On histologic examination, we observed findings secondary to the patients'' preexisting conditions in the heart, lungs, liver, and kidneys, as well as changes secondary to SARS-CoV-2 infection such as various stages of DAD and multiple thromboemboli in large and small vessels in multiple organs. While the lung findings are most significant for the majority of those infected, other organ systems are frequently involved including with widespread microscopic thromboses in numerous organs, as well as liver, kidney, and lymph node pathology.
cord-260215-gsnjlhjd	2016	Given that respiratory diseases are the commonest causes of critical illness, use of aerosol therapy to provide high local drug concentrations with minimal systemic side effects makes this route an attractive option. The efficacy of aerosol drug therapy depends on drug-related factors (particle size, molecular weight), device factors, patient-related factors (airway anatomy, inhalation patterns) and mechanical ventilation-related factors (humidification, airway). NIV non-invasive ventilation, HME heat and moisture exchanger, pMDI pressurized metered dose inhaler, AAD adaptive aerosol device, VMN vibrating mesh nebulizer, DPI dry powder inhaler, PEEP positive end-expiratory pressure Fig. 3 Effects of regional lung aeration and pneumonia on drug concentration in lungs. The patient position, formulation, temperature, endotracheal tube size, presence of airway obstruction or ventilatory asynchrony, flow pattern, respiratory rate, dose and frequency applied or position of the nebulizer in the circuit are important factors that influence delivery to the lung.
cord-260224-1aeqe7fh	2020	A 61-year-old male patient affected by stage IV prostate cancer with bone metastasis at diagnosis presented to our Wound Care Clinic complaining of ulcers on the right forearm that appeared two weeks prior following a referred domestic trauma. He presented no signs and symptoms of recrudescence of cutaneous and neurological cryptococcosis, but the cryptococcal antigen was still positive. There is no typical cutaneous lesion of cryptococcosis, but skin involvement is typically characterized by various non-specific presentations (e.g., papules, pustules, nodules, abscesses, edema, panniculitis, and ulcers) and can be due to a primary infection or due to a secondary systemic hematogenous spread [8] [9] [10] . Our patient presented with two large and necrotic ulcers on his right forearm and was treated with broad-spectrum antibiotics. The studies cited above and the clinical course of our patient showed that cutaneous symptoms in an immunocompromised patient should always alert about the possibility of an opportunistic infection such as cryptococcosis.
cord-260232-98gtlad6	2020	title: Acute Kidney Injury in a Case Series of Patients with Confirmed COVID-19 (Coronavirus Disease 2019): Role of Angiotensin-Converting Enzyme 2 and Renin-Angiotensin System Blockade We present the case series of four patients (2 men and 2 women; 1 Caucasian and 3 African Americans; two survived and two died) with confirmed COVID-19, presenting with respiratory symptoms and acute kidney injury, who have been on angiotensin-converting enzyme inhibitors or angiotensin receptor blockers. We also discussed the role of ACE2 and the renin-angiotensin system (RAS) blockade in patients with COVID-19 infection along with pathogenesis. We presented the case series of four patients who were on angiotensin-converting enzyme inhibitors (ACE inhibitors) or angiotensin receptor blockers (ARBs) with COVID-19 infection and acute renal failure. hypothesized that the use of ACE2 modulation medications in hypertensive and diabetic patients increased the risk of developing severe COVID-19 infection [1] .
cord-260274-c3586tp6	2020	
cord-260456-kjmab3og	2020	title: Massive Pulmonary Embolism Complicating Coronavirus Disease 2019 (COVID-19) Pneumonia: A Case Report On bedside TTE, there was evidence of right heart strain and elevated pulmonary artery systolic pressure of 45 mmHg. All data was indicative of a massive APE as the etiology for his hemodynamic collapse. Furthermore, timely diagnosis can be made to aid in appropriate management with the help of bedside TTE and ECG in cases where CTPA is not feasible secondary to the patient''s hemodynamic instability. (1) Patients with severe coronavirus disease 2019 (COVID-19) pneumonia are hypercoagulable and are at risk for acute pulmonary embolism (APE). (2) Massive acute pulmonary embolism should always be considered in the differential diagnosis for sudden and rapid hemodynamic decline in patients with COVID-19. (3) Critical care bedside echocardiography along with other clinical indicators helps in timely diagnosis and thus treatment of APE in patients with COVID-19 pneumonia, which is lifesaving.
cord-260503-yq4dtf8n	2004	Objectives The authors trace the emergence of the SARS outbreak from southern China and its spread worldwide, discuss the viral etiology of the infection and its clinical features, and review the infection control guidelines issued during the outbreak by the health authorities in Hong Kong, the Centers for Disease Control and Prevention, the World Health Organization and the American Dental Association. Conclusions and Clinical Implications Researchers believe that a combination of factors, including the universal infection control measures that the dental community has implemented and/or the low degree of viral shedding in the prodromal phase of SARS, may have obviated the spread of the disease in dental settings. Interim domestic infection control precautions for aerosol-generating procedures on C L I N I C A L P R A C T I C E patients with severe acute respiratory syndrome (SARS)
cord-260525-bohv78hi	2020	We compiled laboratory results from the first 14 days of the hospitalized patients using parameters that are most significantly different between COVID-19 and influenza and hierarchically clustered COVID-19 patients. Patients in the highest risk cluster had leukocytosis including neutrophilia and monocytosis, severe anemia, increased red blood cell distribution width, higher BUN, creatinine, D-dimer, alkaline phosphatase, bilirubin, and troponin. Overall, our study reveals significant differences in the laboratory parameters between the hospitalized COVID-19 and influenza patients. Compared to influenza patients, the most significant differences over the course of 14 days of hospitalization in COVID-19 patients were worsening anemia, worsening leukocytosis, and an increase in D-dimer, BUN, and ALT. Instead of comparing clinical endpoints to evaluate risks as performed in most of the published studies, we stratified the hospitalized COVID-19 patients through clustering of their laboratory results that were most significantly different from influenza patients (i.e. complete blood count, D-dimer, BUN, and ALT) during the first 14 days of hospitalization.
cord-260605-smkr7b15	2020	However, the biofilm lifestyle of microorganisms were of no interest to medical microbiologists until the early 1970s when Nils Høiby observed a link between the etiology of a persistent infection and aggregates of bacteria in cystic fibrosis patients [1] . This is consistent with the experiments showing that many bacteria causing acute gallbladder infections do not form biofilms on gallstones in the presence of bile [73, 80] . This is consistent with the experiments showing that many bacteria causing acute gallbladder infections do not form biofilms on gallstones in the presence of bile [73, 80] . Several studies have detected higher incidence of Escherichia coli in patients with IBD compared to healthy individuals [90] and although biofilms were not demonstrated in vivo, the isolates were isolated from biopsies after removal of the mucosal layer, indicating adherence to the colonic epithelium and the isolates displayed biofilm forming capacity in vitro [90] .
cord-260630-vvpzp73r	2005	In this issue of Clinical Infectious Diseases, there are 2 articles that provide us with some insight into the various etiologic agents that can cause acute respiratory tract infection (ARTI) in general practice patients in The Netherlands [1] and into the significance of the human metapneumovirus (hMPV) in patients with community-acquired pneumonia (CAP) and exacerbations of chronic obstructive pulmonary disease (COPD) in Quebec, Canada [2] . The objectives of the Dutch study were to estimate the incidence of influenza-like illnesses (ILIs) and of other ARTIs in patients visiting their general practitioners (to determine the etiologic agents) and to test the hypothesis that asymptomatic persons with subclinical infection may act as sources of transmission [1] . Nose and throat swab specimens were obtained from case patients and control subjects, and viral cultures and PCR tests were performed for detection of adenovirus, coronavirus, enterovirus, hMPV, influenza virus, parainfluenza virus, rhinovirus, and respiratory syncytial virus (RSV), as well as for Mycoplasma pneumoniae, Chlamydophila pneumoniae, and Chlamydophila psittaci.
cord-260679-tm1s6wvj	2020	Within the grouping of hospital-acquired pneumonia (HAP), further distinction is usually made according to whether the patient was on an intensive care unit, or intubated (ventilator-acquired pneumonia (VAP)) at the time of infection (Torres et al., 2017; Kalil et al., 2016) . A definitive diagnosis of pneumonia comprises four aspects: (i) symptoms and signs of a respiratory tract infection, (ii) radiological changes, (iii) identification of a putative pathogen and (iv) a treatment response, or clinical course, consistent with pneumonia. A meta-analysis of individual participant data from 26 RCTs found that PCT-directed treatment in the management of acute respiratory tract infections (of varying types and severity, including CAP and HAP) was associated with a reduction in antibiotic exposure (5.0 vs. The respiratory pathogens commonly implicated in patients with CAP remain important aetiological agents in all other types of pneumonia, including HAP and pneumonia in the immunocompromised host (Table 8 ).
cord-260700-u12aa739	2010	title: Recurrent and persistent respiratory tract viral infections in patients with primary hypogammaglobulinemia OBJECTIVE: We conducted a prospective 12-month follow-up study of respiratory tract infections in 12 adult patients with primary hypogammaglobulinemia. METHODS: Nasal swab samples and induced sputum samples were taken at the onset of acute respiratory tract infection and every 3 months thereafter. CONCLUSIONS: Despite adequate immunoglobulin replacement therapy, patients with primary hypogammaglobulinemia have increased susceptibility to respiratory tract viral infections. Using modern diagnostic techniques, we wanted to study the occurrence of respiratory tract infections, especially viral infections, in patients with primary hypogammaglobulinemia who were receiving regular immunoglobulin replacement therapy. If the spouse of the patient had acute symptoms of respiratory tract infection, she or he took nasal swabs at home according to the instructions of the research nurse and sent the vials by post. First, despite adequate immunoglobulin replacement therapy, most patients with primary hypogammaglobulinemia had increased susceptibility to respiratory tract viral infections.
cord-260762-1kuj5dzz	2020	
cord-260854-v7wgb6mr	2020	
cord-260857-oxxle915	2020	BACKGROUND: There is limited data regarding the electrophysiological abnormalities and arrhythmias in children with COVID-19, including those associated with treatment using potentially pro-arrhythmic Hydroxychloroquine (HCQ) and Azithromycin (AZN). Additionally, some of the medications that have been used for treatment of COVID-19 infection, such as Hydroxychloroquine (HCQ) and Azithromycin (AZN), are known to cause corrected QT (QTc) interval prolongation, therefore potentially predisposing patients to malignant ventricular arrhythmia.s 6, 7 However, there is little current data on the electrophysiologic consequences of these drugs in the setting of active COVID-19 in pediatric patients. As per hospital protocol, COVID-19 specific medications including HCQ with or without AZN were initiated at the discretion of the Infectious Disease team for patients needing supplemental oxygen for hypoxia in the setting of positive SARS-CoV-2, if the baseline QTc was less than 480 milliseconds (msec) measured on lead II via 15 lead ECG or telemetry.
cord-260871-dtn5t8ka	2020	Besides, several neurological manifestations had been described as complications of two other previous outbreaks of CoV diseases (SARS ad Middle East respiratory syndrome). Several neurological manifestations were described as complications of two other previous outbreaks of CoV diseases, namely, SARS and the Middle East respiratory syndrome (MERS). Stroke is one of the most frequent neurological diseases associated with SARS-CoV-2 infection, 8 and large-vessel stroke in younger patients was recently reported in five patients. Detection of SARS coronavirus RNA in the cerebrospinal fluid of a patient with severe acute respiratory syndrome Mechanisms of host defense following severe acute respiratory syndrome-coronavirus (SARS-CoV) pulmonary infection of mice Severe acute respiratory syndrome coronavirus infection causes neuronal death in the absence of encephalitis in mice transgenic for human ACE2 Central nervous system involvement by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and the central nervous system
cord-260980-tyf3fuz9	2020	title: Anosmia and Dysgeusia in the Absence of Other Respiratory Diseases: Should COVID-19 Infection Be Considered? We describe two elderly patients evaluated at emergency departments for anosmia/dysgeusia in the absence of any other respiratory symptoms prior to or upon admission. Upon admission, the patient was afebrile, his blood pressure was 110/80 mmHg, heart rate was 82 bmp and oxygen saturation was 94% on room air. Anosmia, hyposmia and dysgeusia in the absence of other respiratory diseases such as allergic rhinitis, acute rhinosinusitis or chronic rhinosinusitis, should alert physicians to the possibility of COVID-19 infection and prompt serious consideration of self-isolation and testing of these individuals. Anosmia and dysgeusia should prompt COVID-19 infection screening even in the absence of classic respiratory symptoms in the present epidemiological context. Epidemiological, clinical and virological characteristics of 74 cases of coronavirus-infected disease 2019 (COVID-19) with gastrointestinal symptoms
cord-260981-647wfa8z	2020	
cord-261006-2xh3f07i	2020	title: Recommendations to Manage Patients for Bariatric Surgery in the COVID-19 Pandemic: Experience from China For the prehospital evaluation, we recommend (1) that consultation be conducted virtually by means of WeChat, email, or telephone, to investigate whether patients may have COVID-19 by asking about symptoms or any history of recent travel to epidemic areas. For the preoperative evaluation, we recommend (1) reevaluation of epidemiological information to exclude COVID-19-infected if necessary; (2) re-evaluate whether there is any history of fever or respiratory symptoms; confirm the results of lung CT, nucleic acid test, routine blood examinations, and other relevant tests. Repeat the PCR if necessary in case of a false positive; (3) complete a preoperative examination of cardiopulmonary function; use continuous positive airway pressure (CPAP) to improve lung ventilation and systemic hypoxia in cases of obesity hypoventilation syndrome (OHS); for cardiopulmonary insufficiency or severe complications, there should be an online consultation of the departments of anesthesia, respiratory, cardiovascular, endocrine, and other relevant departments to plan the surgical timing and provide individualized diagnosis and treatment [12] . Clinical characteristics of 138 hospitalized patients with 2019 novel coronavirus-infected pneumonia in Wuhan, China
cord-261025-y49su5uc	2003	Severe acute respiratory syndrome (SARS) is a recently recognized febrile respiratory illness that first appeared in southern China in November 2002, has since spread to several countries, and has resulted in more than 8000 cases and more than 750 deaths. This article summarizes currently available information regarding the epidemiology, clinical features, etiologic agent, and modes of transmission of the disease, as well as infection control measures appropriate to contain SARS. An RT-PCR test specific for RNA from the SARS-CoV has been positive within the first 10 days after fever onset in respiratory specimens from most patients considered probable cases of SARS who have been tested and in stool samples in the second week of illness. Case definitions of SARS are currently based on the presence of epidemiological risk factors (close contact with patients with SARS or travel to SARS-affected areas) and a combination of fever and respiratory symptoms, with or without chest radiographic changes. Severe Acute Respiratory Syndrome (SARS) in Singapore: clinical features of index patient and initial contacts
cord-261062-9zhe3ejy	2020	In this study, the utility of point-of-care lung ultrasound for the clinical classification of coronavirus disease (COVID-19) was prospectively assessed. Twenty-seven adult patients with COVID-19 underwent bedside lung ultrasonography (LUS) examinations three times within the first two weeks of admission to the isolation ward. Early studies suggested that the irregular pleural line with small subpleural consolidations, white lung, confluents and irregular vertical artifacts (B-lines) are ultrasonic manifestations of COVID-19 pneumonia , and LUS scores have been used for the identification of patients with lung involvement and disease severity (Vetrugno et al. According to Spearman correlation test results (Table 2) Then, we divided the LUS scores into three scales (low ≤9; 9<medium<15; high ≥15) and compared them with the severity of COVID-19 disease ( Table 3 ). Point-of-Care Lung Ultrasound findings in novel coronavirus disease-19 pnemoniae: a case report and potential applications during COVID-19 outbreak
cord-261151-27ocvgnw	2020	Moreover, much like in adult C-L psychiatry, these services can assist medical teams in managing the acute onset of neuropsychiatric disease, including delirium and catatonia, as well as help to identify and treat psychiatric symptoms and sequelae of systemic illnesses and treatments. 2 The survey results highlighted the most common reasons for pediatric psychiatric consultation to include suicide risk assessment, assistance in the diagnosis and management of medically unexplained symptoms, adjustment to medical illness, assessment for psychopharmacologic intervention, delirium, treatment non-adherence, and the management of children admitted to pediatric units to await psychiatric hospital placement (boarding). 27 Though often under-recognized, pediatric delirium is a common problem, present in at least 20-25% of critically ill patients, 28 and is associated with increased cost of care, 29 length of hospitalization, 30 mortality rate, 31 and the risk of future development of post-traumatic stress disorder symptoms for both patients and their families.
cord-261240-osbk041e	2020	The presence of lymphopenia as a signature of severe COVID-19 was confirmed by Wang D et al., who, in their study published in JAMA, reported that ICU patients suffering this infection had a median lymphocyte count of 800 cells/mm [3] , with non survivors exhibiting persistent lymphopenia [4] . Interestingly, hypercytokinemia and lymphopenia were also evident in critical patients with Severe Acute Respiratory Syndrome due to the Coronavirus emerged in 2003 (SARS-CoV) [5 , 6] . These features (lymphopenia + hypercytokinemia) fit the characteristics of a particular immunological phenotype of community acquired pneumonia (CAP), lymphopenic CAP (L-CAP), which, as we recently demonstrated in an article published in the Journal of Infection, is associated with increased severity, mortality and a dysregulated immunological response [7] . Clinical characteristics of 138 hospitalized patients with 2019 novel coronavirus-infected pneumonia in Wuhan, China
cord-261246-m40kwgcg	2020	title: Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study We describe epidemi ological data (ie, shortterm [occasional visits] and longterm [worked at or lived near] exposure to Huanan seafood market); demographics; signs and symptoms on admission; comorbidity; labora tory results; coinfection with other respiratory pathogens; chest radiography and CT findings; treatment received for 2019nCoV; and clinical outcomes. This study is, to our knowledge, the largest case series to date of 2019-nCoV infections, with 99 patients who were transferred to Jinyintan Hospital from other hospitals all over Wuhan, and provides further information on the demographic, clinical, epidemiological, and laboratory features of patients. This is an extended descriptive study on the epidemiology and clinical characteristics of the 2019nCoV, including data on 99 patients who were transferred to Jinyintan Hospital from other hospitals across Wuhan.
cord-261311-j6bmgmhz	2020	COVID-19 patients may present high risk in the use of medications and clinical pharmacists can contribute substantially as part of a multidisciplinary team to improve outcomes in drug therapy in severe and critical illness. The course of an intense inflammatory process leads to alterations in many Review of patients'' medical history Provision of real-time assessment and evidence-based (when possible) advice on drug therapy Support on safe use of medications brought from home Medication reconciliation at different levels of transition of care Simplification of drug administration schedule to reduce the exposure of nurses to COVID-19 patients Monitoring of potential drug-drug, drug-food interactions and adverse drug reactions Adjustments in dosing regimens according to liver and kidney functions Prevention of medication errors Optimization of drug therapy and electrolytes to minimize the risk of prolonged corrected QT intervals and torsade de pointes Support on lung-protective ventilation and neuromuscular blocking agents to facilitate ventilator synchrony Provision of conservative fluid strategies and monitoring of vasopressors use Monitoring of empirical antibiotics for suspected bacterial co-infection with rigorous de-escalation Employment of FASTHUG-MAIDENS mnemonic to identify drug-related problems in intensive care units Support on drug information to patients and multidisciplinary teams, following biosafety protocols Considerations on special situations (pediatrics, older adults, people with chronic diseases, allergies) Research and continuing education Precise documentation of pharmaceutical interventions laboratory tests in patients with acute or severe/critical illness.
cord-261380-xms5su6w	2020	Among an open-label, randomized clinical trial, adult patients (≥ 18 years old) with severe COVID-19 were randomly assigned (1:1) to the IFN group or the control group. According to the presence of this evidence, IFN β was considered as a promising option for the treatment of In this open-label, randomized clinical trial, efficacy and safety of IFN β-1b in the treatment of patients with severe CoVID-19 were assessed. This open-label, randomized clinical trial was designed to evaluate the efficacy and safety of IFN β-1b in the treatment of patients with CoVID19 Adult patients (≥ 18 years old) with positive PCR and clinical symptoms/signs of pneumonia (including dyspnea, cough and fever), peripheral oxygen saturation (SPO 2 ) ≤ 93 % in ambient air or arterial oxygen partial pressure to fractional inspired oxygen (PaO 2 /FiO 2 ) < 300 or SPO 2 /FiO 2 < 315 and lung involvement in chest imaging were included.
cord-261383-izd1vn6f	2020	Patient: Male, 48-year-old Final Diagnosis: Viral pleurisy Symptoms: Pleuritic chest pain Medication: — Clinical Procedure: — Specialty: General and Internal Medicine OBJECTIVE: Unusual clinical course BACKGROUND: Severe acute respiratory syndrome coronavirus 2, the virus responsible for Coronavirus Disease 2019 (COVID-19), has infected more than 8 million people worldwide and placed massive strains on healthcare systems around the world. CASE REPORT: A 48-year-old man with hypertension and type 2 diabetes mellitus presented to the Emergency Department with acute-onset pleuritic chest pain that had developed 1 day earlier and was found to be hypoxemic, requiring supplemental oxygen. CONCLUSIONS: I report a patient who experienced pleuritic chest pain from viral pleurisy that was the initial manifestation of COVID-19 which, to the best of my knowledge, has not yet been reported in the literature. I report a patient who experienced pleuritic chest pain as the initial manifestation of infection with COVID-19, who subsequently developed more typical features, including cough, fever, shortness of breath, and hypoxia.
cord-261410-kb91eagd	2017	The clinical features of respiratory adenoviral infection among military personnel were described previously; however, HAdV pneumonia in immunocompetent individuals and risk factors of disease progression to severe pneumonia or acute respiratory failure have not been well studied. All military trainees or active duty members, but not officers, were eligible for enrollment if they were !18 years old and had been admitted to the study hospital for pneumonia, defined by acute respiratory symptoms (fever, cough, sputum, dyspnea, and pleuritic chest pain) and pulmonary infiltrates on chest X-rays or computed tomography (CT) scans. Most HAdV pneumonia patients were basic military trainees or personnel who had recently completed training; active duty service personnel were not usually affected, even during outbreak peaks. Our results show that an outbreak of HAdV pneumonia occurred in Korean military training centers and indicate that emergent-type HAdV-55 infections might have caused the outbreak.
cord-261455-uejtwgar	2020	Acalabrutinib, a selective BTK inhibitor, was administered off-label to 19 patients hospitalized with severe COVID-19 (11 on supplemental oxygen; 8 on mechanical ventilation), 18 of whom had increasing oxygen requirements at baseline. This prospective off-label clinical study includes 19 hospitalized patients with severe COVID-19 who received off-label acalabrutinib between March 20, 2020 (date of treatment of the first patient) through April 10, 2020 with formal data collection completed on April 23, 2020 (Table S1 ). Our laboratory studies of ex vivo blood samples from patients hospitalized with COVID-19 revealed significantly elevated BTK phosphorylation in peripheral blood monocytes compared with healthy volunteers, demonstrating that the target of acalabrutinib is activated in these innate immune cells. BTK activation occurs in macrophages when TLRs bind single-stranded RNA, as may occur in SARS-CoV-2 infection, leading to NF-κB-dependent expression of multiple inflammatory cytokines and chemokines, including IL-6 which we observed was induced in COVID-19 monocytes and decreased in plasma following acalabrutinib treatment (Fig. 1) .
cord-261470-sqxdwu6j	2020	Two London based hospitals also found increasing numbers of patients with Kawasaki-like symptoms in communities with high rates of COVID 19, which was provisionally called pediatric inflammatory multisystem syndrome temporally associated with SARS-CoV-2 (PIMS-TS) [68] [70] . Another double-blind, placebo-controlled study reported similar effects when supplementing type II diabetes and hypertensive patients, taking ACE inhibitor medication together with 125 mg Pycnogenol ® daily for 3 months. Regarding endotheliitis, Pycnogenol ® studies offer good evidence for potential beneficial effects for patients suffering from COVID-19 by improving endothelial function. As Pycnogenol ® offers antioxidant and anti-inflammatory activities and positively influences endothelial cell function as well as microcirculation and platelet reactivity, a supplementation might support the management of COVID-19 patients. We hypothesize possible additional beneficial effects of Pycnogenol ® in patients infected with the new coronavirus SARS-CoV2 and those who suffer from abiding health problems, when complemented to the standard treatment also upon the first day of symptoms or infection.
cord-261485-0ke5nqy0	2020	Severe COVID-19 pneumonia group were 63 patients who received methylprednisolone, enoxaparin, antiviral drugs, empirical antibiotics for pneumonia, and standard treatment for comorbidity. Conclusion Early use of a combined anti-inflammatory (corticosteroids and Enoxaparin) and antiviral drugs treatment in patients with moderate to severe COVID-19 pneumonia prevent complications of the disease and improve clinical outcomes. This study evaluates the effectiveness of a combination treatment of anti-inflammatory (corticosteroids and Enoxaparin) and antiviral drugs to treat severe COVID-19 pneumonia. There is one patient in medical ward needs low flow oxygen therapy and methylprednisolone for more than 21 days due to unknown reason or confirmed significant lung disease or infection, but Bactrim was given empirically for possible pneumocystis pneumonia, then improved and discharged home. Extra days of length of stay, and virus clearance time, higher oxygen therapy among patients with comorbidity and moderate COVID-19 pneumonia.
cord-261670-rd9uq6tc	2020	Fever, cough, and dyspnea are the most common signs of COVID-19 5 ; it is a respiratory tract infection with pneumonia being the hallmark of more severe illness and the acute respiratory distress syndrome (ARDS), a serious complication and manifestation of its most critical form (Table 1) . 13 Although these findings have not been replicated in human studies or in the setting of COVID-19, such potential upregulation of ACE2 by ACE inhibitors or ARBs has resulted in speculation that these medications might worsen infection or predispose patients to myocardial injury. In a preclinical model of severe acute respiratory syndrome (SARS Co-V), treatment with losartan improved angiotensin signaling, ARDS, and survival, 14 and severe COVID infections are associated with low (not high) expression of ACE2. Clinical course and outcomes of critically ill patients with SARS-CoV-2 pneumonia in Wuhan, China: a single-centered, retrospective, observational study
cord-261736-jlwctmxw	2016	The aim of this study was to qualify and quantify bioaerosol concentrations during bronchoscopy to evaluate the occupational risk to HCWs. Knowing the real exposure is essential to encouraging HCWs to implement better prevention protocols and wear personal protective equipment if needed. The average concentrations (colony forming units/meters 3 of air) and the standard deviations of the culturable bacteria measured in the 2 bronchoscopy rooms are presented in Table 1 . To our knowledge, this is the first study to measure and identify the actual bacterial flora present in the ambient air of a room while bronchoscopies are being performed on patients. The identification of Streptococcus pneumoniae, Neisseria sp, and Corynebacterium sp shows that culturable bacteria from oral, nasal, and pulmonary flora were present in the air of the rooms during bronchoscopy procedures. It provides clear evidence of the presence of culturable opportunistic bacteria originating from the respiratory tract of patients in the air of bronchoscopy rooms.
cord-261801-va2e029z	2020	Lesson 2: While resistance to change was the norm, the COVID-19 crisis motivated improvements to four major internal operational workflows (scheduling, appointment conversions, patient support and Virtual Rooming Assistants) for video visits, which were met with acceptance by both clinical and non-clinical staff. Lesson 4: Regular electronic health record (EHR) training and educational material increased end-user knowledge of video visits and helped ensure the visit was safe, medically effective and maintained patient-provider relationships. Lesson 5: A clearly defined intake and evaluation process to filter out technologies that do not integrate with the patient portal or the EHR, ensures operational consistency and long-term sustainability. • Lesson 2: While resistance to change was the norm, the COVID-19 crisis motivated 23 improvements to four major internal operational workflows (scheduling, appointment 24 conversions, patient support and Virtual Rooming Assistants) for video visits, which 25
cord-261856-i1e0uj0s	2005	Elderly patients with moderate to severe COPD experience acute exacerbations of their airway disease, each of which presents a risk for acute respiratory failure. Criteria for grading the severity of an acute exacerbation of chronic bronchitis American College of Chest Physicians-American College of Physicians/American Society of Internal Medicine Guidelines [13] Mild exacerbation: presence of any one of the cardinal symptoms of increased dyspnea, increased sputum volume, or increased sputum purulence with the addition of an upper respiratory infection within the past 5 days, fever with no other cause, increased wheezing or cough, or a 20% rise over baseline in respiratory rate or heart rate. Bronchial microbial patterns in severe exacerbations of chronic obstructive pulmonary disease (COPD) requiring mechanical ventilation Noninvasive positive pressure ventilation in the setting of severe, acute exacerbations of chronic obstructive pulmonary disease: more effective and less expensive
cord-261921-c97ygxq2	2020	METHODS: Urologic trainees and attending physicians at our institution, who are familiar with existing safety recommendations and guidelines regarding the care of infected patients, were queried regarding their experiences to determine an expert consensus on best practices for bedside procedures for SARS-CoV-2 positive patients. RESULTS: Our team developed the following general recommendations for urologic interventions on SARS-CoV-2 positive patients: maximize use of telehealth (even for inpatient consults), minimize in-room time, use personal protective equipment appropriately, enlist a colleague to assist, and acquire all supplies that may be needed and maintain them outside the room. Our aim is to share our experiences performing bedside urologic procedures on SARS-CoV-2positive patients and offer considerations to maximize the safety of the patients and providers involved and conserve supplies while maintaining a high standard of care. Outlined above are our experiences with inpatient consultations and bedside procedures in SARS-CoV-2 patients and how we have attempted to address urologic challenges that have emerged with this pandemic.
cord-261941-xf1k5uj1	2005	Recommendations for limiting secondary transmission are given based on the Centers for Disease Control and Prevention guidelines on infection control in health care facilities. It is confirmed through laboratory testing showing an acute rise in SARS-CoV antibody titers within 4 weeks of developing the disease. Patients who meet the criteria for suspect SARS should immediately be placed in a private respiratory isolation room that has been specially engineered to contain negative pressure in relation to the outside hallway and have a minimum of 12 air exchanges per hour. Prevention of transmission in medical facilities requires a combination of early identification, isolation, and treatment of infectious individuals with active disease, engineering controls, basic infection control measures, and the use of personal protective equipment. Hospital infection control guidance for severe acute respiratory syndrome (SARS) California Department of Health Services: severe acute respiratory syndrome (SARS)-infection control recommendations Infection control measures for operative procedures in severe acute respiratory syndrome-related patients
cord-261980-bm0benu2	2020	In this paper, we detail our experience with mechanical thrombectomy for acute stroke during this time when any patient could potentially be COVID positive. It remains to be seen whether this increase in the number of acute stroke patients with LVO requiring mechanical thrombectomy will be sustained, but the effects are the same with respect to time and effort on the part of nursing and the rest of the neurointerventional team. Almost all of the patients undergoing mechanical thrombectomy during the month of April at our institution were of unknown COVID-19 status at the time of intervention, requiring significant modifications to our usual workflow to accommodate the necessities of infection control. Our single-institution experience shows that acute stroke patients with LVO are at least as high and likely higher than during the pre-COVID era, with increasing demands on nursing and the rest of the neurointerventional staff to adequately care for these patients while minimizing exposure to themselves and others.
cord-262068-9ixq8hwb	2020	The data that support the findings of this study are available from the corresponding author, upon Clinical characteristics and management of a liver transplanted patient admitted with SARS-CoV-2 infection SUMMARY We present here the case of a 62-year-old man, who was referred to the emergency department with fever and cough for 3 days. Therefore, due to the potential clinical efficacy for COVID-19 patients [11] and based on SARS clinical cases in 2003 [12] , and before the publication of the LOTUS China trial [13] , we started a treatment with lopinavir 200 mg and ritonavir 50 mg 2-0-2, and hydroxychloroquine 200 mg twice daily. Clinical data available so far indicate that up to 53% of the patients with COVID-19 present increased levels of transaminases during the infection and that liver injury is apparently associated with the severity of respiratory symptoms [14, 15] .
cord-262150-j72jbohi	2015	With a prototype developed based on the architecture of this platform, a pilot study was then conducted in two medical wards of the intensive care unit of one of the largest public general hospitals in Hong Kong to demonstrate the feasibility of its practical use. Here, we present the concept and architecture of an RFID-enabled platform for hospital ward management, which aims to provide inpatient care of higher quality, reduce patient risk, and optimize operations. After the outbreak of SARS, a project team from the CUHK considered the feasibility of using RFID technology to enable traceability for person-to-person physical contacts in order to provide immediate response to the widespread of infectious diseases and better risk management within hospital wards. In this paper, we presented an active RFID-enabled platform to keep track of the locations of patients, ward staff, and medical equipment, for hospital ward management.
cord-262236-1lilrqts	2020	There was no statistically significant difference in overall survival based on ethnicity, healthcare status, or individual medical comorbidities, although a negative trend exists for diabetes. There was no statistically significant difference in overall survival based on ethnicity, healthcare status, or individual medical comorbidities, although a negative trend exists for diabetes. The purpose of this study was to explore the disease characteristics in a Brooklyn safety-net hospital affected by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic and the clinical course and outcomes of this uniquely diverse population. Deceased patients were then isolated and a multiple linear regression analysis was performed to compare each comorbidity to the overall days to death which yielded no statistically significant results. We do note a trend towards decreased survival in patients with diabetes (p=0.12), but no individual factor showed a statistically significant impact on overall mortality or median OS.
cord-262339-e2ayh108	2020	The use of protective equipment and dental office isolation were the major points to avoid the contact between infected and non-infected patients. Thus, preventive measures, such as the use of protection equipment, personal hygiene and ventilated rooms, are essential to avoid contamination [2] . The purpose of this report is to describe the protocol adopted by the Departments of Oral Surgery and Radiology, Hospital University Münster, to avoid the cross infection of professionals and patients during the phase of an uncontrolled transmission increase. Usual measures, such as use of personal protective equipment (PPE) and disinfection protocol after each patient consultation, should be respected. All patients should be considered to be infected, and some aspects must be taken into consideration during the dental treatment: -Patient''s screening, as the avoidance of contact between COVID and non-COVID patients, are important measures to prevent spread of the disease; -
cord-262412-bs7quwov	2020	Clinical manifestations are as follows (see Table 1 ): generalized or localized rash (erythematous, papulovesicular, maculopapular, petechial, morbilliform, symmetrical drug-related intertriginous and flexural exanthema (SDRIFE)-like, digitate papulosquamous pityriasis rosea-like), generalized urticaria, varicelliform rash, herpes lesions (zoster), purpuric lesions (retiform purpura), livedoid lesions (livedo reticularis, livedo racemosa), acro-ischemic lesions (dry gangrene, blisters, cyanosis), erythema multiforme-like, chilblain-like lesions (COVID toes) and other lesions such as urticarial vasculitis, acute generalized exanthematous pustulosis (AGEP)-like rash, eosinophilic panniculitis, COVID mask, periorbital dyschromia, oral ulcers and COVID red half-moon nail sign. In a recent report, the postmortem histology of COVID-19 patients revealed lymphocytic endotheliitis in lung, heart, kidney, liver and small intestine, a pathological picture reminiscent of what is seen in skin lesions, suggesting that SARS-CoV-2 infection facilitates the induction of endothelial inflammation in several organs as a direct consequence of viral involvement and of host inflammatory response [61] .
cord-262454-bccrvapy	2020	With all that, we developed a protocol for early recognition and treatment of high-risk patients (in our population, age greater than 40 years because of generally poorer health standards, or with comorbidities) who would come to our outpatient network of emergency rooms with influenza-like symptoms: fever, cough, myalgia and headache, among others, and receive early treatment, provided to patients at the first doctor visit, using physician discretion from among HCQ, azithromycin, ivermectin, oseltamivir, zinc sulfate, nitazoxanide and prednisone (the last starting on day-6 of symptoms). On March 28, 2020, the FDA issued an emergency use authorization for remdesivir and HCQ for patients in both clinical trials and with severe hospitalized disease (31) . We found early outpatient use of HCQ and prednisone, both as individual prescriptions and used together, to lower the risk of hospitalization in symptomatic high-risk COVID-19 patients presenting for primary care at the emergency rooms of our large HMO in Brazil.
cord-262467-epqqd8n8	2020	The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is responsible for the COVID-19 disease as originally shown in Wuhan, China, as early as documented from 1 December 2019 (ref. A recent prospective study failed to find antiviral activity or clinical benefit of this combination for the treatment of our hospitalized patients with severe COVID-19 (ref. More recently, a randomized, controlled study conducted in Wuhan, China also failed to identify beneficial effect of LPV/r beyond standard therapy in hospitalized patients with severe Covid-19 (ref. Clinical trials also showed that in patients with severe H1N1 influenza A, in the 2009 pandemic, therapy with convalescent plasma from patients who recovered, especially within 5 days of symptom onset, resulted in a lower viral load and lower mortality 66, 67 . The duration from onset of symptoms to viral clearance is significantly longer in severe and critical ill SARS-CoV-2infected patients compared with that in the mild cases 48 .
cord-262518-a2ql8hib	2020	Our hospital''s Senior Patient Experience Managers contact all patients admitted to the isolation wards on a daily basis to provide some form of support. Throughout hospitalization in the isolation wards, patients are not allowed to have visitors, and the only contact they have with their family members is via mobile devices. As part of efforts to mitigate against the adverse effects of isolation, our hospital''s Senior Patient Experience Managers contact all patients admitted to the isolation wards on a daily basis. This paper aims to illustrate patients'' and next-of-kins'' needs and concerns during isolation; and to recommend key process improvement that could better support patients and their loved ones during this challenging time of the COVID-19 pandemic. We would like thank the Nursing Division at Singapore General Hospitals as well as all healthcare workers at the isolation wards for standing strong in our fight against COVID-19 and for providing our patients with the care that they need.
cord-262551-hxhlhb5m	2020	CONCLUSIONS: We propose to open up a symptom-based, mood-centered view to a model in which adolescent depression is framed as a consecutive failure of stress coping mechanisms and chronic exhaustion. We offer an alternative integrated approach for the treatment of adolescent and young adult depression by focusing on stress factors and exhaustion reduction, seeing anhedonia and withdrawal as an evolutionary coping mechanism. Reframing depression and shifting clinical practice to a more comprehensive and integrated look at the individual experience of a patient, including all causes for stress, pressure, and exhaustion, might be more helpful in developing promising treatment strategies. Using a combination of treatment modalities could increase therapeutic effectiveness by improving the pace of learning new coping behaviors, exerting a synergistic impact on the developmental perspective, and breaking the downward spiral of stress and exhaustion, which eventually leads to a reduction of the depression symptoms.
cord-262626-yk4e737w	2020	1 Although this is recognized as a viral respiratory illness caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the pathophysiology of the disease is far wider than respiratory, including long-term risk for adverse cardiovascular disease, thromboembolic disorders, and multiple organ failure (MOF). 4, 5 Based on our understanding of the emerging literature, we aim to provide in this short commentary a simple list (►Table 1) of laboratory tests, as may be recommended for patients with COVID-19 and to potentially assist in prognostic monitoring of such patients. D-dimer is associated with severity of coronavirus disease 2019 (COVID-19): a pooled analysis Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China Clinical characteristics of 138 hospitalized patients with 2019 novel coronavirus-infected pneumonia in Wuhan, China Thrombocytopenia is associated with severe coronavirus disease 2019 (COVID-19) infections: a meta-analysis
cord-262708-hctuxrw9	2020	We were quick to adopt best practices and guidelines (PRINT ISSN No. 2277-8179/doi: 10.36106/ijsr) for cancer treatment during the pandemic as prescribed by Indian Association of Surgical Oncology (IASO)COVID-19 guidelines [6] and the Tata Memorial Centre COVID-19 working group [7] . At Kidwai Memorial Institute of Oncology (Regional Cancer Centre at Bengaluru, India) despite having to deescalate operations by about one-third, the department of surgical oncology and allied specialities made the decision to continue graded response in providing cancer care based on, for a centre with an annual registration of more than 25,000 new patients even a slowdown in clinical services is likely to have a deleterious impact on outcomes and a high plausible that surges of population infection, lock downs, resource competition and diagnostic bottlenecks could recur over the next few years and augment the delay in oncological care and its consequences [11] .
cord-262729-qcijsyo6	2020	Therefore, we have empowered a small neurosurgery COVID team consisting of senior neurosurgeons with multidisciplinary backgrounds who review a brief history and select imaging studies and make decisions for urgent surgical cases. We continue to schedule clinic visits to evaluate potentially urgent surgical patients, which are determined during a clinic prescreen. Since implementation, we have decreased the number of clinic visits by 80%; however, we continue to see and evaluate the same number of patients prior to this protocol. Only the minimal number of residents and/or fellows required for patient care are allowed to come to the hospital. To minimize faculty exposure, we have re-organized the call schedules so that one provider covers multiple hospitals and sub-specialties -with appropriate at home Postoperative neurosurgical patients are often medically fragile; thus exposure to COVID-19 may be extremely deleterious. During the COVID-19 pandemic, emergent and urgent neurosurgical procedures should continue to be performed, while deferring elective surgeries.
cord-262766-ndn6iwre	2020	Clinical assessment of possible infection with SARS-CoV-2, the novel coronavirus responsible for the outbreak of COVID-19 respiratory illness, has been a major activity of infectious diseases services in the UK and elsewhere since the first report of cases in December 2019. In addition, many mild respiratory viral infections were managed as influenza 10 , with significant resource implications, both for healthcare services and patients Here we describe our experience of the first 68 patients we have tested for SARS-CoV-2 at a Regional Infectious Diseases unit (RIDU) in the UK. Specialist Infectious Diseases consultant-delivered assessment of a group of patients who predominantly have mild illness is unlikely to be sustainable, especially as the case-definition broadens to include a wider geographical area and/or COVID-19 patients requiring inpatient care becomes more common in the UK.
cord-262780-ilu5oskk	2020	The use of chloroquine (CQ) and hydroxychloroquine (HCQ) for COVID-19 exemplifies the risks of both overinterpreting and amplifying preliminary data by those outside of the scientific community and was followed by swift corrective measures by researchers. By early March, interest in HCQ abruptly transitioned from mechanistic plausibility that would support its study in a clinical trial setting to rapid off-label use in patients with COVID-19, primarily fueled by promotion on social media, lay press, and celebrity influence [8] . By late March, two new studies became publicly available: a second study from the group of IHU-Méditerranée Infection using HCQ and AZM in 80 patients with mild COVID-19 infection released on their webpage, and a preprint of the first randomized controlled trial of 62 patients from Wuhan reporting a difference in clinical time to recovery and radiologic findings with HCQ treatment [22, 23] .
cord-262784-r9gq2oan	2020	title: Clinical Characteristics and Reasons for Differences in Duration From Symptom Onset to Release From Quarantine Among Patients With COVID-19 in Liaocheng, China Methods: We analyzed retrospective data regarding general characteristics, epidemiologic history, underlying chronic diseases, clinical symptoms and complications, chest computed tomography findings, biochemical monitoring, disease severity, treatments, and outcomes among 37 adult patients with COVID-19. Patient diagnosis, release from quarantine, and disease severity among all cases were determined according to the "Protocol for the Diagnosis and Treatment of Novel Coronavirus Pneumonia" issued by the National Health Commission of the People''s Republic of China and the National Administration of Traditional Chinese Medicine (8, 9) . The present study retrospectively analyzed the general characteristics, epidemiological history, chronic underlying diseases, clinical symptoms, complications, chest computed tomography (CT) findings, biochemical features, disease severity, treatment plans, and outcomes of 37 patients.
cord-262796-syu4wbpi	2020	Abstract Background & Aims We compared clinical, laboratory, radiological, and outcome features of patients with SARS-CoV-2 infection (COVID-19) with pneumonia, with vs without diarrhea. Methods We performed a retrospective, single-center analysis of 84 patients with SARS-CoV-2 pneumonia in Wuhan Union Hospital, China, from January 19 through February 7, 2020. Of 76 patients with a negative result from their latest throat swab test during hospitalization, a significantly higher proportion of patients with diarrhea had a positive result from the retest for SARS-CoV-2 in stool (45%) than patients without diarrhea (20%) (P=.039). On admission to hospital, all confirmed COVID patients were tested for SARS-CoV-2 RNA from stool samples. Of 76 COVID-19 patients who had a negative result from their latest throat swab test during hospitalization, a significantly higher proportion of patients with diarrhea had a positive result from the retest for SARS-CoV-2 in stool (45%) than patients without diarrhea (20%) (P=.039) ( Table 5) .
cord-262824-xgf5v1ok	2020	I bore witness to this conflict play out when I transitioned from the role of researcher working on the national opioid overdose epidemic to the front lines of the pandemic, providing palliative care. I paused my own training in addiction psychiatry to join the palliative care service, as we needed physicians capable of supporting patients and their families and conducting conversations to elicit goals of care in the emergency rooms and ICUs. My tasks turned out to be much more than that: I assisted in repositioning patients into the prone recovery position, held an iPad at the bedside for last goodbyes, and grieved deaths with primary teams. Interpreting at the end of life: a systematic review of the impact of interpreters on the delivery of palliative care services to cancer patients with limited English proficiency
cord-262878-ygvbqmxd	2020	Thrombotic arterial events (APE or cerebral stroke) have been previously related to other viral infections, especially among HIV patients, but no acute aortic events have been reported [10] . In our hospital, we established a specific screening protocol to rule out APE in COVID-19 patients with a significant increase of D-Dimer, even with the improvement of clinical and analytical parameters. CXR presented a rapid progression of opacities and a significant increase in acute reactants such as ferritin and IL-6 were detected, so a single dose of 600 mg of tocilizumab was administered following hospital protocols (severity criteria). We have described three moderate-severe COVID-19 patients over 60 years with cardiovascular risk factors, who presented aortic thrombus despite the use of LMWH prophylaxis, in slow and poor clinical progression with highly increased inflammatory markers. Our local incidence for incidental aortic thrombus is 0.75% in moderate-severe COVID-19 patients, representing 6.6% of 45 cases of arterial thrombosis (including pulmonary embolism). High incidence of venous thromboembolic events in anticoagulated severe COVID-19 patients
cord-262928-l2bqcd0l	2020	The collision between the Covid-19 pandemic and the current diabesity epidemic has highlighted that obese and diabetic patients have a worse prognosis due to the impairment of the immune response to infections and due to the mechanical limits that make the management of the hospitalized patients with severe obesity more difficult. The limitations imposed on accessibility to non-urgent care during the lockdown of "phase 1" of this pandemic have created the need to revolutionize clinical practice to meet the health demands of chronic and high-risk diseases such as obesity and diabetes. Extensive Chinese observational reports on confirmed Covid-19 cases indicated that among patients with the most severe form of disease the prevalence of diabetes was 12-16% [5] [6] [7] [8] . In a French study, the risk for invasive mechanical ventilation in patients with COVID-19 infection admitted to Intensive Treatment Unit was more than sevenfold higher for those with BMI > 35 compared with BMI < 25 kg/m 2 [14] .
cord-262954-saqo900k	2020	In this study we aimed to describe the clinical characteristics and outcomes of hospitalized older adults with coronavirus disease 2019 (COVID-19) in Turkey. Through multivariate analysis of the causes of death in older patients, we found that male gender, diabetes mellitus, heart failure, chronic kidney disease, dementia, cancer, admission to intensive care unit, computed tomography finding compatible with COVID-19 were all significantly associated with mortality in entire cohort. The Centers for Disease Control and Prevention (CDC) reported that individuals older than age 65 comprise 17% of the total population in the United States, though they are responsible for 31% of infections, 45% of hospitalizations, 53% of intensive care unit (ICU) admissions and 80% of deaths caused by . Clinical characteristics and outcomes of older patients with coronavirus disease 2019 (COVID-19) in Wuhan, China (2019): a single-centered, retrospective study
cord-262973-mydn7ver	2020	In order to minimize the adverse impact of this unexpected epidemic on patients who need radiotherapy, the expert group of our radiotherapy center immediately formulated comprehensive emergency plans and prevention and control measures, partitioned the work area, launched online staff training, and optimized the radiotherapy process after the outbreak, which provided a strong guarantee for the safe and orderly operation of our radiotherapy center and kept the infection rate to an extremely low level. Patients need to perform hand hygiene disinfection and wear masks and overshoes correctly, every time they enter the radiotherapy center. To minimize the risk of cross-infection, radiotherapy centers should adjust entrances and exits to separate patient passages from medical staff passages and form a one-way channel in the internal area if possible. The level III area, such as the operator room of the accelerator, is where medical staff go after contact with patients and is classified as intermediate risk.
cord-262987-7h91n9ro	2020	OBJECTIVE: The objective of this study was to evaluate the impact of the COVID-19 pandemic on patient satisfaction and surgical outcomes at King Khalid University Hospital in Saudi Arabia. In light of the above, systematized research is needed to understand the change, if any, in the dynamics of patient care, satisfaction, and post-surgical outcomes with regards to revised infrastructure and policies in hospitals in the wake of infectious pandemics like COVID-19. During study period, there were confirmed COVID-19 cases among health care workers (5 cases) and patients (11 cases) in our hospital, and the hospital administration implemented new polices and strict preventative measures to minimize the rate of adverse surgical outcomes among patients, which is also confirmed by the higher level of patient''s satisfaction as detailed above.
cord-262998-cugd2t1l	2020	Frequent hand washing lasting at least 20 s with soap and water, use of hand sanitizers with at least 60% alcohol, avoiding touching mucosal surfaces (mouth, nose, eyes) with unwashed hands, practicing proper cough etiquette, wearing a face mask (if symptomatic), limiting exposure to affected people and maintaining a distance of at least 2 m from others are the suggested preventive steps [1] . It is therefore imperative that guidelines and protocols are made for effectively and efficiently handling patients with COVID-19 in the dental clinic and minimizing risk of nosocomial transmissions. Patients with respiratory infections (current or in the last 48 h) and those with travel histories to COVID-19-affected regions should be reported to the health department and should be rescheduled. The International Association of Paediatric Dentistry [13] has also made recommendations for parents to maintain optimal oral health of children and avoiding dental clinic visits:
cord-263031-cco2vh0f	2020	We discuss immunological and clinical considerations for patients on biologic agents (biologicals)targeting the type 2 inflammatory response due to difficult-to-treat allergic diseases in the context of COVID-19. In other coronavirus infections such as severe acute respiratory syndrome (SARS), type I IFN are critical for the initiation of immune response and virus clearance. In line with a paucity of mechanistic data on COVID-19 in the context of type 2 inflammation, knowledge on the disease course in patients treated with biologicals targeting type 2 inflammation due to severe asthma or other atopic diseases, such as CSU, AD and CRSwNP, is scarce to absent. In the past years, new biological therapies for severe asthma, atopic dermatitis (AD), chronicrhinosinusitis with nasal polyps (CRSwNP) and chronic spontaneous urticaria (CSU) have been developed targeting different aspects of the type 2 immune response.
cord-263046-3aerbonz	2020	Despite this, we have had outbreaks of COVID-19 infections in green zone wards, most notably in our elderly hip fracture patients who tested negative on admission but then became COVID positive in the days after surgery. Early observations and a departmental audit of hip fracture patients admitted during March and April of this year (surgically stabilised) demonstrated a trend to higher 30-day mortality in patients who subsequently tested COVID positive after surgery compared to those who did not. During the coronavirus pandemic, surgical teams operating on COVID-19 positive patients were subject to stringent personal protective equipment (PPE) protocols in theatre. Given the likely increased mortality associated with COVID-19, it is essential that we ensure vulnerable patient groups such as hip fractures continue to receive optimal care regardless of infection status. It can be concluded that patients who present to hospital with a hip fracture and have an initial positive COVID-19 test contracted the virus prior to admission.
cord-263055-4f25h9l4	2020	We are grateful for the comments of Marrietta et al, [1] and welcome the opportunity to provide further details on the coagulopathy observed in our patients with COVID-19 infection [2]. The weight-adjusted low molecular weight heparin (LMWH) thromboprophylaxis used in the study is that routinely used for hospital in-patients in our institution, consistent with national recommendations [3,4] With respect to the cohort of patients with COVID-19 enrolled in our study, it is important to highlight that 74% of patients received enoxaparin 40mg (4000 IU) subcutaneously once daily. This hypothesis is supported by emerging data suggesting that the incidence of thrombotic complications in critically ill patients with COVID-19 may be >30%, even in patients receiving LMWH thromboprophylaxis. From the literature, it is clear that other centres have already elected to institute increased LMWH doses for selected patients with severe COVID-19 infection.
cord-263061-ocplcdiv	2020	This is the first case of complete atrioventricular block in a symptomatic patient affected by the COVID-19 infection treated with early pacemaker implantation to minimize the risk of virus contagion. Recently, the European Society of Cardiology (ESC) Guidance [2] and Italian position paper [3] about the treatment of cardiovascular (CV) disease in COVID 19 infection patients have been published; however, the suggested management of atrioventricular (AV) conduction disorder patients is not matching between the two proposed guidelines. Hence, the ESC recommendation [2] suggested a medical drug approach with isoprenaline and atropine and the implantation of temporary PM (tPM), leading the potential pPM after recovery from the COVID-19 infection. Conversely, the Italian position paper [3] recommends avoiding in any cases the tPM for risk infection, thus preferring early pPM implantation.
cord-263064-n4c0m5hn	2020	We report a case of a 73-year-old male with a history of diabetes mellitus, osteomyelitis, methicillin-sensitive Staphylococcus aureus (MSSA) bacteremia who recently completed an extended intravenous course of cefazolin eight days back, and presented with MSSA bacteremia complicated by epidural abscess, endocarditis, and aortic root abscess. A 73-year-old male recently treated for methicillin-sensitive Staphylococcus aureus (MSSA) bacteremia secondary to presumed source of non-healing diabetic foot ulcer (completed a six weeks course of intravenous (IV) cefazolin eight days ago, negative transesophageal echocardiogram (TEE)) presented to our emergency department with lower back pain with extension to the left flank region, urinary incontinence, and an altered mental status. For a patient with MSSA bacteremia and COVID-19, such as ours, CD4 and CD8 Tcell functional exhaustion may be why our patient required an extended course of IV antibiotic therapy. Our patient presented with a recurrent and persistent MSSA bacteremia and osteomyelitis, complicated by a spinal epidural abscess, bioprosthetic valve endocarditis and aortic root abscess despite appropriate antibiotic therapy.
cord-263066-umvojci8	2020	Ainsi, l''indication doit être discutée en staff pluridisciplinaire et le MK ne doit pas entrer dans la chambre du patient uniquement pour évaluer les besoins en kinésithérapie, mais uniquement quand ces besoins ont été évalués au préalable et que la nécessité d''actes kinésithérapiques a été décidée [14, 18] . Les patients présentant des formes modérées nécessitant une hospitalisation sans passage en réanimation sont également pris en charge dans ces services. Ces mesures d''hygiène, notamment le port du masque chirurgical, le lavage des mains et la distanciation sociale doivent s''appliquer dans la mesure du possible pour tous les patients, même non infectés par le SARS-CoV-2 [4, 10, 15, 20, 34] . Les MK ont donc un rôle essentiel dans la prise en charge des patients atteints de COVID-19 et ce, sur du long terme, plusieurs semaines après la maladie.
cord-263191-osa3ylkl	2020	We aimed to describe the characteristics and outcomes of patients with COVID-19 transferred from the hospital to a HaH unit during the peak of the first wave of the pandemic in Barcelona, Spain. (1) Caregiver available 24 h at the patients'' home; (2) home conditions allowing patient isolation from cohabitants; (3) early discharge from hospital ward: more than 6 days since the start of symptoms; no fever in the last 24 h; respiratory rate < 22 rpm and oxygen saturation > 95% with F i O2 < 0.35; C Reactive protein < 5 mg/dl or descending, normal LDH or descending, lymphocytes > 800 cells/mm 3 or ascending; no radiological progression of pneumonia; (4) admission from Emergency room: bilateral pneumonia in patient without high-risk factors (> 65 years old, hypertension, chronic obstructive pulmonary disease, cardiovascular disease, diabetes, cancer, and immunosuppression); respiratory infection without pneumonia, or unilobar pneumonia in patients with risk factors.
cord-263214-h6lkvlj3	2020	title: BEDSIDE TRANSCERVICAL-TRANSTRACHEAL POST-INTUBATION INJURY REPAIR IN A COVID-19 PATIENT We report the case of a COVID-19 patient developing pneumomediastinum and subcutaneous emphysema secondary to post-intubation tracheal injury. We performed a bedside tracheal injury surgical repair, after failure of conservative management, with resolution of pneumomediastinum and subcutaneous emphysema and improvement of patient''s conditions. However, some patients need hospitalization for respiratory support and a relevant rate (ranging between 9.8 and 15.2%) requires oro-tracheal intubation (OTI) for invasive ventilation. We present a case of a COVID-19 patient who develops massive pneumomediastinum and subcutaneous emphysema for post-intubation tracheal injury. Considering the hemodynamic and respiratory instability after conservative management, a bedside surgical tracheostomy with primary suture of the tracheal lesion was performed. In order to reduce the risk of epidemic spread and avoid transporting, in absence of a COVID-19 dedicated operating room, the procedure was performed bedside.
cord-263241-qzerj9bs	2020	title: Clinical characteristics of hospitalized patients with 2019 novel coronavirus disease indicate potential proximal tubular dysfunction In this study, the clinical data from hospitalized patients were retrospectively analyzed at their admission to identify if there is any evidence of proximal tubule injury. The patients were diagnosed and classified according to the "Diagnosis and Treatment Protocol for Novel Coronavirus Pneumonia (Trial Version 4)." [3] Patients with a history of chronic kidney disease (CKD) and with any abnormal urinalysis result in the past 3 months before admission were excluded. This study found that 10.1% of the patients presented with renal glucosuria, 34.2% with mild proteinuria, 25.8% with hyponatremia, and 20.4% with hypouricemia. The presence of renal glucosuria, mild proteinuria, and hyponatremia in patients with COVID-19 indicated the possibility of proximal tubular injury, highlighting the necessity for further investigation. Clinical characteristics of hospitalized patients with 2019 novel coronavirus disease indicate potential proximal tubular dysfunction
cord-263285-89zqgqx1	2020	After presenting a case of right ventricular thrombus in a COVID-19 patient, we discuss the unique challenges in the workup and treatment of COVID-19 patients highlighting our COVID-19 modified pulmonary embolism response team (PERT) algorithm. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causes COVID-19related critical illness and multiorgan dysfunction in a subset of those infected. Given these findings, the pulmonary embolism response team (PERT) was consulted and the patient was given 100 mg (over 2 hours) of tissue-type plasminogen activator (tPA) and systemic anticoagulation with unfractionated heparin once the tPA infusion was complete. The usual risk stratification schema for acute pulmonary embolism rely on a combination of hemodynamic clinical parameters, such as hypoxemia, tachycardia, and hypotension along with serum biomarkers, such as troponin or brain natriuretic peptide followed by confirmatory imaging tests.
cord-263292-qjfe2t9v	2020	Despite being a trivial matter for patients in intensive care units (ICUs), erectile dysfunction (ED) is a likely consequence of COVID-19 for survivors, and considering the high transmissibility of the infection and the higher contagion rates among elderly men, a worrying phenomenon for a large part of affected patients. Testicular function in COVID-19 patients requires careful investigation for the unclear association with testosterone deficiency and the possible consequences for reproductive health. However, independently of whether testosterone is a friend or foe for COVID-19, it should be acknowledged that the testis is a target for SARS-CoV-2 and the possibility for long-lasting consequences on the endocrine function exists, even for recovered patients. Drugs such as β-blockers and antihypertensive agents, routinely used in COVID-19 patients, have the potential to impair sexual function [41] ; therefore, both the cardiovascular consequences and their treatment might ease progression from subclinical to a clinically overt ED [42, 43] .
cord-263294-9r84f19u	2020	The aim is to evaluate pregnant women infected with coronavirus disease 2019 (COVID‐19) and provide help for clinical prevention and treatment. All five cases of pregnant women confirmed COVID‐19 were collected among patients who admitted to the Maternal and Child Hospital of Hubei Province between January 20 and February 10, 2020. Our study collected a total of five pregnant women with COVID-19, who were hospitalized for regular delivery in Maternal and Child Hospital of Hubei Province between January 20 and February 10, 2020 (Table 1 ). Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study Characteristics and pregnancy outcomes of patients with severe pneumonia complicating pregnancy: a retrospective study of 12 cases and a literature review Pregnancy and perinatal outcomes of women with severe acute respiratory syndrome Middle East respiratory syndrome coronavirus (MERS-CoV) infection during pregnancy: report of two cases & review of the literature Clinical analysis of pregnant women with 2019 novel coronavirus pneumonia
cord-263530-t9ryky6f	2020	► Abdominal CT was normal ► Brain MRI with contrast, performed after 2 weeks to comply with our hospital''s protocol that only allows COVID-19-negative patient to get in contact with the MRI machine, revealed abnormal signal intensity in the temporal lobe cortex bilaterally in a rather symmetrical fashion. Seven hundred and fifty milligrams of intravenous acyclovir sodium, three times per day, was started empirically before the cerebrospinal fluid (CSF) results were obtained, addressing the possibility of herpes simplex virus (HSV) I and II encephalitis. The early suspicion of COVID-19 encephalitis and performing the appropriate CSF studies was the key to establishing the correct diagnosis and timely management. ► A red flag of the possibility of COVID-19 encephalitis should be raised whenever patients present with abnormal behaviour, acute psychosis, confusion state or drowsiness.
cord-263599-cqol8zf2	1999	A large number of organisms have been associated with diarrhea in humans, and most laboratories routinely screen for Salmonella, Shigella, and Campylobacter. Patients with these conditions requhe prompt treatment, A large number of organisms have been associated with diarrhea in humans, and most laboratories routinely screen for Salmonella, ShigelEa, and Campylobacter. Incubation periods shorter than 12 hours suggest an enterotoxin-producing organism; fever and white blood cells in the stool are generally associated with an invasive pathogen. A recent report about a food-borne outbreak demonstrated that ETEC was also a cause of diarrhea in patients who had not been traveling.30 ETEC organisms were isolated from 5 people who had attended a labor union banquet in Milwaukee with attendees from throughout the United States. 70 However, similar studies are not available for infections caused by an invasive organism such as Salmonella, Shigella, or Campylobacter or for C d@cileassociated diarrhea.
cord-263628-ac9gld5l	2020	The ProPac-COVID trial evaluates whether combination therapy with macrolide azithromycin and hydroxychloroquine via anti-inflammation/immune modulation, antiviral efficacy, and pre-emptive treatment of supra-infections can shorten hospitalization duration and reduce the risk of non-invasive ventilation, treatment in the intensive care unit, and death in patients with acute hospital admission and a positive test for 2019-nCoV and symptoms of COVID-19 disease. The objective of this randomized, placebo-controlled, double-blinded multi-center trial is to investigate whether 15-day treatment with azithromycin and hydroxychloroquine added to standard of care can shorten hospitalization and reduce the risk of non-invasive ventilation, admittance to ICU, and death. The interim analysis will focus on reporting the following: selected baseline data (those readily available from the baseline data list below), primary outcome (in an O'' Brien-Fleming Plot), and all-cause mortality at 30 days (chi-square or Fisher''s exact test, whichever appropriate).
cord-263691-ovsi38bx	2020	This study describes how to establish a successful cardio-oncology program, with limited resources, in order to effectively manage the unique care required by this patient population. There are multiple factors that may lead to decreased healthcare access and poor clinical outcomes for many of these patients, including: the lack of knowledge regarding the association between cancer and heart disease, lack of early detection of potentially cardio-toxic effects of certain cancer-related treatments, the prevalence of an aging population amongst cancer survivors [5] . We defined the success of our program by the ability to start and maintain a new service line in our institution, meeting the needs of a growing patient population, our strong cooperation with the oncology department, the achieved goal of bringing awareness of cardiovascular health in cancer patients, and by specific clinical benefits to multiple patients as described herein.
cord-263716-ywsm11aw	2020	Patients in the initial incubation phase often have insidious clinical symptoms, but they are still highly contagious. At the later clinical symptomatic phase, the immune system is fully activated and the disease may enter the severe infection stage in this phase. Although many patients are known for their respiratory symptoms, they had neurological symptoms in their first 1–2 days of clinical symptomatic phase, and ischaemic stroke occurred 2 weeks after the onset of the clinical symptomatic phase. 3 However, we have found that many patients had neurological symptoms in their early stages, 4 and ischaemic stroke often happened around 2 weeks after the onset of infection. 9 Patients with COVID-19 often have insidious clinical symptoms, without fever or coughing, even though their lungs may have rather severe damages. His nucleic acid testing of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) was positive. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China
cord-263793-bmadusm6	2020	In light of the accumulating evidence on the negative predictive value of soluble urokinase plasminogen activator receptor (suPAR), a group of experts from the fields of intensive care medicine, emergency medicine, internal medicine and infectious diseases frame a position statement on the role of suPAR in the screening of patients admitted to the emergency department. The main content of this statement is that sUPAR is a non-specific marker associated with a high negative predictive value for unfavourable outcomes; levels < 4 ng/ml indicate that it is safe to discharge the patient, whereas levels > 6 ng/ml are an alarming sign of risk for unfavourable outcomes. Since the group has shown long-term expertise in the clinical value of suPAR (soluble urokinase plasminogen activator receptor), we decided to frame a position paper on the role of suPAR in the early detection of risk of unfavourable outcome for patients admitted to the ED.
cord-263882-s5oxr6es	2020	It seems that in patients with any severe and serious dermatologic disorders, under treatment with systemic agents, if there is not any suspicion about concurrent infection or any high risk exposures, not only it is not recommend to cessation therapy but only emphasize that these drugs could prevent disease flare-up and control cytokine storm that both in a negative direction, affect the COVID-19 course (41) (42) (43) (44) (45) (46) (47) (48) . So in this systematic review we focused on specific patient groups with a dermatologic disorder (usually under therapy) that concomitantly have been infected by the new corona virus and summed up their data in all aspects of underlying and infectious disease course and management. At the time of the COVID-19, the biologic agents were discontinued except for one case (which was treated with Guselkumab) but the patients did not report any severe exacerbation of their underlying dermatologic disease despite treatment discontinuation.
cord-263883-7ba0huwy	2020	The present study aimed to evaluate the efficacy of bromhexine in intensive care unit (ICU) admission, mechanical ventilation, and mortality in patients with COVID-19. The current study, an open-label, randomized clinical trial, examined the efficacy of early start of oral bromhexine, in the intensive care unit (ICU) admission, rate of mechanical ventilation, and mortality in patients with COVID-19 pneumonia. The data presented in this clinical trial confirmed that the early-onset treatment with oral bromhexine 8 mg three times a day not only effectively mitigated the respiratory symptoms, but also significantly decreased the rate of ICU admissions, intubation, mechanical ventilation, and mortality in COVID-19 disease. The data analysis of this clinical trial also showed that cardinal respiratory symptoms (cough, lassitude, and dyspnea) in patients with COVID-19 disease who received bromhexine treatment was remarkably less than the standard group.
cord-263908-4ti8l2ea	2020	Similarly, despite the recognition of angiotensin converting enzyme 2 (ACE2) as the receptor for severe acute respiratory syndrome coronavirus 2 (SARS CoV-2), and the role of ACE2 in lung injury; there are conflicting results with the use of angiotensin converting enzyme (ACE) inhibitors and angiotensin receptor blockers (ARB) in these patients. There is a need to further study the natural course of COVID-19 in patients with diabetes and to understand the individual, regional and ethnic variations in disease prevalence and course. It is not known whether patients with diabetes with well-controlled blood glucose levels have an increased risk of infection with severe acute respiratory syndrome coronavirus 2 (SARS CoV-2). While one study in China did not find any association of ACE inhibitor use with severity of disease, there was an increased mortality in patients with COVID-19 receiving ACE inhibitors and ARBs in another study [29, 30] .
cord-264042-4hc2i25r	2006	In the early recovery period, potential problems during diving are caused by inadequate lung ventilation in relation to exercise level and increased breathing resistance attributable to weak respiratory muscles, with corresponding risk of hypoxia and hypercapnia, as well as decreased ability to respond to nonrespiratory problems during diving. From our experience, we suggest that computed tomographic scans of the thorax, lung function tests, and careful follow-up monitoring should play a vital role in the assessment of patients during the convalescent period, before certification of fitness to dive. S evere acute respiratory syndrome (SARS) is an emerging infectious disease that was first reported in Guangdong Province in southern China in November 2002 and subsequently caused outbreaks in Singapore, Hong Kong, Southeast Asia, and Canada. In the week following diagnosis of SARS in this patient, only essential personnel in the diving unit were required to report to work to prevent the possible spread of SARS.
cord-264073-yhztrscf	2020	2 Some strategies to minimize the risk of spreading SARS-CoV-2 throughout the dialysis units are simple such as a phone call to the patients just before their HD session asking about any signs of fever or respiratory symptoms. All rights reserved Patients infected with COVID-19 often present clinical markers of kidney injury. 5 According to the available reports, Acute Kidney Injury (AKI) occurs in approximately 3 -15% of patients with COVID-19 infection. 6 Most patients with COVID-19 are affected by mild or asymptomatic renal disease, but those who develop AKI usually share the most severe phenotype of the disease, characterized by cytokine storm, acute lung injury and, eventually, hypercoagulability. 11 In general, dialysis indications in COVID-19 patients follow the same recommendations as in other acute kidney injuries. Management of Patients on Dialysis and With Kidney Transplant During Covid-19 Coronavirus Infection Review Intensive care management of coronavirus disease 2019 ( COVID-19 ): challenges and recommendations
cord-264122-n64tm6qr	2020	title: COVID-19 Fears May Be Worse Than the Virus: A Case of Cardiogenic Shock Secondary to Post-Myocardial Infarction Ventricular Septum Rupture We report a sad and unfortunate case of an 87-year-old female who was experiencing pressure-like chest pain but presented to the emergency room five days later out of fear of catching COVID-19 from the hospital. Ventricular septal rupture (VSR) is an uncommon but fatal mechanical complication of myocardial infarction (MI). Ventricular septal rupture following acute myocardial infarction Post-infarction ventricular septal defect: risk factors and early outcomes Risk factors, angiographic patterns, and outcomes in patients with ventricular septal defect complicating acute myocardial infarction Outcome and profile of ventricular septal rupture with cardiogenic shock after myocardial infarction: a report from the SHOCK Trial Registry Ventricular septal rupture after acute myocardial infarction Surgical repair of ventricular septal defect after myocardial infarction: outcomes from the Society of Thoracic Surgeons National Database
cord-264180-0vd3tr9j	2020	All patients who remained for at least one-day inpatient post-lung surgery were assessed to see if they had an increased incidence of coronavirus infection during the hospital stay or at the follow-up office visit. As of April 20, 2020, we have reported 55 cases requiring intensive care unit (ICU) care at our tertiary medical center Boca Raton Regional Hospital (400 bedded hospital) in Florida and over 250 coronavirus positive patients. From February 1, 2020, to April 14, 2020, the patients who underwent lung surgery were evaluated for the incidence of coronavirus infection during the hospital stay and on postoperative follow-up. Patients underwent surgery after triage and if they fulfilled guidelines set by the American College of Surgeons and hospital review board, so that hospital resources were not exhausted during an increasing number of COVID cases in our community.
cord-264295-7ojvhwb0	2020	Data collected included: demographic information (age and sex); presence of diabetes (defined as at least one random blood glucose value > 200 mg/dl, or fasting blood glucose > 126 mg/dl, or HbA 1c > 6.5%, or self-reported history of diabetes with ongoing anti-diabetes therapy), type of diabetes (type 1, type 2, other); smoking habits (never, ex, current); prior history of hypertension, dyslipidemia, chronic obstructive pulmonary disease (COPD), heart failure, cardiovascular events (myocardial infarction, percutaneous coronary intervention, coronary artery-bass graft or stroke), malignancy (any neoplasia diagnosed within the last five years or active neoplasia); presenting symptoms of SARS-CoV-2 infection (fever, cough, cold, conjunctivitis, chest pain, dyspnea, nausea, vomiting, diarrhea). Logistic regression models adjusted for age and sex were used to investigate associations of the primary and secondary outcomes with diabetes, and with other risk factors explored in the study, namely hypertension, dyslipidemia, COPD, heart failure, previous cardiovascular events, malignancy and smoking status (never vs.
cord-264327-uzlavmhx	2020	To the best of our knowledge, we present here the first confirmed case of COVID-19 in a patient on left ventricular assist device (LVAD) support. In the following days, the patient developed progressive hypotension requiring initiation of vasopressor agents, acute oliguric renal failure requiring continuous renal replacement therapy, and refractory hypoxemia consistent with acute respiratory distress syndrome (ARDS). While it has previously been shown that prone positioning unloads the right ventricle in ARDS due to improved pulmonary pressures, (1) the use of this maneuver in the setting of LVAD has not been well described and may be adversely associated with increase in RV pressures and subsequent RV failure. This report describes the first known presentation of illness secondary to SARS-CoV-2 in a patient with long-term LVAD support. Cellular immunity impaired among patients on left ventricular assist device for 6 months
cord-264368-p2fwuh0i	2020	key: cord-264368-p2fwuh0i title: Left Ventricular Thrombus in a Patient Infecting by Covid-19 cord_uid: p2fwuh0i A 74-year-old woman presented with general condition disorder, nausea and vomiting. The patient had general condition disorder but had no known systemic disease, history of trauma, or medication. Thorax computed tomography (CT) showed bilateral pleural effusion, consolidated areas with air bronchogram in the right hilar region, ground-glass densities in some peripheral locations ( Figure 1A) , abnormal enlargement of the left ventricular apex, and a hypodense appearance that could be compatible with thrombus ( Figure 1B-C, asterisks) . With the present findings, the patient was diagnosed with multiple organ failure due to possible COVID-19. The COVID-19 disease, which has been declared a pandemic by the world health organization, has a variable spectrum of symptoms from asymptomatic carriers to multiple organ failure. These patients have been shown to be susceptible to thrombus. Ventricular thrombus as in our case is a very rare condition.
cord-264449-p3tgjuj4	2020	The fear of asymptomatic carriers in patients and colleagues should not weigh on the decision to operate but should be evaluated by the urgency of the procedure; existing and anticipated COVID-19 cases in the hospital and region; availability of PPE, beds and staff; and finally, age and health of the patient. In one of Indonesian public hospitals, Orthopaedic surgeons are only allowed to perform surgeries on emergency, malignancy, and infection cases, whereas elective surgeries shall be postponed indefinitely. To lessen the number of visits, some Orthopaedic surgeons extend the length of post-operative joint replacement stay of their patients up to 10-14 days to receive the multidisciplinary care, including rehabilitation and wound care. Evidence of COVID-19 transmission from asymptomatic individuals 1 brings challenges to orthopaedic practice in terms of nosocomial transmission, isolation and cohorting requirements and increased post operative complications in undetected individuals. Pre-and post-operative screening in limited-term elective cancer surgery patients during the COVID-19 pandemic
cord-264504-nnvof29x	2020	COVID‐19 infection can cause a severe pneumonia which, in some cases, can lead to admission in intensive care unit for respiratory support.(1) In severe cases, systemic thrombotic complication has been described, including cerebrovascular disease (5.7‐23% of cases).(2,3) COVID-19 infection can cause a severe pneumonia which, in some cases, can lead to admission in intensive care unit for respiratory support. Our case underlines that one of the main causes for clinical deterioration and death during COVID-19 infection is coagulopathy that can involve both arterial and venous systems. [2] [3] 5 As far as we know, the simultaneous occurrence of venous and arterial thrombosis of the brain has not been described yet, and it could represent an important cause of neurological impairment in patients affected by COVID-19: prompt execution of neuroradiological examination of the Accepted Article parenchyma and post-contrast imaging of both arterial and venous systems could allow to perform a correct diagnosis and to apply the more appropriate treatment strategy.
cord-264543-b4zwinh2	2020	[4] The objective of this case report is to describe anosmia and ageusia as emergent initial symptoms of COVID-19 (Coronavirus Disease 2019). After clinical diagnosis, it was instituted home treatment with Oseltamivir 75 mg an oral tablet every 12 hours for five days, Azithromycin 500mg, one oral tablet per day for five days, Acetylcysteine syrup 40mg /ml 15 ml orally at night for 5 days and dipyrone if pain or fever, resulting in marked improvement of the signals and symptoms presented by the patient in five days, however, with persistence of anosmia and ageusia. In the case described, the patient presented as initial symptoms anosmia (absence of smell) and ageusia (change in taste) followed by odynophagia, cough, low fever, chest pain and mild respiratory distress, so it was considered suggestive of Covid-19 and confirmed, later, by the laboratory examination (RT-PCR) of the patient. [6] This examination was performed on the patient of the case at the time of the diagnosis and during the anosmia period and showed no structural changes.
cord-264610-kxebc12r	2020	title: Clinical characteristics of IgG4-RD patients infected with COVID-19 in Hubei, China Since IgG4-RD patients may be susceptible to infections due to the immune-related disease itself and the medications they take, we conducted a study to investigate COVID-19 infection rate in Hubei IgG4-RD patients during the recent outbreak in Hubei province, and to characterize the clinical manifestation of COVID-19 in IgG4-RD patients. Therefore, theoretically IgG4-RD patients have a high risk of progressing to severe/critical COVID-19 once infected and thus need to be identified and properly treated as early as possible. In summary, we describe the infection status and clinical characteristics of COVID-19 among IgG4-RD patients under the pandemic situation in this study. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study Clinical Characteristics of 138 Hospitalized Patients With 2019 Novel Coronavirus-Infected Pneumonia in
cord-264647-9r443j3l	2020	OBJECTIVE: To report the peculiarity of spinal epidural abscess in COVID-19 patients, as we have observed an unusually high number of these patients following the outbreak of SARS-Corona Virus-2. METHODS: We reviewed the clinical documentation of six consecutive COVID-19 patients with primary spinal epidural abscess that we surgically managed over a 2-month period. A primary abscess represents the rarest form of spinal epidural abscess, which is usually secondary to invasive procedures or spread from adjacent infective sites, such as spondylodiscitis, generally occurring in patients with diabetes, obesity, cancer, or other chronic diseases. To our knowledge, cases of spinal epidural abscess in COVID-19 patients have not been reported to date. During the last three months, six patients with SARS-Corona Virus-2 (SARS-COV-2) were referred to us for acute spinal cord syndrome due to primary spinal epidural abscess (SEA) [1] .
cord-264673-67zopf7s	2020	The count and percentage of lymphocytes were significantly decreased in critical patients compared to common and severe patients with COVID-19 pneumonia. The absolute lymphocyte count in patients with COVID-19 pneumonia was remarkably decreased compared with normal controls (Fig. 1a) . In addition, the percentage of lymphocyte in white blood cells (WBC) decreased in turn in common, severe, and critical patients, and the differences among them were statistically significant (Fig. 1d) . In addition, the expression of IL-2Rβ and IL-2Rγc in common, severe, and critical patients was significantly lower than that in normal Table 1 Clinical categorization of the patients with COVID-19 pneumonia by National Health Commission of China. The most significant finding of this study was the low level of IL-2 in plasma and low expression of IL-2R in PBMC of critical patients, which may result in the remarkable decrease of CD8 + T cell and lymphocytes in critical patients with COVID-19 pneumonia.
cord-264751-2l3cqhe2	2019	8e11 The purpose of the present study is to describe all the cases with PRF occurring in children aged 0 18 years diagnosed and hospitalized at the pediatric departments of the Soroka University Medical Center, Beer-Sheva, Israel, during the period 2005 2016, and to compare their microbiologic laboratory, clinical, therapeutic and outcome characteristics in relation to the various etiologies of this syndrome. We conducted a retrospective study enrolling all the children aged 0 -18 years hospitalized at the pediatric departments of the Soroka University Medical Center, Beer-Sheva, Israel, during the period 01/2005 12/2016, with a diagnosis of purpuric rash accompanied by a fever >38 C. The aim of the present study was to determine the etiology of all cases of PRF occurring in children aged 0 18 years hospitalized in southern Israel during the period 2005 2016, and compare their microbiologic, laboratory, clinical, therapeutic and outcome characteristics in relation to the various etiologies of this syndrome.
cord-264779-71s7e18i	2020	As medical toxicologists we serve as a fund of knowledge for our healthcare colleagues and the public: we provide physicians with information regarding antidotal therapy, drug-drug interactions, and novel therapeutics. Neumann natalie.neumann@cuanschutz.edu treatment of toxicities born of the use and misuse of approved and alternative therapies is a service our field can readily provide to an otherwise overburdened medical system. Interpreting the nature of end-organ dysfunction as it pertains to therapeutic drug administration and overdose is well within the wheelhouse of medical toxicology and represents both a service our field may provide and a potential research frontier. Lastly, poison centers, historically considered an underutilized source for reporting adverse drug reactions, may be more mindful of tracking and reporting toxicity from novel therapies [26] . Medical experts explain the use and potential adverse effects of chloroquine and hydroxychloroquine for COVID-19
cord-264829-ynel6ore	2020	The aims of this systematic review and meta-analyses were (1) to calculate pooled frequency of newly developed and pre-existing CVD, hypertension, diabetes mellitus, cardiac symptoms as the initial presentations of COVID-19, elevation of cardiac and inflammatory biomarkers, acute hepatic, and renal injury; (2) to investigate association of newly developed and pre-existing CVD (including any acquired cardiac disease, encompassing ischemic and non-ischemic cardiomyopathies, or congenital heart disease) hypertension, and elevated cardiac and inflammatory biomarkers with severity of the disease and mortality; (3) to define the clinical spectrum and mechanisms of the newly developed cardiovascular diseases in the pediatric and adult population, the spectrum of newly developed arrhythmias and electrocardiographic changes and the pathologic findings of cardiac autopsies; and (4) to propose a TRST for timely detection and appropriate pathophysiologically targeted treatment of high-risk COVID-19 patients with associated CVD.
cord-264843-cwtdkylo	2020	Within psychiatry, a sudden relaxing of insurance and regulatory barriers during the month of March 2020 enabled clinicians practicing in a wide range of settings to quickly adopt virtual care in order to provide critical ongoing mental health supports to both existing and new patients struggling with the pandemic''s impact. In this article, we briefly review the extensive literature supporting the effectiveness of telepsychiatry relative to in-person mental health care, and describe how payment and regulatory challenges were the primary barriers preventing more widespread adoption of this treatment modality prior to COVID-19. Finally, we provide clinical suggestions for optimizing telepsychiatry based on our experience, make a call for advocacy to continue the reduced insurance and regulatory restrictions affecting telepsychiatry even once this public health crisis has passed, and pose research questions that can help guide optimal utilization of telepsychiatry as mainstay or adjunct of outpatient psychiatric treatment now and in the future.
cord-264889-1vsvcza2	2020	We certainly could not know that we would face that challenge in complementary roles-as patient and as critical care physician. Like so many other friends from distant pasts, we reconnected on social media, sharing advice and personal experiences during the current pandemic. " Although the critical care community is changing practice to improve outcomes (1-3), our shared experience of COVID delirium-one as patient and the other as physicianfriend-offered a powerful lesson for both of us. Each patient''s ties to the outside serve as reminders of the importance of team-the care team and the patient''s own team of partner, friends, and family-during the critical care journey. Thus, a partner can become a "project manager" to help share in the patient experience. As friends on a COVID journey, we shared our appreciation of ICU care as a team sport. COVID-19: ICU delirium management during SARS-CoV-2 pandemic COVID-19: What do we need to know about ICU delirium during the SARS-CoV-2 pandemic?
cord-264924-ds6jv5ek	2004	Summary The epidemiology and virology of severe acute respiratory syndrome (SARS) have been written about many times and several guidelines on the infection control and public health measures believed necessary to control the spread of the virus have been published. The epidemiology and virology of severe acute respiratory syndrome (SARS) have been written about many times and several guidelines on the infection control and public health measures believed necessary to control the spread of the virus have been published. The severe acute respiratory syndrome (SARS) coronavirus is a novel pathogen that emerged in southern China at the end of 2002 and because of a single event in a hotel in Hong Kong one night in February 2003, spread to three continents. Mild illness associated with severe acute respiratory syndrome coronavirus infection: lessons from a prospective seroepidemiologic study of health-care workers in a teaching hospital in Singapore
cord-264952-0t0t4x0y	2020	[1, 5] Without rehabilitation, numerous patients may require extra days in the field hospital setting, taking up needed bed space and increasing use of PPE and healthcare personnel. Patients with more impaired function and who have clear barriers to discharge modifiable with rehabilitation intervention -including not being able to navigate steps to enter their house and requiring assistance for transfers -will be triaged to receive as much physical and occupational therapy as resources allow, with physiatry involvement as indicated to help with discharge planning and symptom management. When a field hospital has no dedicated space for rehabilitation, patients should receive appropriate ongoing therapies and be provided with information regarding bed exercises, exercises with family, and home exercise programs that appropriately address the symptoms of the disease.
cord-264972-hrbo3awj	2016	title: Evaluating the impact of the multiplex respiratory virus panel polymerase chain reaction test on the clinical management of suspected respiratory viral infections in adult patients in a hospital setting A retrospective cohort design was used to study the impact of a multiplex respiratory virus panel polymerase chain reaction test in 186 adult patients with suspected influenza-like illness. The objective of our study was to evaluate the impact of the MRVP test on the use of antiviral and antimicrobial therapy among adult patients in a hospital setting (either emergency room or inpatients) with suspected influenza-like illness. We evaluated whether the MRVP test result was associated with the changes in management in antiviral and antibiotic treatment (see the definition in Supplementary Appendix S1), after stratifying by patient location. We conclude that the MRVP test could potentially positively impact the clinical management of respiratory viral infections in adult patients.
cord-265022-p5cab562	2020	Indeed, patients with COVID-19 are at accelerated risk for delirium due to at least seven factors including (1) direct central nervous system (CNS) invasion, (2) induction of CNS inflammatory mediators, (3) secondary effect of other organ system failure, (4) effect of sedative strategies, (5) prolonged mechanical ventilation time, (6) immobilization, and (7) other needed but unfortunate environmental factors including social isolation and quarantine without family. Given early insights into the pathobiology of the virus, as well as the emerging interventions utilized to treat the critically ill patients, delirium prevention and management will prove exceedingly challenging, especially in the intensive care unit (ICU). Many hospitalized patients with COVID-19 will develop delirium, and given early insights into the pathobiology of this virus indicating invasion into the brain stem, as well as the emerging interventions utilized to treat these critically ill patients, delirium prevention and management may prove exceedingly challenging, especially in the intensive care unit (ICU).
cord-265052-hfuvm1oh	2020	Before and after COVID-19, the diagnostic distribution of patients applied to the dermatology outpatient clinics for three periods consisting of 4-weeks was as in Table 2 . Apart from this, the diagnoses of those who applied to the outpatient clinic more than once during this period were as follows in order of frequency: anogenital warts (n = 19/56, 33.9%), verruca vulgaris (59/365, 16.2%), scabies (17/180, 9.4%), psoriasis (11/140,7 .9%), idiopathic generalized pruritus (17/315, 5.4%), urticaria/angioedema (20/394, 5.1%), atopic dermatitis (14/308, 4.5%), bacterial skin/mucosa diseases (10/268, 3.7%), superficial fungal skin/nail infections (15/503, 3.0%). After the COVID-19 pandemic, which rapidly affected the whole world, there were significant changes in the application to outpatient clinics due to reasons such as measures, call to "stay at home", and panic in the community. In our study, we found a significant increase in the frequency of diagnoses such as idiopathic generalized pruritus, pityriasis rosea, alopecia areata, bacterial skin/mucosa diseases, and zona zoster/post-zoster neuralgia after COVID-19.
cord-265053-x70501t3	2020	In the wake of COVID-19 disease, caused by the SARS-CoV-2 virus, we designed and developed a predictive model based on Artificial Intelligence (AI) and Machine Learning algorithms to determine the health risk and predict the mortality risk of patients with COVID-19. We used several machine learning algorithms including Support Vector Machine (SVM), Artificial Neural Networks, Random Forest, Decision Tree, Logistic Regression, and K-Nearest Neighbor (KNN) to predict the mortality rate in patients with COVID-19. In this study, we proposed a data-driven predictive analytics algorithm based on Artificial Intelligence (AI) and machine learning to determine the health risk and predict the mortality risk of patients with COVID-19. After preprocessing the data, we use machine learning algorithms to develop a predictive model to classify the data, predict the medical condition, and calculate the probability and risk of mortality. Table 1 demonstrates the prediction accuracy for predicting mortality in patients with COVID-19 using 10-fold cross-validation for various machine learning algorithms.
cord-265082-gjbabh4g	2020	title: Primary percutaneous coronary intervention in a COVID-19 patient with ST-segment elevation myocardial infarction after lung transplantation: a case report We present an unusual case of a patient with bilateral-lung transplantation due to severe coronavirus disease 2019 , who subsequently suffered complications with acute myocardial infarction and underwent primary percutaneous coronary intervention (PCI). Based on the clinical characteristics of this case, we propose that the possible mechanism of myocardial infarction here included severe pulmonary infection, imbalance between coagulation and fibrinolysis subsequent to lung transplantation, changes in blood flow shear stress, and possible cytokine storms, which in combination led to plaque rupture in the LAD artery. In terms of treating acute myocardial infarction, considering that the patient had recent 2019-nCoV infection and bilateral-lung transplantation, we organized multiple rounds of multi-disciplinary discussions and decided that primary coronary intervention rather than thrombolytic therapy was suitable for the patient. In addition to the patient''s underlying severe coronary atherosclerosis, factors such as viral infection, inflammatory cytokine storm, hypoxia, blood loss, and bilateral-lung transplantation may contribute to the pathophysiology of myocardial infarction.
cord-265098-u5qssib9	2020	title: Effect of COVID-19 outbreak on the treatment time of patients with acute ST-segment elevation myocardial infarction OBJECTIVE: To explore the effect of COVID-19 outbreak on the treatment time of patients with ST-segment elevation myocardial infarction (STEMI) in Hangzhou, China. METHODS: We retrospectively reviewed the data of STEMI patients admitted to the Hangzhou Chest Pain Center (CPC) during a COVID-19 epidemic period in 2020 (24 cases) and the same period in 2019 (29 cases). Cumulative mortality was showed in Kaplan-Meier survival curves after the surgery in the 2020 group was significantly different higher than the 2019 group during the 28 days.The diagnosis and treatment process of STEMI patients during an epidemic should be optimized to improve their prognosis. Suggestions on management strategies for ST-segment elevation acute myocardial infarction (STEMI) combined with novel coronavirus infection Impact of symptom onset to first medical contact time on the prognosis of patients with acute ST-segment elevation myocardial infarction
cord-265111-d44ireu5	2020	A longer duration of COVID-19 with delayed clinical healing (symptom-free) occurred in patients presenting at admission a lower PaO(2)/FiO(2) ratio (p < 0.001), a more severe clinical presentation (p = 0.001) and a lower lymphocyte count (p = 0.035). All adult patients were diagnosed with COVID-19 according to World Health Organization (WHO) interim guidance: they had clinical symptoms of COVID-19 and confirmation of SARS-CoV-2 infection through instrumental signs and a positive result on RT-PCR assays of nasopharyngeal swab specimens. The specific inclusive criteria were as follows: (1) patients confirmed by positive detection of SARS-CoV-2 RNA from nasopharyngeal/throat swabs by RT-PCR with clinical data suggesting for COVID-19, (2) patients aged more than 18 years old and (3) patients with a known date of performing different RT-PCR assays. Disease severity and lower lymphocyte levels at admission also predict longer SARS-CoV-2 viral shedding.
cord-265230-ozyx8u64	2020	In order to reduce the use of medical resources to avoid the risk of COVID-19 infections in both cancer patients and health care providers, oncologists now have to draw the line for cancer treatments by maintaining their efficacy while avoiding severe adverse events. By contrast, for treating patients with high risk and/or during the pandemic, we must choose between reducing the intensity of chemotherapy (e.g., omission of the 5-FU bolus for CRC, replacement of infusional 5-FU by capecitabine or S-1 for ESCC, gastric cancer (GC), and CRC), delaying treatment, skipping cycles, or stopping (i.e., treatment maintenance phase and salvage chemotherapy with relatively few benefits). As first-line chemotherapy, for patients with high tumor burden or tumor-related signs/symptoms or low risk of COVID-19 infection, combination of fluoropyrimidine and oxaliplatin (if HER2 is positive, plus trastuzumab) is recommended as a standard regimen [38] .
cord-265262-r01u4jr6	2020	Furthermore, recent findings on novel coronavirus disease (COVID-19) epidemiology have shown a greater mortality in male compared with female patients and a role of T in promoting the severe acute respiratory syndrome coronavirus 2 (SARS-CoV2) infection of the host cells has been demonstrated. To accomplish the aims of the study, we performed a search on PubMed, Scopus, Ovid and Science Direct, and the following keywords were used: hypogonadism, TD, TRT, blood pressure, hypertension, ischemic heart disease, heart failure, stroke, obesity, insulin, diabetes, metabolic disorders, prostatic hyperplasia, prostate cancer, COVID-19, and SARS-CoV2. 45 In 2017, a meta-analysis including 39 randomized controlled trials (RCTs) and 10 observational studies with a total of about 5500 patients did not find any significant association between TRT and myocardial infarction, stroke, or mortality, even if the quality of the evidence was low.
cord-265278-wf5pbvvt	2020	In transplant recipiAfter infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), viral replication ensues in the respiratory epithelium, followed by viremia and systemic spread to organs by means of the angiotensin-converting-enzyme 2 receptor. 22 Graft rejection and toxic effects from calcineurin inhibitors may be difficult to distinguish from The varied presentation of SARS-CoV-2 infection reflects diversity in host immune responses, notably in immunosuppressed transplant recipients. Although the use of antiinflammatory drugs (e.g., high-dose glucocorticoids or interleukin-6 receptor antagonists) in solid-organ transplant recipients may have the additional benefit of protecting against rejection among patients who are receiving tapering courses of the immunosuppressive agents, especially when calcineurin inhibitors are discontinued because of severe disease, their efficacy in the context of solidorgan transplantation warrants testing in clinical trials. Human kidney is a target for novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection
cord-265472-b1s4stvz	2015	In conclusion, there are several case reports of autoimmune diseases following vaccines, however, due to the limited number of cases, the different classifications of symptoms and the long latency period of the diseases, every attempt for an epidemiological study has so far failed to deliver a connection. We can infer that a similar response may be associated with different safety in relation to the development of autoimmune reactions to vaccines, particularly in the patients with genetic predisposition to an enhanced response to vaccine inoculation [85] . HSP was associated with seasonal influenza, influenza A (H1N1), pneumococcal and meningococcal disease, hepatitis A virus (HAV), HBV, anti-human papilloma virus (HPV) vaccines, and following multiple combinations of vaccines, such as typhoid, cholera and yellow fever [139, [171] [172] [173] . Hepatitis B vaccination and undifferentiated connective tissue disease: another brick in the wall of the autoimmune/inflammatory syndrome induced by adjuvants (Asia)
cord-265721-wmz3wywi	2020	Three cardinal manifestations of neoplasia, namely inflammation, immune dysfunction, and coagulopathy are also seen in patients with severe SARS-CoV-2 infection, providing a biological rationale for testing selected anticancer drugs for their ability to control the symptoms and/or modify the course of COVID-19. The pharmaceutical industry, contract research organisations (CROs), and academia have spent decades developing drugs for cancer-induced inflammation, immune dysfunction, and coagulopathy; given that this triad is also seen in patients affected by COVID-19, it is reasonable to consider testing selected anticancer agents in a rational manner against this viral illness.
cord-265799-qda5awuc	2020	We report two cases of suspected remdesivirassociated acute liver failure (ALF) in patients with COVID-19 in which the liver failure improved with the addition of continuous infusion acetylcysteine and discontinuation of potentially hepatotoxic medications. 10 The EUA fact sheet provided by the manufacturer states that in the original compassionate use program of remdesivir in patients with severe or critical illness with COVID-19, liver function test abnormalities were reported in 12% of patients with a time to onset from first dose ranging from 1-16 days. One published case report by Leegwater discusses a case of acute liver failure 5 days after initiation of remdesivir in a patient with severe COVID-19 pneumonia. The use of the novel antiviral remdesivir in the treatment of COVID-19 pneumonia may put patients at risk of drug-associated acute liver failure.
cord-265812-1hcp36cw	2017	W.; Van der Klift, Marjolein; Cornelissen, Jan J.; Broers, Annoek E. High dose glucocorticosteroids, are currently recommended as first-line treatment for grade II-IV aGVHD resulting in overall complete responses (CR) in 40%-50% of patients. CONCLUSION: Second-line treatment with etanercept does induce responses in SR-aGVHD of the gut but appears to be associated with poor long-term survival even in responding patients. High dose systemic glucocorticosteroids (steroids) are currently recommended as first-line treatment for grade II-IV aGVHD resulting in overall complete responses (CR) in 40%-50% of patients [2, 3] . Studies evaluating second-line treatment with the anti-TFNα agent etanercept have shown promising results with overall response rates of 50-80% [8] [9] [10] . In conclusion, although second-line treatment of SR-aGVHD of the gut with etanercept was associated with a promising initial response rate, overall survival appeared very poor, mainly due to progression of GVHD and opportunistic infections.
cord-265818-wme1360n	2020	Patients and families often struggle with the uncertainties related to personal health and the delivery of care. Heightened emotional states threaten the quality of communication encounters for both patients/families and clinicians/staff. Encouragingly, despite the recent difficulties threatening relationships in health care, clinicians and staff have resiliently responded to the challenge. A recent article published Harvard Business Review highlighted upward trends in patient experience scores during the spring months of the 2020 COVID-19 pandemic: "For example, ratings of the skill of physicians rose 2.4% nationally, 2.8% in Washington and 10.4% in New York. (2) In this issue of The Journal of Patient Experience, I am pleased to feature several "Special Collection" submissions reflecting the context of COVID-19 and/or Telehealth. While our collective energy may continue to be influenced by the pandemic, this issue also contains an assortment of patient experience research and perspective articles. Implications of the current COVID-19 pandemic for communication in healthcare
cord-265848-afkeuwup	2007	With the use of drugs having a short duration of action, RSI also is advantageous because it is a measure that permits temporary airway control for the patient with mildly compromised airway reflexes who requires gastrointestinal decontamination (lavage followed by activated charcoal administration) but who does not require prolonged intubation. The management of gastrointestinal disturbance in the toxic patient includes following the general principles of blood, fluid, and electrolyte resuscitation, when indicated; judicious use of parenteral antiemetics to control persistent vomiting; specific measures such as antidotal therapy (e.g., in iron or organophosphate poisoning); or interventional therapy, such as charcoal hemoperfusion (in theophylline overdose) or hemodialysis (in lithium overdose), when indicated.
cord-265934-wjdxqj8h	2020	21 Recent studies on remote free flap monitoring provide clear examples of how telemedicine can not only expedite care, but also improve patient outcomes. There is a further need for controlled studies comparing telemedicine to in-person assessment of head and neck cancer patients in terms of cost, safety, surveillance adherence, and oncologic outcomes. published clinical practice guidelines for the management of dysphagia in the COVID-19 pandemic, suggesting use of telemedicine for triage and remote evaluation. 63 High levels of patient satisfaction were also achieved with smartphone-based follow-up of facial cosmetic surgery and reviewing images remotely. Telemedicine has a wide applicability in pediatric ORL for obtaining patient history and assessing need for common surgeries such as obstructive sleep apnea, recurrent tonsillitis, and recurrent otitis media (Table VII) . Utilization of SAF techniques have already proven useful in head and neck oncology consultations, remote otologic and audiologic evaluation, cochlear implant and hearing aid management, laryngeal ultrasonography, nasolaryngoscopy, as well as CT sinus review.
cord-265967-y4639p9m	2020	title: Geriatric patient-centered care during the COVID-19: Provision of interactions vs. 1 Older persons diagnosed with cancer, their families, and the medical staff face a meticulous trade-off between aggressive physical/social distancing and maintaining as close an interaction with family and community life as possible. This seems to contradict older patients'' preference for autonomy and decision-making about their life and health. It can be hypothesized that the COVID-19 virus and the chronic condition of cancer goals of the older patients population increases with age. In most families, the current isolation policy and total uncertainty alongside the fears of older patients with cancer becoming infected contradict the basic physical needs of security, namely, the need to touch, embrace, hear the sound of a familiar voice, and not be abandoned. The illness trajectory of elderly cancer patients across cultures: SIOG position paper Palliative care of cancer in the older patient
cord-266010-ectnfv5z	2020	The Italian College of Breast Radiologists by the Italian Society of Medical Radiology (SIRM) provides recommendations for breast care provision and procedural prioritization during COVID-19 pandemic, being aware that medical decisions must be currently taken balancing patient''s individual and community safety: (1) patients having a scheduled or to-be-scheduled appointment for in-depth diagnostic breast imaging or needle biopsy should confirm the appointment or obtain a new one; (2) patients who have suspicious symptoms of breast cancer (in particular: new onset palpable nodule; skin or nipple retraction; orange peel skin; unilateral secretion from the nipple) should request non-deferrable tests at radiology services; (3) asymptomatic women performing annual mammographic follow-up after breast cancer treatment should preferably schedule the appointment within 1 year and 3 months from the previous check, compatibly with the local organizational conditions; (4) asymptomatic women who have not responded to the invitation for screening mammography after the onset of the pandemic or have been informed of the suspension of the screening activity should schedule the check preferably within 3 months from the date of the not performed check, compatibly with local organizational conditions.
cord-266079-nv28ppft	2020	Coronavirus disease 2019 (COVID-19) pneumonia, firstly reported in Wuhan, Hubei province, China, has rapidly spread around the world with high mortality rate among critically ill patients. In the following sections, we present two representative confirmed severe COVID-19 cases according to WHO interim guidance [1] who have received corticosteroid treatment during their hospitalization. Clark Russell and his colleagues [4] summarized the available clinical evidence on corticosteroid therapy in severe COVID-19 [5] , Middle East respiratory syndrome (MERS) [6] and influenza [7] against corticosteroid use in 2019 novel coronavirus pneumonia, except in the setting of a clinical trial. Reports showed that the proper use of corticosteroids could reduce the mortality of critically ill SARS patients and shorten their hospital stay without causing secondary infections and other complications [8] . reported that methylprednisolone treatment might be beneficial for patients with COVID-19 who developed acute respiratory distress syndrome (ARDS) [10] .
cord-266160-464v4g8o	2020	COVID-19 and cirrhosis characteristics, development of organ failures and acute-on-chronic liver failure (ACLF) and mortality (inpatient death+hospice) were compared. Patients with cirrhosis alone had higher cirrhosis-related complications, maximum model for end-stage liver disease (MELD) score and lower BiPAP/ventilation requirement compared with patients with cirrhosis+COVID-19, but CCI and ACLF rates were similar. CONCLUSIONS: In this multicentre North American contemporaneously enrolled study, age/gender-matched patients with cirrhosis+COVID-19 had similar mortality compared with patients with cirrhosis alone but higher than patients with COVID-19 alone. Cirrhosis-alone patients had higher rates of grade III/IV HE, developed a higher model for end-stage liver disease (MELD) score and required more endoscopic procedures, including variceal banding, and large-volume paracentesis, than the cirrhosis+COVID-19 group. We conclude in this multicentre study that patients hospitalised with COVID-19 in the setting of cirrhosis have an inpatient mortality rate that is similar to that of patients admitted due to cirrhosis alone but higher than those admitted with COVID-19 without cirrhosis.
cord-266214-l8pmhcd5	2020	CONCLUSION: The management strategy here we proposed could improve the outcome of patients after CABG during the pandemic and benefit both cardiovascular patients and health-care workers. According to the data reported by the Chinese Center for Disease Control and Prevention, elderly patients with preexisting medical comorbidities are prone to severe illness and death after infection, which places the patients recovering from CABG surgery at a higher of infection. It is reported that in the over 40,000 confirmed cases, the casefatality rate of patients with CVD, diabetes, or hypertension is notably higher than average, which indicates the control of blood glucose (BG) and blood pressure (BP) playing a significant role in the prevention and outcome of COVID-19 infection for patients after CABG. Self-monitoring of COVID-19-related symptoms, including cough, fever, and dyspnea, is recommended for cardiovascular health-care workers, and a SARS-CoV-2 virus test should be considered when any kind of suspected exposure to infection occurs.
cord-266255-898h9rl1	2020	Thus, in addition to a more severe LHD at baseline, patients whose TR progress represents a subset characterized by an accelerated course of LHD, including a more rapid increase in LA size, pulmonary pressures, and higher rates of new atrial fibrillation, reduction in LVEF, worsening valvular disease, and need for pacemaker or device therapy. Increased LA LGE has been found to be associated with future diagnosis of atrial arrhythmias in patients with preexisting cardiac disease (9) but no study has investigated the prognostic value of LA LGE in a population-based cohort or by use of continuous monitoring. Positron Emission Tomography) study revealed that total sympathetic denervation size independently predicts appropriate ICD therapy for fast VA (7 ACE ¼ angiotensin converting enzyme; ARB ¼ angiotensin-II-receptor blocker; CFR ¼ coronary flow reserve; CI ¼ confidence interval; HED ¼ hydroxyephedrine; HR ¼ hazard ratio; LVEDVi ¼ leftventricular end-diastolic volume index; LVEF ¼ left-ventricular ejection fraction; MBF ¼ myocardial blood flow; NT-proBNP ¼ N-terminal prohormone of brain natriuretic peptide; NYHA ¼ New York Heart Association; RI ¼ retention index.
cord-266294-ua22udlc	2010	Metabolism The hemochromatosis gene polymorphism HFE 187C> G and possibly mitochondrial haplogroup J gave relative protection against lipoatrophy during antiretroviral drug therapy in a trial in which 96 patients were randomized to didanosine þ stavudine or zidovudine þ lamivudine, combined with efavirenz and/ or nelfinavir in AIDS Clinical Trials Group (ACTG) 384 sub-study A5005s (20 C ). Gastrointestinal In a retrospective obser vational study of highly active antiretroviral therapy (HAART), 27 of 50 patients who took indinavir in combination with zidovudine and lamivudine developed nausea and were significantly more likely to stop taking the treatment than those who were taking zidovudine þ lamivudine þ tenofovir (24 c ).
cord-266429-0xaz8kbs	2020	A more recent large global observational study that included 169 hospitals from three continents and close to 9000 patients found coronary artery disease and congestive heart failure (mortality of 15.3%, vs. Pressure guide, physician-directed, patient self-management has been previously shown to not only reduce heart failure related hospitalizations but also lead to higher frequency of medication adjustments including neurohormonal antagonists [59] . When infected by the virus, immunosuppression may influence the typical clinical presentation of COVID-19 patients who are also heart transplant recipients, resulting in unusual symptoms such as gastrointestinal manifestations [65] . Reported cases from a European transplantation center showed that solid organ recipients with COVID-19 had a more severe clinical course and high complications rates when compared with the general populations [65] . Considerations for heart failure care during the coronavirus disease 2019 (COVID-19) pandemic. Association of renin-angiotensin system inhibitors with severity or risk of death in patients with hypertension hospitalized for coronavirus disease 2019 (COVID-19) infection in Wuhan, China
cord-266450-g9vihgbk	2020	Careful attention to his daily platelet count suggested the possibility of immune mediated heparin-induced thrombocytopenia (HIT) which was confirmed by laboratory testing and resolved when anticoagulation was switched to a direct thrombin inhibitor. CONCLUSIONS: Since excessive platelet activation and in situ thrombosis occur in HIT, this case underscores the need to consider that thrombocytopenia in patients with SARS-CoV-2—most of whom receive heparinoids—may be unrecognized HIT. Emerging reports suggest the possibility of HIT developing in SARS-CoV-2 patients receiving heparin anticoagulation [4, 5] . The patient''s platelet count decreased from 487 k/uL to a nadir of 91 k/uL over the following 4 days, raising the concern for heparin induced thrombocytopenia (HIT) with an intermediate pretest probability by the 4Ts score of 4 ( Table 1 ). Platelet count and time points for anticoagulation administration and laboratory testing COVID-19 patients receiving heparin-involved treatment.
cord-266455-rbblg4pu	2019	Syndromic diagnostic testing using novel, rapid multiplexed molecular platforms represents a new opportunity for rapidly targeted antimicrobial therapy to improve patient outcomes and facilitate antibiotic stewardship. This is an FDA approved and CE marked platform that uses nested real-time PCR to detect 34 clinically important respiratory targets (15 semi-quantitative bacterial targets, 3 qualitative atypical bacterial targets, 8 [30] [31] [32] Furthermore, the pneumonia panel detects pathogens in a much higher proportion of samples than culture. Rapid syndromic molecular platforms have the potential to significantly improve the use of antibiotics and clinical outcomes in patient with pneumonia, but high quality randomised controlled trials are urgently required to evaluate their clinical impact. an observational study comparing the performance of two multiplex PCR platforms against routine microbiology for the detection of potential pathogens in patients with suspected hospital acquired/ventilator associated pneumonia (HAP/VAP) across
cord-266456-10tjzqep	2020	title: Management of ST‐segment‐elevation myocardial infarction during the coronavirus disease 2019 (COVID‐19) outbreak: Iranian"247" National Committee''s position paper on primary percutaneous coronary intervention Such safety concerns, along with the acceptable mortality benefit of the new generation of fibrinolytic agents, have placed thrombolytic therapy as a potential first choice on several occasions during the outbreak. Indications for fibrinolytic therapy in suspected acute myocardial infarction: collaborative overview of early mortality and major morbidity results from all randomised trials of more than 1000 patients Primary versus tenecteplase-facilitated percutaneous coronary intervention in patients with ST-segment elevation acute myocardial infarction (ASSENT-4 PCI): randomised trial Impact of coronavirus disease 2019 (COVID-19) outbreak on ST-segment-elevation myocardial infarction care in Hong Kong The management of antiplatelet therapy in acute coronary syndrome patients with thrombocytopenia: a clinical conundrum Management of ST-segment-elevation myocardial infarction during the coronavirus disease 2019 (COVID-19) outbreak: Iranian"247" National Committee''s position paper on primary percutaneous coronary intervention
cord-266463-ci0g1dno	2020	title: Continuing versus suspending angiotensin-converting enzyme inhibitors and angiotensin receptor blockers: Impact on adverse outcomes in hospitalized patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) Secondary outcomes include progression of COVID-19 disease, all-cause mortality, death from vascular causes, myocardial infarction, stroke, transient ischemic attack, new or worsening heart failure, myocarditis, pericarditis, arrhythmias, thromboembolic events, hypertensive crisis, respiratory failure, hemodynamic decompensation, sepsis, renal failure, troponin, B-type natriuretic peptide, N-terminal-pro hormone and D-dimer levels. The secondary objectives are to compare the impact of continued use versus discontinuation of reninangiotensin system inhibition on COVID-19 disease severity, all-cause mortality, cardiovascular death, acute myocardial infarction, new or worsening heart failure, hypertensive crisis, transient ischemic attack, and stroke at 30 days. Patients ≥18 years of age with a confirmed diagnosis of COVID-19 who are on chronic renin-angiotensin system inhibitor (ACEI/ARB) therapy will be assessed for the BRACE CORONA trial.
cord-266469-n484zqq1	2020	title: Lung base CT findings in COVID-19 adult patients presenting with acute abdominal complaints: case series from a major New York City health system Data is rapidly emerging given the novel nature of this devastating disease, with a paucity of published reports investigating abdominal presenting symptoms and subsequent CT imaging findings in COVID-19 patients. The purpose of our study is to describe the demographic, clinical, biological, and lung base CT findings in COVID-19 patients presenting with acute abdominal complaints, either in isolation or in combination with respiratory complaints. In this study, we described demographic, clinical, biological, and lung base CT findings in a population of COVID-19 patients who presented to our Health System with acute abdominal complaints, either in isolation or in combination with respiratory complaints. In conclusion, we report demographic, clinical, biological, and lung base CT findings in a group of patients presenting to our Health System with acute abdominal complaints who were found to have COVID-19.
cord-266475-t04pukea	2020	[1] [2] [3] [4] SARS-CoV-2 has been hypothesized as the aetiologic agent of CLL, on the basis of the temporal correlation between the "burst" of skin manifestations and the viral pandemic, even though we have scarce evidence of swab-confirmed infections. Authors have therefore suggested some pathogenetic mechanisms such as a delayed immunemediated reaction to the virus in genetically-predisposed patients 1 or an early IFN-I response in young patients, muting early viral replication but also inducing microangiopathic changes. [4] [5] [6] We would like to report a case of SARS-CoV-2-related acro-ischemia, peculiar for several reasons: i) the patient presented real acral ischemia that progressed toward necrosis; ii) she was otherwise completely asymptomatic; iii) she was on regular medication with warfarin for atrial fibrillation. Characterization of acute acro-ischemic lesions in non-hospitalized patients: a case series of 132 patients during the COVID-19 outbreak
cord-266478-642m488a	2020	title: Automated Inflating Resuscitator (AIR): Design and Development of a 3D-Printed Ventilator Prototype and Corresponding Simulation Scenario Based on the Management of a Critical COVID-19 Patient The aim of this technical report is twofold: first, to describe the design and manufacturing process of the automated inflating resuscitator (AIR), a 3D-printed ventilator training device which operates on the principle of pushing a bag valve mask; second, to present a simulation scenario that can be used for training health professionals how to use this and similar, low-cost, 3D-printed ventilators in the context of ventilator shortages caused by COVID-19. In addition to the description of the ventilator, we also present a simulation case using AIR to train safety, operational ability, crisis resource management, and communication skills. If there is a limited supply of participants, the paramedics team can only be reported by the facilitators, as the main objective of this simulation is training with the use of AIR and care involving a patient with COVID-19.
cord-266512-xh6zed03	2020	In infection, the Th2 response counteractsthe microbicidal Th1 response, which could limit the tissue damage induced by Th1-mediated inflammation (4) on one hand, but also cause a less efficient anti-virus response, as shown in a study on experimental Coronavirus 229E infection in healthy volunteers, where atopy appeared to be associated with a more severe rhinitis score (5) .Further, atopic subjects show a reduced expression of ACE2, the SARS-CoV-2 receptor, which could be associated with reduced susceptibility to the virus (6) . The multiple logistic regression analysis(details in supplementary material) confirmed a significant association between atopic status andmilder COVID-19;non-atopic patients had a significantly higher risk of having severe Covid-19 (OR adj 3.0, 95% CI 1.6-5.7, p =0.001) ( Table 1) In severe SARS-CoV-2 infection hyper-expressed cytokines include IFN-gamma, TNF-alpha, and IL-6, which cause fever, fatigue, flu-like symptoms, vascular leakage due to endothelial dysfunction, cardiomyopathy, hypotension, lung injury, activation of the coagulation cascade, and diffuse intravascular coagulation (7) .
cord-266583-avhiqlgy	2014	PURPOSE: The aim of this study was to evaluate the image quality of ultra-low-dose computed tomography (ULDCT) and its diagnostic performance in making a specific diagnosis of pneumonia in febrile neutropenic patients with hematological malignancy. Mean radiation expose dose of ULDCT was 0.60±0.15 mSv. Each observer regarded low-dose CT scans as unacceptable in only four (1.9%), one (0.5%), and three (1.5%) cases of ULDCTs. Sensitivity and area under the ROC curve in making a specific pneumonia diagnosis were 63.0%, 0.65 for reader 1; 63.0%, 0.61 for reader 2; and 65.0%, 0.62 for reader 3; respectively CONCLUSION: ULDCT, with a sub-mSv radiation dose and acceptable image quality, provides ready and reasonably acceptable diagnostic information for pulmonary infection in febrile neutropenic patients with hematologic malignancy
cord-266713-rghowch1	2020	DISCUSSION Our results suggest that case fatality of COVID-19 is significantly higher among patients with primary degenerative dementia than in other patients with similar mean ages and comorbidities. S a m p l e c h a r a c t e r i s t i c s COVID-19 was diagnosed according to the classification of the Spanish Ministry of Health: confirmed cases (patients with positive RT-PCR results for SARS-CoV-2) and probable cases (patients with a severe acute respiratory infection requiring hospitalisation and with clinical and radiological characteristics compatible with COVID-19, in the absence of RT-PCR confirmation). 13 These results are similar to our own: we found a COVID-19-associated case fatality rate of 43.4% in patients with dementia; this was significantly higher than the rate in the control group. Heart diseases were more prevalent in the group of patients with primary degenerative dementia, and were associated with a statistically significant increase in the mortality rate. Our study suggests that the case fatality of COVID-19 is significantly higher in patients with primary degenerative dementia than among other patients with similar ages and comorbidities.
cord-266722-qfn2dc1q	1987	Antibiotic therapy and menstruation can have a profound effect on the composition of this group of microorganisms.2 Disturbance of the delicate host-commensal relationship may cause a clinically significant infection due to these "nonpathogens." This may occur in response to the aforementioned factors (eg, pregnancy predisposing to vaginal candidiasis) or because of disruption of the anatomic barrier (eg, local mucosal infection at a site of trauma, or injury from cytotoxic drugs) or in association with exogenous infection (eg, rhinoviral infection leading to secondary bacterial otitis media). The skin lesions are tender and consist of papules and clear vesicles with a surrounding zone of erythema.617 Pharyngitis with tonsillar exudate persisting for 4 or more days with a negative throat culture for group A streptococci, or occurring in association with diffuse lymphadenopathy, splenomegaly or with many atypical lymphocytes on blood smear suggests the possibility of infectious mononucleosis (IM) (Epstein-Barr virus).
cord-266730-mio282vy	2020	We statistically analyzed the clinical symptoms and laboratory results of COVID‐19 patients and explained the discharge rate and fatality rate with a single‐arm meta‐analysis. The results of the random effects model meta-analysis showed that the fatality rate of the COVID-19 patients was 5% (95% CI 15, 27 found that the fatality rate of patients with viral pneumonia increased when they had a basic disease and mixed bacterial infection, which was consistent with the results of our study. Epidemiologic and clinical characteristics of novel coronavirus infections involving 13 patients outside Wuhan, China Clinical Characteristics of 138 Hospitalized Patients With 2019 Novel Coronavirus-Infected Pneumonia in Wuhan Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study Analysis of clinical features of 29 patients with 2019 novel coronavirus pneumonia COVID-19 patients'' clinical characteristics, discharge rate, and fatality rate of meta-analysis
cord-266744-31p212aq	2020	title: Changes in Emergency General Surgery During Covid-19 in Scotland: A Prospective Cohort Study The proportion of patients undergoing surgery increased (19.1 vs 42.3 per cent, p = < 0.05) as did the mean operating time (102.4 vs 145.7 min, p = < 0.05). CONCLUSION: Covid-19 has significantly impacted the number of admissions to emergency general surgery. Of the 36 patients undergoing surgery during 2020, 5 (13.9 per cent) had a change in the surgical procedure. Furthermore, in our cohort, only 50 per cent of patients diagnosed with acute appendicitis underwent Covid-19 testing. Furthermore, 12 (75 per cent) patients were deemed to require surgical management as opposed to the intercollegiate recommendation of a conservative approach [9] again suggesting an increase in severity. Covid-19 has significantly impacted the number of admissions to emergency general surgery. Author''s reply-clinical characteristics and outcomes of patients undergoing surgeries during the incubation period of COVID-19 infection
cord-266750-41gth6o0	2020	A better understanding of this relationship can inform the development of evidencebased management strategies in these patients and limit admissions to overcrowded ICUs. To demonstrate and further define these developing theories on the coagulative and inflammatory risks associated with the surgical treatment of trauma patients with COVID-19, we will present an unexpected outcome on such a patient at our institution. In addition, the hypercoagulable state secondary to COVID-19 and the inflammatory load of intramedullary reaming, fat emboli, and pulmonary embolism resulted in a "second hit" that may have cumulatively pushed our patient past a "tipping point" and into respiratory failure (Fig. 4) . The level of cytokine response, hypercoagulability, and pulmonary dysfunction associated with the COVID-19 virus may predispose to a catastrophic "second hit" after even low-energy trauma. Careful consideration and risk/benefit analysis, including preoperative evaluation of systemic inflammation and respiratory status, is paramount in patients with COVID-19 presenting with orthopaedic trauma injuries.
cord-266775-4npowkkz	2005	In the present study, we isolated a SARS coronavirus strain from a brain tissue specimen obtained from a patient with SARS with significant central nervous symptoms. In the present study, we isolated a SARS-CoV strain from a brain tissue specimen obtained during autopsy from a patient with SARS who became severely sick and showed significant central nervous symptoms during the course of his illness. Immunohistochemistry stains for N protein of severe acute respiratory syndrome (SARS) coronavirus (SARS-CoV) in a specimen of brain tissue obtained from the patient with SARS during autopsy. With regard to the superinfection with invasive Aspergillus in the brain and other organs of the patient, we think that severe immunodepression resulting from the damage to the immune system induced by SARS-CoV infection, combined with high-dosage treatment with a corticosteroid, provided access for conditional pathogens, causing a superinfection with invasive Aspergillus in multiple organs [24] .
cord-266905-j9ljwqv0	2020	Condensation: To minimize risk of exposure to health care workers, some have proposed eliminating 4 spouses, partners and other visitors to support women during their labor and delivery. In most institutions, however, labor and delivery units have been rare exceptions to the "no-visitor" 23 rules, for visitors there are felt to have, in the words of the New York Department of Health, an 24 "essential" role in process of care, and not having a partner present for the birth of a child seems 25 unimaginable,unkind and, for some, even traumatic. As 100 noted above, the process of labor and delivery requires close quarters, but it is difficult to estimate the 101 true incremental risk that comes with accompanying and supporting a patient, especially if members of 102 the health care team are symptom free and wearing appropriate PPE.
cord-266932-567lbktm	2020	title: Early Brain Imaging Shows Increased Severity of Acute Ischemic Strokes With Large Vessel Occlusion in COVID-19 Patients METHODS: We performed a comparative cohort study between patients with COVID-19 who had anterior circulation large vessel occlusion and early brain imaging within 3 hours from onset, in our institution during the 6 first weeks of the COVID-19 outbreak and a control group admitted during the same calendar period in 2019. Patients with COVID-19 had more severe strokes than patients without COVID-19, with a significantly lower clot burden score (median: 6.5 versus 8, P=0.016), higher rate of multivessel occlusion (50% versus 8.8%, P=0.005), lower DWI-ASPECTS (Diffusion-Weighted Imaging–Alberta Stroke Program Early Computed Tomography Scores; median: 5 versus 8, P=0.006), and higher infarct core volume (median: 58 versus 6 mL, P=0.004). CONCLUSIONS: Early brain imaging showed higher severity large vessel occlusion strokes in patients with COVID-19. Early brain imaging showed higher severity of anterior circulation large vessel occlusion strokes in patients with COVID-19.
cord-267020-4mpc246u	2020	In this context, we must prevent intuitive decision-making and insecurity from leading us to exhaust the available critical-care beds before they are truly necessary, while still recognizing the importance of rapid decision-making in emergency situations. The disease pandemic caused by the novel coronavirus has triggered significant changes in the medical decision-making process relating to critically ill patients. The disease pandemic caused by the novel coronavirus has triggered significant changes in the medical decision-making process relating to critically ill patients. The disease pandemic caused by the novel coronavirus has triggered significant changes in the medical decision-making process relating to critically ill patients. (2) (3) (4) More experienced doctors use intuitive and automatic cognitive processing -the infamous "clinical eye." Basically, this system relies on heuristics (mental shortcuts) to assess to what extent the patient''s symptoms fit the patterns and prototypes of diseases that professionals have stored in their memory.
cord-267041-i94lyfsh	1988	ELLNER, M.D. Cleveland, CM Pharyngitis, bronchitis, and pneumonia represent the most common respiratory tract infections. Potentially pathogenic bacteria can be isolated in most sputum specimens from persons with chronic bronchitis, even in the absence of symptoms of acute infectious exacerbation, Although it is true that Streptococcus pneumoniae is isolated in increased quantities when patients experience exacerbation [Sl, it is not clear in the SYMPOSIUM ON CEFIXIME / ELLNER Determination of the Cause of Pneumonia * Is the current condition accurately termed "acute," or is it really chronic? Although the Gram''s stain may suggest that the cause of a pneumonia is not bacterial by the finding of inflammatory cells and no organisms, the clinical presentation can be even more useful for distinguishing a bacterial from a nonbacterial infection. The search for elastin fibers appears to be a generally useful adjunct for diagnosis not only in hospitalized patients but in all persons with pneumonia, particularly when symptoms do not fit the classic patterns of either bacterial or nonbacterial syndromes.
cord-267124-8efdzlc0	2020	In response to the pandemic spread of SARS-CoV-2, the authorities of the German federal state of Hamburg ordered mandatory autopsies in all patients dying with a diagnosis of COVID-19 confirmed by polymerase chain reaction (PCR). During autopsy, tissue samples for histology were taken from the following organs: heart, lungs, liver, kidneys, spleen, pancreas, brain, prostate and testes (in males), ovaries (in females), small bowel, saphenous vein, common carotid artery, pharynx, and muscle. In this autopsy study of 12 consecutive patients who died of COVID-19, we found a high incidence of deep venous thrombosis (58%). In studies that examined deceased patients with COVID-19 without relying on autopsy, no increased rates of pulmonary embolism were observed clinically. To our knowledge, only 3 case reports have been published on patients with COVID-19 who have undergone complete autopsy and a few more in which only lung tissue was examined (7, 8) .
cord-267132-nb0j6k3h	2013	Clinical effectiveness (i.e. using prevention measures that are based on reliable evidence of efÀ cacy) is a core component of an effective strategy designed to protect patients from the risk of infection, and when combined with quality improvement methods can account for signiÀ cant reductions in HCAI such as meticillin-resistant Staphylococcus aureus (MRSA) and Clostridium difÀ cile. Full text conÀ rms that the article: relates to infections associated with hospital hygiene; is written in English; is primary research (randomised controlled trials, prospective cohort, interrupted time series, controlled before-after, quasi-experimental, experimental studies answering speciÀ c questions), a systematic review or a meta-analysis including the above designs; and informs one or more of the review questions. 334 In a prospective cohort study using data from two randomised trials and a systematic review to estimate rates of PICC-related bloodstream infection in hospitalised patients, the author concluded that PICCs used in high-risk hospitalised patients are associated with a rate of CR-BSI similar to conventional CVCs placed in the internal jugular or subclavian veins (two to À ve per 1000 catheter-days).
cord-267142-ys7z7j8j	2020	This case emphasizes the importance of ensuring that first-line health care providers, including ophthalmologists, optometrists, emergency physicians, and family physicians, consider COVID-19 on the differential for any patient with recent travel who presents with acute conjunctivitis. At the time of the visits to our clinic (March 3rd and 5th), the patient did not meet provincial health authority recommendations for testing of coronavirus infectious disease 2019 (COVID-19) based on country of travel. 8 Given this, eye care professionals, most notably ophthalmologists, may be the first point of contact in the health care field for patients with possible COVID-19, before the onset of characteristic respiratory symptoms. The case emphasizes the importance for eye care professionals to remain vigilant and consider SARS-CoV-2 as the causative agent in patients presenting with viral conjunctivitis, particularly in high-risk patients with travel to areas of active transmission of the virus.
cord-267287-qodj254z	2020	The current study''s overall aim was to examine the impact of the current COVID-19 outbreak on the number of non-COVID-related patient presentations to a major national emergency traumatology/orthopedics referral center in Latin America. Numbers of non-follow-up patients presenting to the traumatology/ orthopedics service were counted and compared between January through April 2019 and January through April 2020; and between the month immediately prior to the Peruvian government''s implementation of national lock-down measures (Feb 16—Mar 15; Period 1) and the month immediately following (Mar 16—Apr 15; Period 2). Our institute, which performs more trauma and orthopedic surgeries than any other center in Peru [6] , was declared a national referral center for patients with suspected or confirmed COVID-19 during the pandemic. On the other hand, strengths include it being the first to report on the impact of the present global crisis on Latin-American traumatology and orthopedic services, and that our institution is our country''s largest tertiary referral center for trauma cases within the Peruvian National Health Service.
cord-267300-zbipv9er	2020	Even though end-stage renal disease (ESRD) patients are particularly susceptible to COVID-19 infection and can develop severe to critical disease, there are limited studies and case reports about COVID-19 in ESRD patients. Even though ESRD patients are particularly susceptible to COVID-19 infection and can develop severe to critical disease, there are limited studies and case reports about COVID-19 in ESRD patients. We report a case of an ESRD patient on regular hemodialysis with severe COVID-19 pneumonia. This report describes the clinical presentation of this disease in a hemodialysis patient, the diagnostic process, the laboratory and imaging investigations, as well as the course of treatment. reported five cases of COVID-19 disease in hemodialysis patients in Zhongnan Hospital of Wuhan University. Lopinavir-ritonavir and Ribavirin have been used successfully as monotherapies in the treatment of mild COVID-19 pneumonia in hemodialysis patients [8, 10] . COVID-19 in hemodialysis patients: a report of 5 cases
cord-267357-7aap2cte	2020	title: The coronavirus (COVID-19) epidemic and patient safety The coronavirus (COVID-19) epidemic and patient safety Dirk M. Elston, MD Charleston, South Carolina I n this issue of the JAAD, Chen et al 1 discuss patient safety measures in a Chinese dermatology clinic during the coronavirus outbreak (2019-nCoV acute respiratory disease), including patient screening, respiratory precautions, and telemedicine consultations. 2, 3 Large health care organizations often address these issues during in-processing of employees, but many dermatologists practice in private clinics and should review existing policies to prepare for the inevitability of contagious patients entering the clinic. Prior outbreaks of virulent coronavirus strains have also been associated with severe respiratory syndromes and patient deaths. 4 Our responsibility for patient and employee safety is not limited to respiratory pathogens. Prevention of transmission of blood-borne infections deserves special mention, and readers should review the JAAD continuing medical education articles that focused on patient safety and blood-borne pathogens (https://www.jaad.
cord-267402-kca05rvz	2020	What follows herein is a detailed summary of the current literature surrounding COVID-19, encompassing the immune and inflammatory responses to infection, thrombotic manifestations and vascular consequences of infection with a focus on possible mechanisms by which these elements may contribute to acute stroke events. 89 This is not the case in COVID-19 (and the previous SARS outbreak) and a recent retrospective cohort study has suggested an incidence of stroke 7-8 times higher in patients hospitalized with COVID-19 infection compared with those hospitalized by influenza, 90 supporting the possibility of a SARS-CoV-2-driven hyper-coagulant state. [91] [92] [93] Obesity, in particular, is emerging as a prominent risk factor in the development of severe COVID-19 disease and is generally associated with increased incidence and increased severity of respiratory viral infection. Notably, the cytokine IL-33 is persistently elevated in obese individuals and is capable of stimulating endothelial cells to release pro-coagulant tissue factor 97 which may expose them to more severe COVID-19 disease and/or stroke.
cord-267525-tg4uwent	2020	PURPOSE: This study reports and analyzes the findings from the responses of 192 neurologists in the United States and Canada to a new survey instrument distributed in April 2020 to assess NMO practice and prescribing changes during the Covid19 pandemic. The objective of this study is to document the prescribing and treatment patterns of neurologists with expertise in NMO patient care during the Covid19 pandemic. Neurologists also indicated several unmet needs for their NMO patients, including improved testing for Covid19, more information on the risks of NMO treatment in this context, and increased telemedicine access. Neurologists across the United States and Canada believe that Covid19 poses a higher-thanbaseline risk of disease among their NMO patients, in part due to the immunosuppressive nature of most NMO treatments currently available and necessarily in use.
cord-267621-oc8bw7ft	2020	title: Early short-course corticosteroids and furosemide combination to treat non-critically ill COVID-19 patients: An observational cohort study 5 Therefore, to address the effectiveness of early short-course corticosteroid/furosemide treatment in the non-critically ill COVID-19 patient, we designed a retrospective observational cohort study. In the corticosteroid/furosemide treatment group, incidence of invasive MV or death given once daily for up to ten days reduced 28-day mortality by one-third among mechanically ventilated COVID-19 patients and by one-fifth among patients treated with oxygen, while no benefit was observed in patients not receiving respiratory support at randomization. To conclude, our data provides evidence that early short-course of corticosteroids combined to furosemide reduces the risk of invasive MV requirement or 28-day mortality in the non-critically ill COVID-19 patients.
cord-267788-ukz2wz4a	2020	[1] [2] [3] [4] In this issue of the European Heart Journal, the group from Wuhan Renmin University describe, in one of the larger cohorts (n = 671) reported to date, the importance of increases in cardiac troponin I (cTnI) in patients with a COVID-19 infection who were sick enough to require respiratory support. However, in critically ill patients, supply-demand imbalance leading to myocardial injury is more common, 10 due to the metabolic stress of the infection because of tachycardia, hypoxia, acidosis, and hypotension with or without substantial pre-existing epicardial coronary disease. Although arrhythmias have been described in the present and other studies of COVID-19, it is not clear that, in the absence of drugs that prolong the QTc interval which some now use as therapy, the incidence of these are greater than one might expect from patients with any severe respiratory infection leading to myocardial injury.
cord-267947-dnv2xl0h	2020	Fecal-oral transmission of the infection is possible, especially insofar as viral shedding in stools seems frequent and of longer duration than at the ENT level, including in patients with negative throat swab and without digestive symptoms. At the outset of the epidemic, there was a reported case of a 22-year-old female patient presenting with isolated febrile diarrhea along with normal blood test and negative fecal culture; on the other hand, chest scan revealed bilateral pneumopathy suggesting COVID-19 [7] . In a recent retrospective study involving 1141 patients presenting with documented infection, the frequency of initially isolated digestive disorders came to 16%, whereas in 96% of cases, injured lungs appeared on CT-scan [8] . This has also been reported in COVID-19, with a well-documented case of positive RT-PCR results in stools (during 7 days after hospital admission there were also 4 other negative RT-PCR test results, 2 on throat swabs, and the other 2 on sputum) in a patient presenting with non-severe bilateral pneumopathy [14] .
cord-268049-7xqln70d	2020	DISCUSSION: Patients presenting with SARS-CoV-2 infection are at high risk for acute respiratory failure requiring airway management. [29] [30] [31] [32] Based on currently available evidence, the WHO states that "HFNC and NIV systems with good interface fitting do not create widespread dispersion of exhaled air and therefore should be associated with [a] low risk of airborne transmission." 15 The risk of respiratory pathogen transmission when using HFNC is subject to a variety of factors, including the duration of support, maximal flow rate, patient sneezing or coughing, cannula fit, and patient cooperation. 35 Many guidelines, including those by Australian and New Zealand Intensive Care Society (ANZICS), the WHO, and the Surviving Sepsis Campaign recommend the use of HFNC in COVID-19 patients presenting with acute hypoxemic respiratory failure unresponsive to conventional oxygen therapy. 20 Notably, the SCCM guidelines on the management of critically ill patients with COVID-19 recommend "a trial of NIV with close monitoring and shortinterval assessment for worsening of respiratory failure" if HFNC is not available and there is no urgent indication for intubation.
cord-268140-s5lailkp	2020	Considering the proven role of cytokine dysregulation in causing this hyperinflammation in the lungs with IL-6 being a key driver, particularly in seriously ill COVID-19 patients, it is crucial to further explore selective cytokine blockade with drugs like the IL-6 inhibitors tocilizumab, sarilumab, and siltuximab. Considering the proven role of cytokine dysregulation in serious COVID-19 and interleukin (IL)-6 being the key driver of this hyperinflammation, which can cause multi-organ failure, a series of clinical trials with IL-6 inhibitors like tocilizumab, sarilumab and siltuximab are underway. Another Italian Phase II open-label trial (NCT04315480) with tocilizumab 8 mg/kg single dose is being conducted in patients with severe multifocal interstitial pneumonia due to COVID-19 to evaluate its role in the virus-induced cytokine storm, in blocking deterioration of lung function or even promoting a rapid improvement of clinical conditions, preventing naso-tracheal intubation and/or death [51] .
cord-268155-b8lqo52f	2020	title: Plasma from donors convalescent from SARS-CoV-2 infection – A matter of priorities In the interim, donor panels for hyperimmune Ig production may be constructed and an optimal path for the provision of this medicine may be developed, hopefully with harmonisation between the major regulatory agencies. Convalescent plasma harvested from voluntary donors in state blood services is at risk of being deflected from therapeutic use through preferential patient allocation to clinical trials for other Covid-19 therapies funded by large pharmaceutical companies. Given the continued body of evidence and public effort in the collection and use of convalescent plasma, it is to be hoped that this treatment will be considered as a first line modality and will not be obstructed by commercial considerations. Treatment of 5 Critically Ill Patients With COVID-19 With Convalescent Plasma Effectiveness of convalescent plasma therapy in severe COVID-19 patients Donor centers for convalescent plasma
cord-268168-yzvag38x	2020	We report the case of a 29 year-old woman who struggled with severe and enduring anorexia nervosa for 15 years, and experienced a complete recovery following a novel treatment of adopting a ketogenic diet followed by ketamine infusions. CONCLUSIONS: This is the first report of a ketogenic diet used specifically for the treatment of anorexia nervosa, followed by a short series of titrated IV ketamine infusions leading to complete remission of severe and enduring anorexia nervosa, with weight restoration, and sustained cessation of cognitive and behavioral symptoms, for 6 months. Complete and sustained remission of chronic anorexia nervosa is quite rare, and the novel use of a ketogenic diet and IV ketamine treatment in this potentially lethal condition suggests avenues for further research, and hope for patients and their families. We report a case of severe and chronic AN treated successfully by adopting a ketogenic (KG) diet for 3 months followed by a series of intravenous ketamine infusions.
cord-268211-egy8rgtl	2020	Methods: We identified patients from the two public hospitals in Vitoria who were admitted to ICU with confirmed infection by SARS-CoV-2. Conclusion: This early experience with SARS-CoV-2 in Spain suggests that a strategy of right oxygenation avoiding non-invasive mechanical ventilation was life-saving. Seven-day mortality in SARS-CoV-2 requiring intubation was lower than 15%, with 80% of patients still requiring mechanical ventilation. Because of mortality reports in Wuhan [5] suggesting a close association, we assessed correlation between plasma procalcitonin at ICU admission and 7-day mortality. Our findings suggest that an oxygenation strategy emphasising optimisation of oxygenation, intubation based on clinical criteria of hyperventilation and avoiding ventilator-induced lung injury associated with non-invasive mechanical ventilation would be life-saving in a significant proportion of patients. Seven-day mortality in SARS-CoV-2 requiring intubation was lower than 15%, with 80% of patients still requiring prolonged mechanical ventilation.
cord-268252-6g0vbd08	2020	The authors provide information on the COVID-19 pandemic in order to inform front-line dentists. The paper is as essay on the available information relating to: Background to the pandemic • Coronaviruses in general • Pathogenesis • COVID-19 • Clinical manifestations • Patient characteristics • Diagnosis • Protocol for managing the disease in the clinical setting • Transmission dynamics • Transmission dynamics in dentistry practice • Infection control • Mouth rinses • Rubber dam isolation • Anti-retraction handpiece • Appropriate disinfectants • Management of medical waste. The authors apply available international guidelines to provide a protocol for managing possible exposure to patients or those suspected of having a 2019-nCoV infection. Practice point • Cross infection protocols will prove essential to protect dentists, patients and society at large in the current pandemic. In dentistry face to face contact with patients means dental personnel are exposed to respiratory tract secretions, blood, saliva and other contaminated body fluids.
cord-268254-1mg7a17c	2020	This study determined the seroprevalence of 733 non-COVID-19 individuals from April 2018 to February 2020 in the Hong Kong Special Administrative Region and compared the neutralizing antibody (NAb) responses of eight COVID-19 patients admitted to the intensive care unit (ICU) with those of 42 patients not admitted to the ICU. In this study, the absence of NAb in the serum of over 733 HKSAR residents indicates that SARS-CoV-2 is unlikely to have spread silently in Hong Kong before its emergence in COVID-19 patients. During our manuscript revision, a preprint paper indicated that SARS-CoV-2 neutralizing antibody responses are more robust in patients with severe disease [26] . Neutralizing antibodies responses to SARS-CoV-2 in COVID-19 inpatients and convalescent patients. SARS-CoV-2 neutralizing antibody responses are more robust in patients with severe disease Neutralizing antibody responses to SARS-CoV-2 in a COVID-19 recovered patient cohort and their implications.
cord-268324-86a0n0dc	2020	The severe acute respiratory syndrome-coronavirus-2 (commonly known as SARS-CoV-2) is a novel coronavirus (designated as 2019-nCoV), which was isolated for the first time after the Chinese health authorities reported a cluster of pneumonia cases in Wuhan, China in December 2019. The clinical picture of critical patients with severe inflammatory-induced lung disease and with sepsis or septic shock needing intensive care support and mechanical ventilation is characterized by a wide range of signs and symptoms of life-threatening multiorgan dysfunction or failure, including dyspnoea, tachypnoea (respiratory rate of > 30/min), tachycardia, chest pain or tightness, hypoxemia, virus-induced distributive shock, cardiac dysfunction, elevations in multiple inflammatory cytokines, renal impairment with oliguria, altered mental status, functional alterations of organs expressed as laboratory data of hyperbilirubinemia, acidosis [serum lactate level > 2 mmol/L (18 mg/dL)], coagulopathy, and thrombocytopenia.
cord-268326-sbz3uk5h	2019	With a focus on lysosomal dysfunction in autoimmune disorders and neurodegenerative diseases — including lupus, rheumatoid arthritis, multiple sclerosis, Alzheimer disease and Parkinson disease — this Review critically analyses progress and opportunities for therapeutically targeting lysosomal proteins and processes, particularly with small molecules and peptide drugs. Alterations in lysosomal functions, either in the fusion processes involved in the general pathways mentioned above or related to the function of lyso somal enzymes and non enzymatic proteins, can result in broad detrimental effects, including failure to clear potentially toxic cellular waste, inflammation, apopto sis and dysregulation of cellular signalling 8 .
cord-268347-xz6fptol	2020	It is not known for certain if there is an association between any pharmacological agent used for rheumatologic treatment, including biological and non-biological disease-modifying antirheumatic drugs (DMARDs), and an increased risk of COVID-19 acquisition or adverse outcomes from COVID-19, although these agents have been associated with an overall higher risk of infections. To illustrate, the aforementioned prospective case series [3] that included 86 patients from New York with confirmed or presumptive COVID-19 with concurrent immunemediated inflammatory disease reported no increased odds of COVID-19 hospitalization among those who were receiving biological agents or Janus kinase (JAK) inhibitors at baseline [adjusted odds ratio (OR) 0.85; 95% CI 0.71-1.02]. There are proven benefits for initiation or continuation of any pharmacological agents for the management of systemic rheumatic diseases, including treatment with conventional DMARDs and other immunosuppressive agents (e.g. hydroxychloroquine/chloroquine, sulfasalazine, methotrexate, leflunomide, tacrolimus, ciclosporin, mycophenolate mofetil and azathioprine), as well as biological DMARDs, such as abatacept, tocilizumab and JAK inhibitors (e.g. tofacitinib, baricitinib and upadacitinib).
cord-268455-btuzihsy	2020	The aim of this study was to evaluate surgical treatment of gynecological cancer patients during the COVID-19 outbreak in our center. During this period, the hospital was divided into two separate areas, independent of each other, assisting COVID-19 cases and at the same time allocating resources to surgical care, follow-up, or ongoing treatments of patients with cancer. Our study showed that we were able to safely manage 126 gynecological cancer surgeries in the COVID free zone during the pandemic, avoiding delays or cancellations. The number of low complexity surgeries with short hospital stays included in the study may have influenced the risk of postoperative contagion, and the fact that the PCR test before surgery was not performed in half of the patients due to low availability could have reduced the diagnosis of the infection. This study, conducted in a partial COVID-19 free hospital, showed that with adequate preventive and protective measures, cancer surgery was possible and did not significantly compromise patients or healthcare workers.
cord-268531-igjeai8c	2020	title: Clinical Characteristics and Outcomes of 821 Older Patients With SARS-Cov-2 Infection Admitted to Acute Care Geriatric Wards: A Multicenter Retrospective Cohort Study On multivariate analysis, at COVID-19 onset, the probability of in-hospital mortality was increased with male gender (odds ratio [OR] 1.85; 95% CI 1.30–2.63), ADL score <4 (OR 1.84; 95% CI 1.25–2.70), asthenia (OR 1.59; 95% CI 1.08–2.32), quick Sequential Organ Failure Assessment score ≥2 (OR 2.63; 95% CI 1.64–4.22), and specific COVID-19 anomalies on chest computerized tomography (OR 2.60; 95% CI 1.07–6.46). Although age has been widely reported as a major risk factor for severe COVID-19 and death, no large geriatric cohort of older patients hospitalized in a geriatric ward has been described. The objective of this multicentric French retrospective study was to describe the clinical characteristics and outcomes of a large cohort of older patients with confirmed COVID-19 who were admitted to acute care geriatric wards and to determine the prognostic factors of in-hospital mortality.
cord-268540-wrjzr3ws	2020	A potential target for drug development for COVID-19 also involves inhibition of ACE2, the host cell receptor for the S protein of SARS-CoV-2 that is primed by TMPRSS2 protease and may prevent the entry of the virus. As previously described, the intermolecular interaction between the viral SP and human ACE2 Phase II CAStem cells will be intravenously injected into patients with or without acute respiratory distress syndrome (ARDS) induced by COVID-19. Phase II Patients with acute respiratory distress syndrome caused by COVID-19 will be treated with intravenous UC-MSCs at a dose 1 million xKg. Patient improvement will be evaluated over three weeks, along with the assessment of the immune profile, investigating the stem cells'' effect on the cytokine storm. The similarities in systemic multi-organ complications between H7N9 and Sars-Cov-2 infections, along with direct evidence of the benefits of MSCs transplantation for COVID-19, further supports the potential of stem cells as an effective treatment [138] .
cord-268561-vq1uhj5i	2020	11 The causative agent was identified as a novel CoV, eventually named SARS-CoV-2, and the respiratory syndrome associated with the infection was designated as coronavirus disease-2019 (COVID-19) by the World Health Organization (WHO). In direct tests, the clinical sample is examined directly for the presence of particles, virus antigens, or viral nucleic acids, whereas indirect methods detect the serological response against the infection (Figure 2 ). 11 Culture-based methods for SARS-CoV-2 detection have been used in research and public health laboratories in different parts of the world, but virus isolation is not recommended as a routine diagnostic procedure because it has low sensitivity, it is time-consuming, and it requires BSL-3 containment. 11 In addition to unequivocally confirming the diagnosis of a SARS-CoV-2 infection, regular sequencing of a percentage of patient samples from clinical cases can be used to monitor changes in the viral genome over time and trace transmission patterns.
cord-268617-1t7yaoct	2020	Given this epidemiological context, the establishment of guidelines for patients with gynecological cancers, requiring multidisciplinary management during the global COVID-19 pandemic, is crucial to limit their infection while maintaining their chances for a cure. The surgical prioritization is determined according to: The highest priority should be given to the surgical treatment of high-risk cancers, especially those candidates for minimally invasive surgery (such as robotic surgery) and short hospital stay, in addition to potentially curative procedures for early-stage cancers. In stage II endometrial cancer, proceed with radical surgery and consider adjuvant therapy for patients with high-risk factors (same as stage I). For patients with advanced stage (stages III/IV) high-grade epithelial (serous or endometrioid) ovarian cancer, the standard treatment is based on primary debulking surgery and adjuvant chemotherapy (protocol based on the result of the surgery).
cord-268632-p1rsz8fk	2020	cord_uid: p1rsz8fk 1 The disease was defined as COVID-19 (Coronavirus Disease 2019) 1 and principally affects the respiratory tract with a clinical scenario ranging from common cold to severe pneumonia. 2 The clinical scenario differs with most patients only needing supportive care, while others require admission to an intensive care unit (ICU) for invasive mechanical ventilation. 2 In Italy, the first person-to-person transmission of the SARS-CoV-2 was recorded on February 21, 2020, and to date (04/28/2020) the number of COVID-19 positive subjects is more than 100,000. However, little is known on the cutaneous manifestations of COVID-19-positive patients. [3] [4] [5] We aim to expand our knowledge by reporting four zoster infections in COVID-19-positive patients observed between March and April 2020. Clinical characteristics of 138 hospitalized patients with 2019 novel coronavirus-infected pneumonia in Wuhan, China Decreased absolute numbers of CD3+ T cells and CD8+ T cells during aging in herpes zoster patients
cord-268843-zml9lbve	2018	In the Canadian province of Manitoba, our group has periodically managed young infants of Northern Cree First Nations (Aboriginal) descent presenting with early-onset and life-threatening viral, bacterial, Mycobacterial, and fungal infections, clinically resembling severe combined immune deficiency (SCID). Herein we describe the clinical presentation, immunologic features, and HSCT outcomes for the largest cohort of infants with IKBKB immune deficiency resulting from complete loss of IKKβ expression published to date. Supporting a more profound immune deficiency are the other six reported patients with IKBKB mutations, who also presented with severe bacterial, fungal and viral infections as young infants. Like IKBKB immune deficiency, patients with hypermorphic NFKBIA mutations that result in reduced degradation of IκBα, present with multiple and severe bacterial, fungal and viral infections starting at an early age, typically before 3-months.
cord-268879-ajd7ofc8	2019	The huge clinical burden of common respiratory viruses, such as respiratory syncytial virus (RSV) and seasonal influenza, on healthcare resources and utilization highlights the importance for developing more effective treatment modalities in order to reduce morbidity and mortality. 20 The therapeutic role of baloxavir in older or immunocompromised patients with severe seasonal or avian A(H7N9) influenza especially with some time delay in administration of the drug later in the clinical course of the infection or in combination with an NAI requires investigation. While the sizeable protective effects of metformin in the abovementioned studies suggest a potential role of the drug as host-directed therapy in the treatment of latent TB infection and active TB, randomized trials are need to delineate its exact role(s) before introduction into clinical practices. Mortality in patients with community-onset pneumonia at low risk of drug-resistant pathogens: impact of β-lactam plus macrolide combination therapy
cord-268886-mpceglk1	2020	Given the challenges of the current coronavirus (SARS-CoV-2) pandemic and to protect both patients and ultrasound providers (physicians, sonographers, allied professionals), the International Society of Ultrasound in Obstetrics and Gynecology (ISUOG) has compiled the following expert-opinion-based guidance for the rationalization of ultrasound investigations for gynecological indications. While these are extremely troublesome conditions, patients and healthcare providers should consider delaying ultrasound evaluation until resolution of the COVID-19 pandemic. Although associated symptoms (mass effect leading to pressure, bladder/bowel symptoms) are not usually acute or life-threatening, they may signal advanced ovarian cancer, in which case, it may be reasonable to recommend that ultrasound assessment should be carried out by an expert soon and appropriate treatment commenced. • Abdominopelvic ''mass'' without associated symptoms (SOON or LATER): the healthcare provider may consider delaying the ultrasound evaluation until the resolution of the pandemic if there is a known history of pelvic pathology, such as leiomyoma.
cord-268939-ws74xprt	2020	The increased burden has substantially impacted the neurosurgery practice and intensive modifications were required in surgical scheduling, inpatient and outpatient clinics, management of emergency cases, and even academic activities. Operations of COVID-19 positive patients, and emergency cases, where screening can not be obtained, should be performed following level 3 protective measures. [5] [6] [7] In neurosurgery practice, intensive modifications were required in surgical scheduling, administration of inpatient and outpatient clinics, management of emergency cases, and even academic & educational activities. 26 A recent study from Wuhan City, China reported that some severe COVID-19 patients developed neurologic manifestations, such as acute cerebrovascular diseases (5.7%), and impaired consciousness (14.8%). 76, 80 Also, a patient with a mass lesion in the sellar region that underwent endonasal endoscopic surgery in Neurosurgery Department, Tongji Medical College, Wuhan City, China was diagnosed with COVID-19 after surgery, and disease was confirmed in 14 healthcare professionals in the same clinic afterwards.
cord-268952-3j43p9j3	2020	Situated in the initial epicenter of the pandemic, the Blood and Marrow Transplant (BMT) Program at Fred Hutchinson Cancer Research Center (Fred Hutch)/Seattle Cancer Care Alliance (SCCA) was at the forefront of delivering care to transplant patients during the surge of this public health crisis. In early March 2020 when community transmissions resulted in a steep increase of COVID-19 cases in Washington state, the individual risk for hematopoietic cell transplant (HCT) patients who acquired the infection was unknown. In early March 2020, the Institute for Health Metrics and Evaluation at the UW predicted that the COVID-19-driven demand for healthcare resources including acute and intensive care hospital beds and ventilators might exceed the available supply in Washington state and particularly in our region [6] . Once a COVID-19 vaccine is available, vaccination approaches for the posttransplant period in immunosuppressed patients, vaccination of caregivers, family, and clinical staff, and even assessing potential benefits of vaccinating donors prior to stem cell donation will have to be determined.
cord-268974-7bqh1yas	2020	title: Characterising non-melanoma skin cancer undergoing surgical management during the COVID-19 pandemic Our findings show that throughout the height of the COVID-19 pandemic our department saw significantly larger NMSC lesions, with a higher proportion of these being SCCs that required more complex reconstruction following excision. Larger, more invasive lesions may be likely to result in an increase in incomplete excision margins. Despite prioritisation of oncological services throughout the pandemic thus far, our findings show substantial differences in the patients accessing skin oncology services in our centre. It appears that current delays to definitive surgical treatment of smaller, less aggressive BCCs may mean patients are missing the opportunity to benefit from early excision of these lesions. Reduction in skin cancer diagnosis, and overall cancer referrals, during the COVID-19 pandemic Global incidence of incomplete surgical excision in adult patients with non-melanoma skin cancer: study protocol for a systematic review and meta-analysis of observational studies
cord-269009-0i2bvt77	2020	Should patients develop coronavirus disease (COVID‐19) pneumonia requiring hospital admission for treatment of hypoxia, the risk for thromboembolic complications increases greatly. 2 As pregnancy is a prothrombotic state, the possibility of an increased risk of thrombosis in pregnant women with COVID-19 has become an area of concern, and a number of international organiPatients with severe COVID-19 may be at risk for pulmonary thromboembolic complications through at least two distinct mechanisms -immunothrombosis and hospital-associated venous thromboembolism (VTE). 12 A recent study of patients with severe COVID-19 demonstrated a correlation between IL-6 and fibrinogen levels, 3 further supporting the theory that massive activation of the acute phase response, with increased production of coagulation factors, appears to be the predominant prothrombotic mechanism in COVID-19. A critical review of the pathophysiology of thrombotic complications and clinical practice recommendations for thromboprophylaxis in pregnant patients with COVID-19
cord-269031-sz8ieltb	2020	Abstract In France, the epidemic phase of COVID-19 caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) began in February 2020 and resulted in the implementation of emergency measures and a degradation in the organization of neuromuscular reference centers. In the context of NM diseases, particular attention must be paid to two experimental COVID-19 treatments, hydroxycholoroquine and azithromycin: risk of exacerbation of myasthenia gravis and QT prolongation in patients with pre-existing cardiac involvement. In France, the epidemic phase of COVID-19 caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) began in February 2020 and resulted in the implementation of emergency measures and a degradation in the organization of neuromuscular reference centers. The main addressed topics pertain to the disease itself, its mode of transmission, the official national public health recommendations to prevent it, the behaviors to adopt in case symptoms appear, and its consequences specific to the neuromuscular patient (e.g., relating to the management of steroids and immunosuppressor treatments, medical appointments, rehabilitation, and 6 ventilation).
cord-269051-nl0jfqxt	2020	Baseline patient demographic and clinical characteristics including severity of COVID-19 illness using the Chinese CDC definition were recorded up to 10 days prior to anti-cytokine therapy. Survival and clinical outcomes were assessed for 42 tocilizumab-treated patients and 41 matched controls for whom at least 7 days of follow-up data were available or who had been discharged or died before 7 days following administration of tocilizumab or the corresponding time for the matched controls. The median time from hospitalization to receipt of tocilizumab therapy was 4 days (IQR, 4) and similar between severely and critically ill patients. At last follow-up 15 (71.4%) severely ill patients have been discharged, 4 (19.0%) died, with 2 (9.5%) remaining hospitalized ( Figure 1G ). In this retrospective cohort study, we report on use of tocilizumab in the treatment of severely and critically ill hospitalized COVID-19 patients.
cord-269087-f9hyntvf	2020	Results: We included 25 published literature references related to the epidemiology, clinical manifestation, accessary examination, treatment, and prognosis of pediatric patients with COVID-19. The risk factors which may suggest severe or critical progress for children are: Fast respiratory rate and/or; lethargy and drowsiness mental state and/or; lactate progressively increasing and/or; imaging showed bilateral or multi lobed infiltration, pleural effusion or rapidly expending of lesions in a short period of time and/or; less than 3 months old or those who underly diseases. To help better understand how it would affect children and what is the latest specific clinical and research finding on children with it, we provide a mini-review based on 25 literature references covering the fields of epidemiology, clinical manifestation, accessary examination, treatment, and prognosis of pediatric patients with COVID-19. According to the current literature on the pediatric cases, children confirmed with COVID-19 mostly had good prognosis, with considerably less severe to critical progress (5.9%) as compared to adult patients (18.5%).
cord-269099-q5nyzlhs	2020	The agent-based simulation was conducted to model nurses'' walking trails, and the distance of one nurse travel to assigned patient rooms was measured for each nurse. The agent-based simulation was conducted to model nurses'' walking trails, and the distance of one nurse travel to assigned patient rooms was measured for each nurse. With revisions in the spatial arrangement of patient rooms, locating multibed rooms near the nurse station, symmetric room layout centering the nurse station, and planning both single/double-bed and multi-bed rooms on one side of corridors, nurse travel distance decreased more than 15%. In the racetrack type units where single/double-bed and multi-bed rooms are located on the opposite sides of the floor (with the service core in the middle), nurses have to travel along both sides to care assigned patients. Among Korean inpatient unit case studies, Shin and Kang (2016) assessed nurse walking distances using traditional point-to-point linear measurement based on field interviews of nurses'' patient room assignments.
cord-269105-yuphgyrn	2020	Thrombotic complications due to considerable inflammation, cytokine-mediated microvascular damage and pulmonary immunothrombosis formation seem to have emerged as an important issue in people infected with COVID-19. Cytokine-mediated microvascular damage, hypoxia, systemic inflammation, microangiopathy, coagulation pathway activation, and eventual immunothrombosis development have been described as key features of severe COVID-19 [4] . COVID-19 infection is related with high morbidity and mortality, mainly due to respiratory failure, with microvascular hyaline membrane and pulmonary immunothrombosis formation presumably playing a crucial role. In patients with COVID-19 pneumonia, presenting with disease progression or worsening of respiratory symptoms and significant elevation of D-Dimer levels, more attention should be paid to the occurrence of potential pulmonary embolism (PE) with or without deep venous thrombosis (DVT). During the study period, four COVID-19 pneumonia patients in conjunction with high-risk PE were treated with EKOS ™ Acoustic Pulse Thrombolysis ( [11] . Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China
cord-269190-w74bjtq1	2010	This article examines the spectrum of disease that can affect the geriatric rabbit as well as crucial factors concerning the clinical management of the animal up to the end of its life. Though designed for dogs and cats, the author and others have used this product in rabbits with chronic renal failure requiring longer-term at-home subcutaneous administration of fluid (see Hospice and end-oflife issues later in this article) (Fig. 1) . In some cases all teeth are eventually lost, and patients survive with good to excellent quality of life on a diet of liquid Critical Care (Oxbow Animal Health, Murdoch, NE). Causes are varied, and can include chronic renal failure and acquired dental disease. Use is not recommended in humans and tested animal patients that are dehydrated, or have liver or renal disease (due to reduction of blood flow to the kidneys).
cord-269205-g6eyvnou	2020	These guidelines address five key areas: (a) surveillance for recurrence, (b) screening for second primary cancers, (c) assessment and management of physical and psychosocial effects of cancer and treatment, (d) health promotion, and (e) care coordination. Based on the PROs and patient assessment, the visit is personalized to provide an evaluation of recurrence, prevention of second primaries, identification of treatment-effects, and, subsequently, coordination of care. The COVID-19 pandemic has led to changes in medical oncology and radiation oncology care, including surveillance after completion of treatment, in an effort to still provide the care needed, but also reduce risks as much as possible. Prior to the COVID pandemic, our goal as a head and neck program has been to offer at least one visit with medical oncology and radiation oncology at the primary cancer center in order to help develop the plan and offer clinical trials if applicable for all patients.
cord-269275-b7xxk48t	2020	SARS-CoV-2 has been reported to be associated with Guillain-Barré syndrome, rhabdomyolysis, acute cerebrovascular disease, central nervous system infections and other neurological diseases. Four formal reports have described neurological problems in SARS patients, including polyneuropathy [35] , myopathy and rhabdomyolysis [36] , large artery ischemic stroke [37] and central nervous system infections [38] . In a study by Mao et al., 214 patients diagnosed with COVID-19 were enrolled, and six (2.80%) of them developed acute cerebrovascular disease (five cases of ischemic stroke and one case of cerebral hemorrhage). Strokes are not uncommon in critically ill patients with multiple comorbidities, so SARS-CoV-2 infections in humans may increase the risk of stroke. Since some COVID-19 patients have complained of headaches, nausea etc, care providers should be alert for central nervous system infections caused by SARS-CoV-2 if such patients also exhibit symptoms such as a fever, epilepsy and disturbances of consciousness.
cord-269280-1zbxjmxu	2020	As the first wave of this pandemic subsides, hospital systems are faced with prioritizing which surgical services can resume while simultaneously minimizing the disruption of ongoing care for the remaining COVID-19 patients. Patients requiring oncologic surgery now face a "double jeopardy" of increased exposure to COVID-19 due to frequent interactions with medical facilities, but also worse outcomes associated with delaying surgery. As the immediate wave of morbidity and mortality associated directly with the COVID-19 pandemic subsides, the effects of delaying both diagnosis and surgery will be revealed. Guidelines, such as those created by ACS, for careful and precarious resumption of local "elective" surgeries are moot when conservation efforts are overrun by an uncontrolled Ro. At a time that we do not have herd immunity and a vaccine does not yet exist, government-mandated orders are necessary to protect our patients, ourselves, and those who will become our patients.
cord-269289-6uog10j4	2020	These include additional respiratory complications (pulmonary fibrosis -reported in 21% of those hospitalised with SARS-CoV-2 9 months post-discharge in one study 3 ) 7 , cardiovascular complications (acute cardiac injury (7% 8 ), cardiomyopathy (1/3 patients 9 ), cardiac tamponade, heart failure, dysrhythmias (17% 8 ) and venous thromboembolic events (20% 10 )) 11 , neurological complications (myopathy, acute stroke (5.7% of those with severe infection 12 ), Guillain-Barre syndrome (0.4% hospitalised patients 11 ) and encephalopathy) 13 , acute liver and/or pancreatic injury (29% and 17% respectively in one cohort) 14 , cytokine storm syndrome, septic shock, DIC, diarrhoea, Kawasaki-like disease 14 and renal complications (acute tubular injury, rhabdomyolysis, proteinuria, secondary focal segmental glomerulosclerosis and possible renin-angiotensinaldosterone system activation) 15 . The study reported that the degree of hypokalaemia correlated with severity of SARS-CoV-2 symptoms and they suggested that hypokalaemia can be difficult to correct as seen in two patients because the renal potassium wasting persists until clinical recovery from the virus.
cord-269345-5tlyy8jp	2020	Recently, thromboembolic events have been reported in 20/81 patients with severe SARS-CoV-2 32 pneumonia admitted to intensive care units (ICUs). In our case series, the involvement of segmental and subsegmental branches of the pulmonary 75 arteries along with the peculiar multiple and bilateral filling defects distribution, suggest a non-76 embolic origin of the pulmonary arteries thrombosis [4] . Compared to the rates previously reported in patients with pneumonia or other severe infections, a 81 higher prevalence of PTE in patients with SARS-CoV-2 pneumonia might be inferred from this 82 small series. The absence of major risk factors for thromboembolic events in 5 out of 6 patients 83 seems to further confirm the role of bilateral SARS-CoV-2 pneumonia as a risk factor for PTE. Prevalence of venous thromboembolism in patients with 119 severe novel coronavirus pneumonia
cord-269425-e9iyso7n	2020	A systematic review was done to analyze the clinical profile and outcomes in a total of 45 cases of new-onset ITP in COVID-19 patients described in literature until date. Diagnosis of ITP in patients with moderate-to-severe COVID-19 poses a major diagnostic as well as therapeutic challenge to clinicians owing to presence of multiple concomitant conditions including HLH, DIC, sepsis, antibiotic use, heparin prophylaxis, and thromboembolic events. The following data were extracted from the included studies: age of the patient at presentation, gender, COVID-19 illness severity, comorbidities, medication use, nadir platelet count, onset of COVID-19 symptoms to diagnosis of ITP, bleeding manifestations of ITP, time to recovery from start of treatment, and clinical outcomes. Bone marrow study in these few selected cases of ITP would reveal low number of megakaryocytes, as seen in one patient of this review, who presented with severe thrombocytopenia (count 2 × 10 9 /μL) [7] .
cord-269469-7pmnxi9a	2020	[10] [11] [12] Such results were embraced by some clinicians and clinical institutions, leading to a change in their routine practice, including recommendations for escalated-dose prophylaxis in all, or some hospitalized patients with COVID-19. Multiple randomized trials have been registered and are at various stages of progress to identify the optimal antithrombotic therapy for outpatients, inpatients, and critically-ill patients with COVID-19. 18 In a pilot single-center study, the authors randomly The authors should be congratulated for completing the first randomized controlled trial of anticoagulant therapy in patients with COVID-19. Anticoagulation, Mortality, Bleeding and Pathology Among Patients Hospitalized with COVID-19: A Single Health System Study Intermediate versus Standard-dose Prophylactic anticoagulation and Statin Therapy versus Placebo in Critically-ill Patients with COVID-19: Rationale and Design of the INSPIRATION/ INSPIRATION-S Studies Anticoagulant interventions in hospitalized patients with COVID-19: A scoping review of randomized controlled trials and call for international collaboration Therapeutic versus prophylactic anticoagulation for severe COVID-19: a randomized phase II clinical trial (HESACOVID)
cord-269503-ij4u980v	2020	This is a retrospective case series of four patients with laboratory-confirmed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, admitted to St. Luke''s University Health Network ICU between 24 March 2020 and 5 April 2020. A study involving 138 patients infected with COVID-19 in Wuhan, China, demonstrated cardiogenic shock, arrhythmia, and acute cardiac injury to be among common complications; 8.7%, 16.7%, 7.2% respectively [1] . Patient demographics, comorbidities, presenting day of illness since symptom onset, admission heart rate, duration of illness at intubation, duration of illness at onset of bradycardia, vital signs [blood pressure, mean arterial pressure (MAP), oxygen saturation, respiratory rate, temperature], laboratory studies (including cTnI, ferritin, C-reactive protein, D-dimer, fibrinogen), as well as medications and dose adjustments were investigated and compared against episodes of bradycardia. As previously described, acute myocardial injury was thought to be the most common cardiac manifestation in COVID-19 patients and potential for developing cardiac arrhythmias has been noted in a few studies.
cord-269511-bfd1dmt3	2020	Multivariate logistic regression was Accepted Article used to look at the factors associated with inpatient mortality as primary outcome, and need for vasopressors, CRRT/HD, and mechanical ventilation as secondary outcomes. In this retrospective single center study, clinical characteristics were described, and risks factors were determined in association with inpatient death, need for intubation, need for CRRT/HD, and vasopressor use among hospitalized COVID-19 patients in an underserved minority population. Multivariate regression analysis showed that age as a continuous variable is significantly associated with inpatient mortality (p<0.001) with mean age higher amongst patient who died compared to those who survived (73 years old vs 64 years old; p<0.0001). Although African American patients, who were 70% of our study population, tended to have higher rates of obesity, hypertension, and diabetes, there were no significant difference compared to other races (see Table S2 ). Patients in this study who received COVID-19 specific treatment (steroid, tocilizumab, and hydroxychloroquine) had poor clinical outcomes.
cord-269554-fzu6dy4e	2020	Univariate analysis of COVID-19 outcomes revealed that asthma was significantly associated with higher rate of endotracheal intubation (40.3% vs 27.8%, p = 0.036), mechanical ventilation (both invasive and non-invasive) (70.7% vs 52.2%, p = 0.039), and longer hospital length of stay (15.14 ± 12.48 days vs 11.51 ± 10.58 days, p = 0.015). Asthma was not associated with a higher rate of Intensive Care Unit (ICU) admission (22.2% vs 14.9%, p = 0.12), acute respiratory distress syndrome (37.5% vs 30.9%, p = 0.27), or death (9.7% vs 13.5%, p = 0.45) among COVID-19 patients. On comparison to non-asthmatic obese patients, obese asthmatic patients were more likely to develop sepsis (25.9% vs 14.2%, p = 0.042), had higher risk of ICU admission (48.1% vs 33.2%, p = 0.042), and required prolonged intubation (2.73 ± 3.63 days vs 1.38 ± 2.07, p = 0.032).Impact of asthma comorbidity on COVID-19 outcomes
cord-269564-r5mmsnbx	2008	Reports have suggested a mortality rate of 30% to 70% despite aggressive treatment [35] TSS is most commonly caused by Staphylococcus aureus and group A streptococcus. Unfortunately, complicated group A streptococcus infections are shown to have a high mortality rate despite aggressive antibiotic therapy, and penicillin has been shown to have limited effects if not initiated early in the disease. Fifty-three percent of the patients were positive for MRSA, and the risk factors associated with colonization included recent antibiotic use (within 3 months), hospitalization within the past year, skin or soft tissue infection on admission, and HIV infection [68] . PVL-positive S aureus pneumonia typically occurred in younger patients (median age, 14.8 years) who were previously healthy, and 75% were found to have had a viral infection in the preceding days. Two deadly viral infections that have emerged in recent years include severe acute respiratory syndrome (SARS) and influenza A (H5N1), also known as avian influenza or bird flu.
cord-269591-lu415jcp	2020	authors: nan Based on the above limited data, our National Society, taking into account the critical situation with the COVID19 infection worldwide and the potential risk for severe disease in our patients: Although the World Health Organisation (WHO), 6 the National Organisation of Public Health in Greece (https:// eody.gov.gr/covid-19-odigies-therapeias/) and experts in the field 7 do not recommend glucocorticoids (GCs) in patients with severe COVID19 infection, in a recent retrospective study from China, administration of methylprednisolone in patients with acute respiratory distress syndrome (ARDS) resulted in a significant reduction in mortality (from 62% to 46%, Hazard Ratio = 0.38). WHO: Clinical Management Of Severe Acute Respiratory Infection (SARI) When COVID-19 Disease Is Suspected. Risk Factors Associated With Acute Respiratory Distress Syndrome And Death In Patients With Coronavirus Disease 2019 Pneumonia In Wuhan, China
cord-269690-6r2bfydw	2020	Primary outcome was need of follow-up, defined as the presence at follow-up of at least one among: respiratory rate (RR) >20 breaths/min, uncontrolled blood pressure (BP) requiring therapeutic change, moderate to very severe dyspnoea, malnutrition, or new-onset cognitive impairment, according to validated scores. At regression tree analysis, the ratio of arterial oxygen partial pressure to fractional inspired oxygen (PaO(2)/FiO(2)) and body mass index (BMI) at ED presentation, and age emerged as independent predictors of the need of follow-up. Demographical data (i.e. age, gender, and ethnicity), comorbidities (i.e. hypertension, HTN, coronary artery disease, CAD, diabetes mellitus, DM, chronic obstructive pulmonary disease, COPD, chronic kidney disease, CKD, active cancer, and current psychiatric disorder according to DSM-5), as well as body mass index (BMI), axillary body temperature, and laboratory values (i.e. the ratio of arterial oxygen partial pressure, PaO 2 in mmHg, to fractional inspired oxygen, FiO 2 , expressed as a fraction, PaO 2 /FiO 2 , white blood cell count, WBC, neutrophil to lymphocyte ratio, NLR, liver enzymes, lactate dehydrogenase, LDH, C-reactive protein, CRP, estimated glomerular filtration rate, eGFR using the CKD-EPI equation) at ED presentation were extracted for all patients.
cord-269776-hj1s3ipp	2004	Concerning HAE-I and HAE-II, just as variations in serum concentrations of APP appear to determine which individuals in a normal population develop angioedema with a second perturbation of kinin metabolism, such as the use of ACE inhibitors, 96 it could be speculated that variations in either kinin activation or inactivation pathways might contribute to the differences in severity of angioedema in individuals with a pre-existing perturbation in kinin metabolism, such as a mutation in C1-INH (as occurs in HAE). 13, 14, 27 This increase in plasma bradykinin was demonstrated both for patients with HAE with C1-INH deficiency and for patients with drug-associated angioedema who had an angioedematous attack in conjunction with ACE inhibitor treatment. The patient''s daughter had recurrent skin angioedema and gastrointestinal pain attacks since age 12 years; therefore, with a normal C1-INH concentration and activity in both mother and daughter, a diagnosis of HAE type III was assumed.
cord-269835-mz7i66qp	2020	The current coronavirus disease 2019 (COVID-19) pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection has required a complete change in the management of patients with inflammatory bowel disease (IBD) who need to undergo endoscopic procedures. In particular, recommendations regarding the use of personal protective equipment to prevent COVID-19 transmission, both for patients and health-care professionals, are proposed and different scenarios in endoscopic IBD management are evaluated to suggest when endoscopy could be rescheduled and replaced by alternative biomarkers. The panel of experts con sidered possible aerosolization during colonoscopy, in particular during the insertion and removal of instruments through the biopsy channel and the presence of the virus in the stool and advised on the use of N95 masks for lower gastrointestinal procedures as a precautionary measure to protect the endoscopist from the risk of possible COVID-19 transmission from the patient if infected by SARS-CoV-2 (ref.
cord-269981-xm0by310	2020	The day surgery center of West China Hospital is a hospital-based surgical setting that has nine operating rooms, a post-anesthesia care unit (PACU), 33 beds, and two nurse stations. Patients have to visit appropriate specialist clinics to evaluate whether they qualify for thoracic day surgery. In this scenario, patients must complete a thoracic specialist clinic evaluation and a COVID-19 epidemic survey. For the first time, patients must bring all their test results and anesthesia consultation to the Day Surgery Appointment Center for the surgeon to review and confirm whether all the tests have been completed prior to surgery. Generally, postoperative patients will transfer to the day surgery center ward after PACU for stage II recovery. To our knowledge, our data provide the first direct program and clinical pathway for thoracic day surgery to prevent the spread of COVID-19.
cord-270019-er70ehk4	2020	title: Clinical characteristics, outcomes, and risk factors for mortality in patients with cancer and COVID-19 in Hubei, China: a multicentre, retrospective, cohort study METHODS: We did a retrospective, multicentre, cohort study of 205 patients with laboratory-confirmed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and with a pathological diagnosis of a malignant tumour in nine hospitals within Hubei, China, from Jan 13 to March 18, 2020. Multivariable regression analysis showed that receiving chemotherapy within 4 weeks before symptom onset (odds ratio [OR] 3·51 [95% CI 1·16–10·59]; p=0·026) and male sex (OR 3·86 [95% CI 1·57–9·50]; p=0·0033) were risk factors for death during admission to hospital. 5 In particular, male sex and receiving chemotherapy within 4 weeks before symptom onset were identified as risk factors for death in patients with cancer who were diagnosed with COVID-19. Clinical characteristics of COVID-19-infected cancer patients: a retrospective case study in three hospitals within Wuhan, China
cord-270079-vwnzp6zj	2020	We report a case of severe coagulopathy manifesting with right upper limb arterial and deep vein thrombosis in an 80-year-old male patient with severe COVID-19 associated pneumonia. At that point, his coagulation laboratory tests were deranged, and he eventually developed dry gangrene in his right thumb and index finger, as well as a deep venous thromboembolism in his right axillary vein. Since the beginning of the pandemic, it has become evident that COVID-19 infection does not only affect the respiratory tract but in some patients it seems to evolve to a systemic disease with severe complications such as acute respiratory distress syndrome (ARDS) and multi-organ failure [1] . We present a case of an 80-year-old patient with confirmed COVID-19 infection, who developed severe coagulopathy with peripheral arterial infarcts and deep venous thromboembolism. Seven days later, while his general condition was deteriorating, he developed acute ischemia in his right thumb and index finger (Fig. 2) .
cord-270124-tqhkzd2w	2020	The present article aimed to bring to the colorectal surgeon the current recommendations and general safety measures in order to prevent infection dissemination, to improve surgical planning in terms of timing and specific technical aspects. Since its appearance in China, in December of last year, the infection J o u r n a l P r e -p r o o f caused by the new coronavirus, SARS-CoV-2 (known as COVID-19), has spread rapidly and was declared a pandemic by the World Health Organization (WHO) in March of this year. While there is an increasing number of new cases and deaths, there is a recommendation to delay elective surgeries (including selected cancer cases) in order to provide medical resources and beds (including ICUs), increase the hospital areas that can be used, concentrate hospital activities for emergency care and, mainly, reduce the chances of cross-infection of doctors, patients and visitors. [15] General recommendations and care measures during surgical procedures Any procedure performed on a COVID-19-positive or suspected patient must be performed in a specific room.
cord-270153-krhkqcev	2020	Synchronous telemedicine allows clinicians to expand their reach by using technology to take care of patients who otherwise may not be seen. If the clinician is planning to transition current in-person patients to a telemedicine model, or if it has been determined that there is room in the clinic schedule, the next step is to assess the financial feasibility of a telemedicine practice. It is vital to take the time to create an appropriate clinical experience for both the patient and the clinician, which involves setting up the environment and paying attention to specific details that will allow the clinician to execute a successful telemedicine encounter. 26 Clinicians are able to reach patients who would otherwise never be seen by using telemedicine technology. Many of these health care consumers also expect to be able to have a face-to-face visit with their clinicians on demand in the convenience of their homes or places of work.
cord-270210-gfy2ytg5	2020	The aim of this study was to estimate the effect of continuous activity monitoring using an electronic activity tracker (AT) on exercise performance and fatigue of sarcoidosis patients, compared to controls (cohort study), and the effect of additional personal coaching (randomized trial) over a period of 3 months. Exercise performance of patients wearing an AT (Group I) improved compared with controls (Group II), including the 6MWD, % predicted (∆4.4 ± 9.1 versus ∆0.7 ± 5.0, respectively), and fatigue levels decreased (∆−3.9 ± 5.7 versus ∆−1.8 ± 5.3). The aim of this study was to estimate (1) the potential effect of continuous activity monitoring using an electronic AT, compared with a historical control group in a cohort study and (2) the effect of additional personal coaching of sarcoidosis patients in a randomized trial. Wearing an AT in general, even without personal coaching by a physical therapist, improved exercise capacity and reduced fatigue in sarcoidosis patients.
cord-270245-zziwb2jy	2020	Being of Asian ethnicity [3.73 (1.28–10.91)], receiving palliative treatment [5.74 (1.15–28.79)], having an initial cancer diagnosis >24 months before [2.14 (1.04–4.44)], dyspnea [4.94 (1.99–12.25)], and increased CRP levels [10.35 (1.05–52.21)] were positively associated with COVID-19 death. During a median follow-up of 37 days, the following cancer patient characteristics were found to be positively associated with COVID-19 death: Asian ethnicity, palliative treatment, initial cancer diagnosis >24 months, dyspnea at presentation, and high CRP levels. Apart from the CCC-19 Consortium (16) , no study to date has specifically looked at COVID-19 severity at presentation in COVID-19 positive cancer patients and hence our observation of an association with time since cancer diagnosis and presenting symptoms needs further validation in other large cohorts with homogenous definitions of inclusion criteria, testing strategies, and outcome measures.
cord-270294-g95skuik	2008	Furthermore, viral etiology studies in pneumonia are difficult to interpret as noninvasive viral detection methods are often considered to be only markers of infection rather than the cause of pneumonia." Clearly, much better knowledge of the potential role of respiratory viruses present in patients with pneumonia is needed. More recently, the introduction of highly sensitive nucleic acid amplification tests (NATs) has dramatically improved our ability to detect multiple viral pathogens such as influenza, respiratory syncytial virus (RSV), rhinovirus, parainfluenza, and adenovirus. [13] [14] [15] To date, there have been few studies, 5, 7, [9] [10] [11] 16 ,17 reported in patients with pneumonia using NATs to detect viral infection, and these studies have either not included clinical data 7.9.11 or have not tested for all potentially important respiratory viruses in a comprehensive manner.lv-!?
cord-270327-v4td3zsa	2020	The first and perhaps most significant overlap between COVID-19 and cardiac disease lies in the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)''s pathogenicity and virulence. Of this cohort, 19.7% of patients had cardiac injury, accompanied by more comorbidities, and higher levels of C-reactive protein (CRP), procalcitonin, creatine kinasemyocardial band (MB fraction), myoglobin, high-sensitivity troponin I (hs-cTnI), N-terminal pro-B-type natriuretic peptide (NT-proBNP), aspartate aminotransferase (AST) and creatinine. 5 With relation to COVID-19, a meta-analyses of four studies that included a total of 341 patients in China found the values of cTnI to be significantly increased in cases of severe disease (SMD, 25.6 ng/L; 95% CI, 6.8-44.5 ng/L) compared to milder forms. Association of Cardiac Injury With Mortality in Hospitalized Patients With COVID-19 in Wuhan, China. Association of troponin level and age with mortality in 250 000 patients: cohort study across five UK acute care centres.
cord-270348-5804ffwx	2020	To prevent COVID-19 outbreaks in our units, we next decided to require universal nasal swab testing for SARS-CoV-2 for all medically asymptomatic patients being admitted to psychiatric units 3 . Second, we realized that we needed to decide where to care for SARS-CoV-2 positive, medically asymptomatic patients with mental illnesses who required hospitalization-those without symptoms of COVID-19. In light of the above, we concluded it would best serve our patients if we developed an inpatient psychiatric unit capable of accepting SARS-CoV-2 infected patients without COVID-19 symptoms, or with mild enough symptoms that they would not require medical hospitalization. Further, it is highly beneficial for continuity of care if the patient requires transfer to a medical COVID-19 unit that the psychiatrist be able to follow them there and maintain the psychiatric treatments as indicated.
cord-270388-nozh463l	2020	Despite the extracorporeal cytokine hemadsorption device CytoSorb was granted FDA emergency approval for critically ill COVID19 patients, to our knowledge no published studies are currently available to support its use. 4 An alternative treatment able to reduce circulating cytokines in critically ill patients is CytoSorb (Aferetica srl, Italy), a device containing adsorbent polymer beads designed to irreversibly remove cytokines currently used for septic shock and other conditions where elevated levels of cytokines are present. Despite the lack of published results, based on bench performance testing and reported clinical experience, CytoSorb was granted FDA emergency approval for critically ill SARS-CoV-2 patients on April 10, 2020. . https://doi.org/10.1101/2020.06.28.20133561 doi: medRxiv preprint C-reactive protein (CRP) levels and respiratory parameters including the PaO2/FiO2 ratio (P/F) were assessed daily. Further studies are required to assess if CytoSorb can improve the clinical outcome of critically ill patients.
cord-270391-703js942	2020	Additional workup showed a deficiency of all the anterior pituitary hormones likely secondary to mass effect. Pituitary apoplexy, for example, presents with the rapid development of symptoms causing sudden impairment of adrenocorticotropic hormone (ACTH) secretion and, consequently, the sudden onset of cortisol deficiency symptoms. We describe a patient who presented following a syncopal episode with a wide range of differential diagnoses based on initial laboratory results, clinical course, and workup, ultimately leading to the diagnosis of panhypopituitarism. 2020 The patient was discharged with recommendations for outpatient follow-up with the endocrinology team for continued monitoring of his pituitary hormone level deficiencies and sellar mass. Patients admitted to the hospital for further workup of syncope usually undergo an extensive cardiac and neurological assessment. The patient presented above was diagnosed with a sellar mass leading to hyposecretion of all the pituitary hormones. Postural hypotension and syncope are the most common presentations of secondary adrenal insufficiency and panhypopituitarism.
cord-270509-roc93m4f	2020	We also did explore the current literature and recommendations for tracheostomy in patients with COVID-19 and studied the previous data from severe acute respiratory syndrome coronavirus 1 (SARS-CoV-1), the virus responsible for the SARS outbreak of 2003. • The benefit of performing early tracheostomy in critically ill COVID-19 patients are unclear from available data [1] . • To reduce time in contact with aerosolized secretionscomplete paralysis of patient to prevent coughing; stopping mechanical ventilation just before entering trachea; reducing use of suction during the procedure [14] . 4. Tracheotomy is performed under direct vision without movement of patient; tracheostomy tube is inserted, followed by inflation of the balloon. Effect of early versus late or no tracheostomy on mortality and pneumonia of critically ill patients receiving mechanical ventilation: a systematic review and metaanalysis Surgical considerations for tracheostomy during the COVID-19 pandemic: lessons learned from the severe acute respiratory syndrome outbreak
cord-270525-nmebqrb1	2020	METHODS An organized response regarding personnel, surgical case selection, operating room behavior, and facility reorganization were designed to prevent an internal coronavirus outbreak in the neurosurgery department at the Fray Antonio Alcalde Civil Hospital of Guadalajara. Based on the epidemiological and biological information available in the literature on COVID-19, specific measures adapted to our resources were implemented to design a protocol of organized administration of human resources both assistant and administrative, optimized surgical procedures, proper handling of personal protective equipment and adaptation of the facilities of the neurosurgery department of the FAAHC when treating neurosurgical patients with no SARS-CoV-2 known condition. This would lead us to a catastrophic scenario because there are reports of a 12% of hospital-associated transmission of the virus as the mechanism of infection of patients, that in our case are weak and many of them immunosuppressed; thus, cases of contamination of health-care personnel have also been reported, especially in non-designated COVID areas in which precautions might relax.
cord-270628-jtj30v0r	2020	[1] [2] [3] [4] [5] [6] Lung US was suggested to be particularly useful during the COVID-19 pandemic because of its ability to identify subtle lung parenchymal changes early in the course of disease, monitor the evolution of pulmonary lesions in hospitalized patients, and guide mechanical ventilation therapy in critically ill patients with acute respiratory failure and acute respiratory distress syndrome. [14] [15] [16] [17] [18] [19] [20] [21] [22] Chest computed tomography (CT) rapidly became the mainstream imaging method in the diagnosis and monitoring of COVID-19 pneumonia by identifying the typical pattern of ground glass opacities with variable infiltrates and consolidations, while showing a high correlation with laboratory detection of the virus by real-time polymerase chain reaction (RT-PCR) assays. [23] [24] [25] [26] [27] [28] [29] [30] Hence, in this study, the primary end point was to analyze the lung US findings in critically ill patients with severe COVID-19 pneumonia or admission to the ICU longitudinally throughout their disease course.
cord-270654-cz2y6ta9	2020	Among its potential mechanisms of action is the non-selective inhibition of NLRP3 inflammasome which is thought to be a major pathophysiologic component in the clinical course of patients with COVID-19. Among its potential mechanisms of action is the non-selective inhibition of NLRP3 inflammasome which is thought to be a major pathophysiologic component in the clinical course of patients with COVID-19. Based on the aforementioned data, the question which arises is whether colchicine, administered in a relatively low dose, could potentially have an effect the patients'' clinical course by limiting the myocardial necrosis and pneumonia development in the context of COVID-19. Severe acute respiratory syndrome coronavirus ORF3a protein activates the NLRP3 inflammasome by promoting TRAF3-dependent ubiquitination of ASC Severe Acute Respiratory Syndrome Coronavirus Viroporin 3a Activates the NLRP3 Inflammasome Colchicine therapy in acute coronary syndrome patients acts on caspase-1 to suppress NLRP3 inflammasome monocyte activation
cord-270665-z4l3lq39	2020	However, due to the distinctive epidemiological characteristics of SARS‐CoV‐2 (the virus causing COVID‐19), healthcare providers are exposed to the patient''s respiratory and gastrointestinal fluids, rendering endoscopy a high risk for transmitting a nosocomial infection. This article introduces preventive measures for endoscopic treatment enacted in our medical center during COVID‐19, including the adjustment of indications, the application of endoscope protective equipment, the design and application of endoscopic masks and splash‐proof films, and novel recommendations for bedside endoscope pre‐sterilization. During the COVID-19 pandemic, due to the distinctive epidemiological characteristics of SARS-CoV-2, endoscopy poses a high risk of nosocomial infection, since healthcare providers are exposed to the patient''s respiratory and gastrointestinal fluids 6 . 6) All medical personnel who a) have fever or respiratory symptoms, b) had contact with suspected or confirmed COVID-19 patients, c) live in or had contact with individuals residing in areas where the disease is prevalent, or d) recently returned from a high-pandemic area or country should undergo self-isolation for 14 days.
cord-270712-v6nnnzhm	2020	patients'' general medical practitioners (GMPs), funding restraints have resulted in NHS Clinical Commissioners advising against the routine prescription of high fluoride toothpaste in primary medical settings. For oncology patients without a regular GDP, or those who may have intermittent treatment in a tertiary dental centre, accessing prescriptions for high fluoride products may be particularly challenging during COVID-19. Sir, there are two reasons why the current guidelines pose an existential risk to dental practice: • The additional costs involved plus the required fallow periods make general practice dentistry unsustainable • The necessity to approach our patients while dressed like Darth Vader will raise perceived levels of fear and panic among them. It is important to reflect that we have always been an infection aware profession and have therefore often been at the forefront of infection control in the surgery for both our patients and the whole dental team.
cord-270723-cjfglili	2020	Age > 65 years, congestive heart failure, severity of disease, C‐reactive protein level, hypokalemia and furosemide treatment, were all associated with QTc prolongation. CONCLUSION: In patients treated with HCQ, QTc prolongation was associated with the presence of traditional risk factors such as hypokalemia and furosemide treatment. All rights reserved Univariate analysis revealed that in COVID-19 patients treated with HCQ, age above 65 years, severe or critical illness, congestive heart failure, hypokalemia, furosemide treatment and increased CRP level were all significantly associated with the composite endpoint (Table 2) . However, multivariate analysis in this small dataset also suggested that in COVID-19 patients treated with HCQ, concomitant hypokalemia and furosemide treatment were strongly associated with QTc prolongation. In conclusion, our study shows that QTc prolongation among HCQ-treated patients was associated with traditional, modifiable risk factors such as hypokalemia and furosemide treatment which are both commonly observed in COVID-19 patients.
cord-270740-3su8pc3f	2020	A Chinese scientist(5) used a bio-informatics model to describe the hypothesis of COVID 19 as methemoglobin, where the COVID-19 virus structural protein sticks to heme -displaces oxygen -which alters the iron-free ion, leading to inflammation of alveolar macrophages, which culminate in a systemic response ending in a cytokine storm . What we must focus on is that COVID19 attacks RBCs. Patients have frequently been found COVID-19, SARS2 is not ''pneumonia'' nor ARDS Through the current experience across the world, invasive ventilation is becoming the last resort, as emergency intubation from the Chinese, Italian and American experience evidences higher mortality, not to mention complications from tracheal scarring and stiff lung during the duration of intubation. The lung damage seen on CT scans is due to the oxidative stress released from the hemolysed red blood cells, which in turn overwhelm the natural defenses against pulmonary oxidative stress and cause a cytokine storm.
cord-270763-idkylpb6	2020	The purpose of this study was to review the acute and late phase pulmonary findings in influenza A(H1N1) associated pneumonia using high resolution computed tomography (HRCT), and to determine the importance of performing end expiration series. RESULTS: Ground glass opacities, consolidations, and the combination of both were associated with the acute phase, whereas persistence or worsening of the lesions, lesion improvement, and air trapping in the end expiration series (as seen using HRCT, n=6) were observed in the late phase. In this study, the findings were divided according to the acute and late (10 days to 4 months after first onset of respiratory symptoms) phases of the disease, in patients with persistent pulmonary complaints. The images obtained in our study in patients with influenza A (H1N1) pneumonia included areas of consolidation and/or ground glass opacities, unilateral or bilateral findings, and predominated at the periphery of the lungs.
cord-270776-oulnk1b3	2004	title: Value of initial chest radiographs for predicting clinical outcomes in patients with severe acute respiratory syndrome Purpose To determine whether the initial chest radiograph is helpful in predicting the clinical outcome of patients with severe acute respiratory syndrome (SARS). Results Bilateral disease and involvement of more than two zones on the initial chest radiograph were associated with a higher risk of liver impairment and poor clinical outcome. Together with the clinical characteristics of SARS, such as fever and chest symptoms, and a recent history of contact with a suspected or confirmed SARS patient, radiographic evidence of infiltrates consistent with pneumonia or acute respiratory distress syndrome is important in establishing the diagnosis (5) . Studies involving patients with community-acquired pneumonia (10) , acute interstitial pneumonia (11) , or idiopathic pulmonary fibrosis (12) have shown that quantitative and qualitative changes on chest radiographs might predict clinical outcome.
cord-270799-2pmpspuj	2020	Fever or feeling of fever, fatigue, cough and pain 133 symptoms (myalgia, arthralgia and headache) were the fourth most prevalent symptoms for both 134 diseases (COVID-19 and influenza A/B) without significant statistical differences except for frontal 135 headache and other localization of headache. The onset of 145 these symptoms (from illness onset) didn''t differ between the two groups except for fever which 146 appeared earlier in COVID-19 than in influenza (respectively 1.9 days [±1.5] vs 2.7 days [±1.5], 147 p=0.045). However, we noticed two otorhinolaryngological symptoms recently described 169 with SARS-CoV-2: anosmia and dysgeusia, present in half of our patients. On the other hand, sore throat, conjunctival hyperemia, tearing, sneezing, sputum production, 222 dyspnea, vomiting and rhonchi at pulmonary auscultation were more frequently described in 223 influenza group than COVID-19 group with statistically significant differences.
cord-270876-kul6bs3w	2020	2 By allowing patients to remotely attend appointments through audiovisual applications, virtual visits bring promise for decreasing outpatient no-shows. Patients can attend virtual visits from anywhere, including their homes, their workplaces, or even their parked cars, decreasing the burdens of making it to in-person appointments. In the study of general surgery outpatients from 2018, 123 (55%) of 223 patients reported they would prefer in-person appointments over virtual ones, even when accounting for the time and cost of coming to in-person appointments. 2 Patients and clinicians might struggle with setting up the technology needed for virtual visits, which might waste time and resources. For example, a 2019 study from Canada of home virtual visits for 75 patients at a stroke prevention clinic reported a no-show rate of 2 (3%) out of 81 appointments, but the study did not include comparisons of no-show rates for in-person clinic visits. Why do patients miss their appointments at primary care clinics?
cord-270933-ecmg8kti	2020	Furthermore our newly applied combination (Lianhuaqingwen and Arbidol Hydrochloride) showed effects in 5-7 days for patients with mild symptoms and was found effective with 98 % recovery rate. The significant alternation in laboratory findings during hospitalization was a high level of C reactive protein, lymphopenia, increases in WBC, and neutrophil count ( Both patients with mild symptoms and asymptomatic, received TCM LH Capsule in combination with Arbidol Hydrochloride tablets, with dosage and duration detail in (Table 03 ). Findings of the current study have shown that the treatment of COVID-19 patients with LH capsule in combination with Arbidol Hydrochloride resulted in significant recovery. Furthermore, the combination of LH with Aribidol hydrochloride can be used as effective therapeutics against COVID-19, specifically for Patients with mild symptoms. The effect of Arbidol Hydrochloride on reducing mortality of Covid-19 patients: a retrospective study of real world date from three hospitals in Wuhan
cord-271149-qnhlfozo	2016	Disease severity, proportion of reimbursement and family member monthly average income were identified as the key factors that contributed to a patient''s direct medical cost of hospitalization. The mean direct cost of hospitalization with H7N9 (US$ 10 969) estimated in this research is much higher than that of hospitalization There are 1, 7 and 3 missing data in District, Health insurance and Family member monthly average income respectively associated with seasonal influenza (US$ 1 797) [11] and the healthcare costs per patient with severe acute respiratory syndrome (SARS) in Beijing (US$ 1 886) most likely due to higher rates of ICU admission and death [12, 13] and the use of more expensive modern medical devices [14] . The mean direct medical costs of hospitalized H7N9 patients were found to be ¥12 060 (US$1 861), ¥136 120 (US$21 006) and ¥218 610 (US$33 736) (estimated by model), or ¥12 790 (US$1 974), ¥96 780 (US$14 935) and ¥228 650 (US$35 285) (medians observed) for mild, severe and dead cases respectively in this study.
cord-271180-cnrs0zpg	2020	CytosorbentsⓇ cytokine filter is a potential treatment methodology aimed at reducing the cytokine storm, thus serving as a bridge for therapy in the acutely ill patients infected with COVID-19. The following case report demonstrates the utility in a critically ill patient who survived the cytokine storm after receiving the cytokine filter via continuous renal replacement therapy bridging him to further definitive therapy. The following is a case report on a patient encounter and management course through the course of illness in which the Cytosorbents Ⓡ filter was used for his presentation of COVID-19 with severe ARDS, worsening renal dysfunction and evidence of evolving cytokine storm. Chest x-ray hospital day 16, 5 days after the initiation of cytokine filter when the patient developed worsening hypoxia and increased oxygen requirements as indicated in Table 2 below.
cord-271212-y8denvju	2020	title: Analysis of inflammatory parameters and disease severity for 88 hospitalized COVID-19 patients in Wuhan, China Methods: In this retrospective single-center study, demographic, clinical and laboratory data were collected and analyzed among moderate, severe and critically ill group patients. From February 3, 2020, to March 20, 2020, we conducted a retrospective study focusing on the clinical characteristics of confirmed cases of COVID-19 in Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, during which the rapid growth speed of diagnosis rated up to 58% in Wuhan, Hubei province. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study Clinical Characteristics of 138 Hospitalized Patients With 2019 Novel Coronavirus-Infected Pneumonia in Wuhan, China
cord-271220-sntawlnf	2020	Additionally, data indicate that hypertension, diabetes, and cardiovascular diseases are important risk factors for progression and unfavorable outcome in COVID‐19 patients. Even though the number of studies with follow-up is rather limited, these data are suggesting that hypertension, diabetes, and cardiovascular disease are underlying conditions associated with adverse outcome-admission in intensive care unit, mechanic ventilation, and death [6] [7] [8] [9] 13, 18 (Table 3) . In one of the largest study published (n = 1099) so far, diabetes was present in 7.4% of COVID-19 patients and it was significantly more prevalent in patients with severe form of disease and those who experienced primary outcome end point (admission to an intensive care unit, the use of mechanical ventilation, or death). In meta-analysis that included 1558 patients with COVID-19, it was found that diabetes, as well as hypertension and chronic obstructive pulmonary disease, was associated with exacerbation and admission to intensive care unit.
cord-271262-xglhx928	2020	Although reducing exposure of medical personnel is of obvious importance, there has been a dearth of literature discussing clinical strategies during the induction and intubation of COVID-19 patients. Ketamine could be a good agent for COVID-19 patient inductions; however, the anesthesiologist must be wary of cardiac failure with induction doses, especially if there is any preexisting history of cardiac disease or concern for viral cardiomyopathy. Prior to entering the COVID-19 patient''s room, a review of the chart or a discussion with the primary team should include past medical history, current hemodynamic state, pertinent labs and findings, current medication regimens and the need to intubate over other strategies to improve oxygenation and ventilation. Upon entering the COVID-19 patient room, after securing appropriate personal and procedural equipment, the anesthesiologist should quickly move to the head of the bed while assessing the patient''s current oxygenation and airway.
cord-271358-5666nsb9	2020	authors: Roncon, Loris; Zuin, Marco; Rigatelli, Gianluca title: Switch from oral anticoagulants to parenteral heparin in SARS-CoV-2 hospitalized patients: comment Doubtless this is a very important issue in the management of COVID-19 patients, but can heparin be administered in all cases? Should we consider a dose reduction in those patients with a severe thrombocytopenia? In this regard, it is would be important also to establish different anticoagulant strategies in COVID-19 patients with thrombocytopenia which is frequently observed in clinical practice. This article does not contain any studies with human participants performed by any of the authors. Switch from oral anticoagulants to parenteral heparin in SARS-CoV-2 hospitalized patients Thrombocytopenia is associated with severe coronavirus disease 2019 (COVID-19) infections: a meta-analysis Thrombocytopenia and its association with mortality in patients with COVID-19 Loris Roncon and Marco Zuin are equally contributed to the manuscript as first author
cord-271483-33kuvpl7	2020	Based on USFDA regulation, investigational use of off-label medications helps the development of their safety and efficacy which needs to be used in the context of a clinical study protocol [18] . Likewise, we would like to define pseudo-research as using off-label medications in clinical practice without obtaining the patient''s informed consent, and finally publishing the results of drug efficacy as a research article. To do this, the national and international regulatory bodies such as USFDA, and EU, as well as the national ones such as the National Committee of Ethics in Biomedical Research of Iran, should step out of their routine and codify a range of guidelines to address therapeutic and/or investigational use of off-label medications by highlighting the safety concerns of the off-label uses as well as respecting patients autonomy especially in critical situations such as the COVID-19 outbreak. However, the physicians should be careful that the information about the efficacy and safety of off-label medication in clinical practice should not be published as a research article.
cord-271603-zy4l9vtf	2020	title: Guidance and Best Practices for Reestablishment of Non-Emergent Care in Nuclear Cardiology Laboratories During the Coronavirus Disease 2019 (COVID-19) Pandemic: An Information Statement from ASNC, IAEA, and SNMMI • For SPECT myocardial perfusion imaging studies in inpatients who are not eligible for stress only testing, consider performing the rest injection in the patient''s inpatient room, to avoid completely or minimize waiting time in the laboratory. The nuclear cardiology laboratory''s protocols and patient scheduling templates will need to be closely monitored and refined multiple times over the coming months as the COVID-19 pandemic slowly recedes, with potential for local or widespread waves of new COVID-19 infections. • Providers and institutions should monitor local data and follow national, state, and department of public health recommendations for possible second COVID-19 waves that may require decreasing nuclear cardiology laboratory activities and enhanced protective measures.
cord-271660-5sfkhg19	2020	METHODS: We measured the impact of switch to fluorescent microscopy on the smear detection rate of culture-confirmed pulmonary TB, timing of respiratory isolation, and total non-isolated infectious person-days in hospital at a high-caseload medical center (approximately 400 TB cases annually) in Taipei. Hospitalized patients had typical presentations of pulmonary TB if they had: (a) a prolonged cough for >3 weeks; (b) clinical suspicion of pulmonary TB based on chest radiography, such as cavitary pulmonary lesions, upper lobe diseases, or miliary lesions; or (c) already received a confirmed diagnosis of pulmonary TB by a positive sputum culture of Mycobacterium tuberculosis, positive acid-fast stain (AFS), or positive TB PCR, before the hospitalization. Our previous survey on age/sex-standardised TB incidence ratio of HCWs (using general population as reference)---the excess TB risk that are attributable to nosocomial TB transmission---in Medical Center A showed a drop of this risk, from 3.11 in 2006 to 1.37 in 2012 [23] , and the decrease in time-to-isolation and total non-isolated infectious patient-days was in parallel in the present study.
cord-271871-8grkln6o	2020	Abstract Background The COVID-19 pandemic has resulted in reduced performance of elective surgeries and procedures at medical centers across the U.S. Awareness of the prevalence of asymptomatic disease is critical for guiding safe approaches to operative/procedural services. Conclusions These data demonstrating low levels (0.13% prevalence) of COVID-19 infection in an asymptomatic population of patients undergoing scheduled surgeries/procedures in a large urban area have helped to inform perioperative protocols during the COVID-19 pandemic. These data demonstrating low levels (0.13% prevalence) of COVID-19 infection in an asymptomatic 117 population of patients undergoing scheduled surgeries/procedures in a large urban area have helped to 118 inform perioperative protocols during the COVID-19 pandemic. As a large urban referral center, we adopted the CDC and ACS recommendations early in the pandemic, 327 suspending elective surgical and interventional procedures, and later relaxing those suspensions while 328 balancing local/regional COVID-19 epidemiology, data regarding our pre-operative/pre-procedure 329 testing results, and health system resources and priorities.
cord-271887-blwrpf38	2020	Our initial examination of the suitability of the PHC and its associated technologies as a key contributor to public health responses is designed to "flatten the curve", particularly among unreached high-risk NCD populations in developing countries. Portable Health Clinic (PHC) services, which is an RHS, have proven efficacy in providing necessary information and preventive measures for people without access to healthcare facilities [17] [18] [19] . No previous study to date has examined the scopes of designing and developing an RHS based on the general requirements to facilitate primary screening and triaging COVID-19 and primary healthcare services for preventing COVID-19 and controlling NCDs. However, such screening and triaging COVID-19 by an RHS is important for cost-effective check-ups and for reducing the risk of transmission for unreached communities with various needs. In its existing functional form, deploying the PHC and related RHS technologies for socially distanced populations during a public health emergency, such as the COVID-19 pandemic, is beneficial in reducing the risk of transmission to frontline healthcare professionals.
cord-271896-1ad18z11	2020	CONCLUSIONS: The results of this case series suggest that high-dose oral famotidine is well tolerated and associated with improved patient-reported outcomes in non-hospitalised patients with COVID-19. Based on a national institute of health (nih)-endorsed Protocol to research Patient experience of cOViD-19, we collected longitudinal severity scores of five symptoms (cough, shortness of breath, fatigue, headaches and anosmia) and general unwellness on a four-point ordinal scale modelled on performance status scoring. Based on a national institute of health (nih)-endorsed Protocol to research Patient experience of cOViD-19, we collected longitudinal severity scores of five symptoms (cough, shortness of breath, fatigue, headaches and anosmia) and general unwellness on a four-point ordinal scale modelled on performance status scoring. The results of this case series suggest that high-dose oral famotidine is well tolerated and associated with improved patient-reported outcomes in non-hospitalised patients with cOViD-19.
cord-271920-1dzkgt6w	2020	3 As waves of COVID-19 patients present to ED''s in coming months with symptoms or potential exposures, understanding the diagnostic accuracy and reliability of history, physical exam, routine labs, advanced imaging, and an evolving array of COVID-19 diagnostics will be essential knowledge to inform the timing of testing, optimal specimen and test selection, shared decision-making, and ultimately derivation of clinical instruments to guide disposition, follow-up, and shared The search strategy used a combination of standardized terms and key words, including but not limited to (Covid-19 OR Novel Coronavirus OR SARS-COV-2) AND (diagnosis OR polymerase chain reaction OR serology OR CRISPR-CAS OR sensitivity/specificity) (Appendix). 40,42 It is known, however, that false negatives are frequent, so current recommendations advise incorporating patient''s exposure risk, clinical signs and symptoms, routine lab and imaging findings, serology, and (when available) CT results into real-time determination of COVID-19 status.
cord-271944-oxtus5vb	2020	Since the emergence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in Wuhan, China, this highly transmissible virus has since spread rapidly around the world. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV2) is a novel coronavirus that causes Coronavirus Disease of 2019 (COVID19) , a disease that can present with a variety of symptoms [1] . The most common symptoms at the onset of COVID-19 illness are fever, cough, and fatigue; in severe cases, patients may develop severe pneumonia, acute respiratory distress syndrome, and organ failure [4] . This article presents a review of the current literature on seizures linked with SARS-COV 2 infection and describes possible underlying mechanisms. describes the demographic data, time to onset of neurological symptoms, diagnostic criteria, intervention, and outcomes from 11 studies of seizures associated with SARS-COV-2 infection.
cord-272071-445ivhx0	2020	What we are seeing in the current publications on COVID-19 are different rates of invasive mechanical ventilation across the world that have always existed, but these differences are now writ large because it is a particularly high-stakes game of worldwide data interpretation and a desperation to learn as much as possible from the experiences of others. This variability in preferences is intertwined with resources and always will be a huge factor in understanding the data coming out of different countries; for example, in 2008, Gray and colleagues published a large randomized controlled trial comparing noninvasive ventilation to conventional oxygen therapy for patients with acute cardiogenic pulmonary edema. Similarly, information on care preferences, such as how many patients preferred not to receive mechanical ventilation (because of age, comorbidity, or other personal preference) would aid in interpreting data, such as when reporting that only 20.2% of those who died with COVID-19 received this intervention (12) .
cord-272112-egsha2j7	2020	The recently published Italian recommendations advise to evaluate case by case the possibility of postponing a treatment, considering the biological aspects of cancer, the clinical characteristics of the patient and the potential health risks for COVID-19 infection [9] . According to French guidelines, clinical management of cancer patients during the COVID-19 pandemic should be based on the following priority order: curative or non-curative intent of the treatment, age, life expectancy, time since diagnosis and symptoms [11] . TERAVOLT data confirmed a high mortality rate among patients with lung cancer who develop COVID-19; in both studies similar independent factors were associated with increased mortality, which included older age, number of comorbidities, poor performance status, active cancer and administration of chemotherapy alone or in combination with other treatments at the time of infection.
cord-272135-a09bf50o	2009	However, because the modes of infectious agent transmission are often underestimated, as was recently reported for infl uenza and SARS, 55 and because tuberculosis cannot be identifi ed without biological testing, EUNID recommends that droplet precaution should be upgraded to airborne precaution each time Situations in which a patient would need to be admitted to an HLIU • Patients with an unknown human-to-human transmittable or a potentially transmittable epidemic febrile illness that is native or imported from abroad • Patients with a known infectious disease caused by a group 3 or 4 agent* At admission of patients with HID to an emergency department • Systematically apply standard precautions and cough and respiratory etiquette • Set up at least one single room with a dedicated route and direct access, or an isolation room as recommended by EUNID for a referral hospital, † if HLIU cannot be used for ruling out HID diagnoses • Off er special training to the emergency department team • Retain close relationships with the HLIU team of the referral hospital 
cord-272143-6ej3eibd	2018	We have evaluated these infections in children with humoral immunodeficiencies who required immunoglobulin replacement therapy, considering their relationship with symptoms, lung function, bacterial co‐infection, and outcomes. CONCLUSIONS: In our experience, viral respiratory tract infections can cause significant respiratory symptoms and impaired lung function, in children with HID, despite immunoglobulin replacement therapy. Children with severe T-cell immunodeficiencies present impaired clearance of respiratory viruses, and pulmonary complications of viral infections are leading causes of morbidity and mortality in this group of patients. 1 However, the role of respiratory viruses in children with other types of primary immunodeficiency (PID), mainly those with humoral immunodeficiencies (HID) or diseases of immune dysregulation, has hardly been studied. 2, 7 We report, to the best of our knowledge, the first study that analyses respiratory viruses in pediatric patients with predominantly antibody deficiency who required IRT, considering their relationship with clinical symptoms and pulmonary function, bacterial co-infection, treatment and outcomes.
cord-272154-nrm9ulj5	2020	Under these circumstances, the Indian Society for Sleep Research (ISSR) created a task force to develop guidelines for the practice of sleep medicine, not only for the Indian environment but also for other countries that are affected by the COVID-19 pandemic. As sleep services resume operations, there is a need to find innovative ways to reduce contact with COVID-19 patients, follow personal protection guidelines, as well as social distancing. Indian Society for Sleep Research (ISSR) created a task force to develop guidelines for the practice of sleep medicine that are applicable not only to India but also to other countries that are affected by the COVID-19 pandemic. Various levels of sleep studies, telemedicine, and positive airway pressure (PAP) therapy are the major aspects, given emphasis by the task force group of ISSR in these guidelines.
cord-272318-8yfg1j0o	2020	To further characterize cerebrovascular disease (CVD) in COVID-19, we review the current literature of published cases and additionally report the clinical presentation, laboratory and diagnostic testing results of 12 cases with COVID-19 infection and concurrent CVD from two academic medical centers in Houston, TX, USA, between March 1 and May 10, 2020. To date, few studies have reported cerebrovascular complications in COVID-19 [3, 4] and 4 small case series have described the clinical and laboratory findings in patients with COVID-19 and concurrent stroke [5] [6] [7] [8] . We review the current literature of published cases and describe our experience of 12 cases with COVID-19 infection and concurrent cerebrovascular disease (CVD) to highlight the clinical presentation and proposed mechanisms of central nervous system (CNS) involvement by SARS-CoV-2. Additionally, we performed a retrospective chart review of all hospitalized cases with confirmed COVID-19 infection (SARS-CoV-2 RT-PCR positive) and CVD (ischemic and hemorrhagic stroke) between March 1 and May 10, 2020 seen at two comprehensive stroke centers in Houston, TX, USA.
cord-272419-y3ebt4jm	2020	Possible inhibition of SARS-CoV-2 3-chymotrisyn-like (3CL)-protease and papain-like protease Lopinavir is excreted in the gastrointestinal (GI) tract, and thus coronavirus-infected enterocytes might be exposed to higher concentrations of the drug LPV/r tab 200/50 mg: 2 tab BID LPV/r oral sol 80/20 mg: 5 mL BID DRV/cobi tab 800/150 mg: 1 tab QD Gastrointestinal: diarrhea, nausea, vomiting, increased amylase, lipase, total cholesterol and triglycerides (risk factor for pancreatitis) Hepatotoxicity: increasing in GGT, AST, ALT, total bilirubin, hepatitis Cardiological: QT-and PR-interval prolongation, hypertension, bradyarrhytmias; torsade de pointes have been reported in patients treated with LPV/r Metabolical: hyperglycemia and diabetes mellitus, increased uric acid Recently, a randomized, controlled, open-label trial comparing the efficacy of LPV/r versus standard of care was conducted in 199 hospitalized adult patients with severe COVID-19: no significant difference between the two groups neither in the time of clinical improvement (hazard ratio [HR] 1.31; 95% CI 0.95-1.80; p 0.09), nor in the 28-day mortality rate (19.2% versus 25.0%; 95% CI −17.3 to 5.7) was observed [40] .
cord-272427-jqs00ilp	2020	After admission during the COVID period, the waiting time before surgery was longer (PCG: 3[IQR: 2,5] vs. Based on our experiences during the pandemic period, we propose some surgical strategies for gastric cancer patients. We aimed to compare the differences in demographics, baseline characteristics, clinicopathological features, and health economics between the two groups to investigate the feasibility of gastric surgery during the pandemic of COVID-19. These data included patient demographics and baseline characteristics (sex, age, body mass index, comorbidity, clinical TNM classification, pathological TNM classification, hemoglobin, CEA, CA199, AFP, CA724), origin of patients (from local district or other provinces), operative method (open surgery or laparoscopic surgery), operating time, estimated blood loss, postoperative complications, postoperative fever, waiting time before admission, length of postoperative hospital stay, hospital costs etc. Length of postoperative hospital stay was defined as the period from the time when patient had undergone surgery to discharge. In conclusion, there are no studies on the impact of COVID-19 on gastric cancer patients.
cord-272553-bcmta2he	2020	METHODS: A retrospective study to review and compare clinical data including electronic medical records and laboratory tests from pregnant and nonpregnant patients admitted the Central Hospital of Wuhan, China from December 8, 2019 to April 1, 2020. Laboratory test results showed that levels of inflammation markers such as white blood cell count, neutrophil count and percentage, C‐reactive protein, procalcitonin, and D‐dimer were significantly higher in pregnant women, whereas mean lymphocyte percentage was significantly lower compared with nonpregnant women. Therefore, the aim of the present study was to investigate and report the clinical characteristics and laboratory test results of pregnant women with COVID-19 to strengthen the knowledge base. 6 The treatment strategy in the present study folThe clinical characteristics of pregnant patients extracted from medical records were gestational age; time interval between symptom onset and admission; time interval between hospitalization and delivery; delivery mode; length of hospital stay; initial symptoms (fever, cough, abdominal pain, blood-tinged mucus, ruptured membranes at term, chest tightness, asthma, fatigue, poor appetite, headache, nausea, and vomiting); and maternal comorbidities (gestational diabetes, gestational hypertension, intrahepatic cholestasis of pregnancy, premature rupture of membranes, and obesity).
cord-272585-346ef6qy	2020	title: Addressing a National Crisis: The Spine Hospital and Department''s Response to the COVID-19 Pandemic in New York City As peak infections spread across the United States, we hope this article will serve as a resource for other spine departments on how to manage patient care and healthcare worker deployment during the COVID-19 crisis. Our institution has been on the forefront of the COVID-19 pandemic, as we treated "patient zero" in New York City, who presented to our Emergency Department (ED) on February 28 th . Published data by healthcare providers in Asia and Europe demonstrated that the most substantial threat to COVID-19 patient morbidity and mortality was the lack of adequate critical care resources including intensive care unit (ICU) beds and respiratory support [8] [9] . It is vital to note that although redeployment was an important initiative to our department during this time of crisis, our primary concern was to maintain an adequate workforce to meet all orthopaedic surgical demands at our institution.
cord-272630-2na1gndu	2020	The Coronavirus Disease-2019 (COVID-19) pandemic has created an unprecedented economic and public health crisis in the United States. As healthcare system strain became imminent, the Centers for Medicare and Medicaid Services (CMS) 3 , the Surgeon General, and the American College of Surgeons (ACS) [4] recommended postponing elective procedures in efforts to mitigate the spread of disease and preserve personal protective equipment (PPE). [12] In addition, patients who may require office-based procedures should be screened and should be strongly considered to undergo COVID-19 testing prior to arrival, if possible ( Table 2 ). In-person examinations pose obvious risks of SARS-CoV2 (novel coronavirus) transmission among patients, family and friends of patients, and clinical staff. High-Risk Aerosol Generating Procedures in COVID-19: Respiratory Protective Equipment Considerations. Protecting patients and healthcare personnel from COVID-19: considerations for practice and outpatient care in cardiology How to train health personnel to protect themselves from SARS-CoV-2 (novel coronavirus) infection when caring for a patient or suspected case
cord-272655-qeojdpez	2015	OBJECTIVES: To identify the viral aetiology in adult patients with severe acute respiratory infection (SARI) admitted to sentinel surveillance institutions in Bogotá in 2012. DESIGN: A cross-sectional study was conducted in which microarray molecular techniques for viral identification were used on nasopharyngeal samples of adult patients submitted to the surveillance system, and further descriptions of clinical features and relevant clinical outcomes, such as mortality, need for critical care, use of mechanical ventilation and hospital stay, were obtained. Under this initiative, countries have developed surveillance systems by following cases of influenza-like illness and severe acute respiratory infections (SARIs), which are clinically diagnosed among patients with fever, coughing or sore throat, difficulty breathing and the need for hospitalization [3] . In our study, viruses were identified as the most frequent causal agents of SARI requiring hospitalization in 2012, with most cases showing a high rate of viral co-infection, a high degree of morbidity, prolonged hospital stays and frequent needs for ICU management and mechanical ventilation.
cord-272677-6t9kl3hq	2020	Conclusions: Fever and cough are the typical clinical features of NCP patients, and chest CT mainly manifested as multiple lesions in both lungs, often accompanied by GGO, vascular enlargement and cobblestone/reticular pattern.Changes in these main CT features can indicate development of the disease. Conclusions: Fever and cough are the typical clinical features of NCP patients, and chest CT mainly manifested as multiple lesions in both lungs, often accompanied by GGO, vascular enlargement and cobblestone/reticular pattern.Changes in these main CT features can indicate development of the disease Keywords: 2019-nCov; New coronavirus pneumonia; Chest CT; Ground glass opacification Based on the clinical observations and summary, the main diagnostic criteria [6] of 2019-nCov infections are : 1) Contact history of the epidemic area and related patients; 2) Nucleic acid is positive; 3) Fever, cough, shortness of breath and other clinical symptoms; 4) Laboratory examination showed that white blood cells were normal or decreased and lymphocytes decreased; 5) Lung lesions.
cord-272727-a5ngjuyz	2020	Specifically, we propose a comprehensive data-driven approach to understand the clinical characteristics of COVID-19, predict its mortality, forecast its evolution, and ultimately alleviate its impact. Each column reports 128 cohort-level statistics on demographics (e.g., average age, gen-129 der breakdown), comorbidities (e.g., prevalence of diabetes, 130 hypertension), symptoms (e.g., prevalence of fever, cough), 131 treatments (e.g., prevalence of antibiotics, intubation), lab 132 values (e.g., average lymphocyte count), and clinical outcomes 133 (e.g., average hospital length of stay, mortality rate). The models with lab values provide 309 algorithmic screening tools that can deliver COVID-19 risk 310 predictions using common clinical features. These findings 333 are also in agreement with clinical reports: an elevated CRP 334 generally indicates an early sign of infection and implies lung 335 lesions from COVID-19 (27), elevated levels of leukocytes 336 suggest cytokine release syndrome caused by SARS-CoV-2 337 virus (28), and lowered levels of serum calcium signal higher 338 rate of organ injury and septic shock (29) .
cord-272778-aixiioii	2020	We recorded demographic data including age and gender, the clinical data including underlying diseases, medical history, exposure history, symptoms, signs, laboratory findings, chest computed tomographic (CT) scans, and treatment measures (ie, antiviral therapy, corticosteroid therapy, respiratory support), Sequential Organ Failure Assessment (SOFA) score, MuLBSTA score, the Acute Physiology and Chronic Health Evaluation (APACHE) II, epidemiological, and outcomes data. For severely and non-severely ill patients, refer to Diagnosis and Treatment of Pneumonia caused by SARS-CoV-2 (version 7) [19] issued by of National Health Commission of the People''s Republic of China. Last, we took reference on Diagnosis and Treatment of Pneumonia Caused by SARS-CoV-2 (version 7) [19] issued by of National Health Commission of the People''s Republic of China, to define the severity of COVID-19, so its applicability may be limited. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study
cord-272975-gzsd4ybt	2020	Significance EEG abnormalities are common in COVID-19 related encephalopathy and correlates with disease severity, preexisting neurological conditions including epilepsy and prolonged EEG monitoring. [6] [7] [8] Individual studies stress a specific population demographic or peculiar aspect of the EEG, but together provide a mosaic of EEG findings in varied groups from children to elderly, and asymptomatic patients to those with severe encephalopathy and status epilepticus. Here, we perform a systematic study of the EEG findings in patients with COVID-19 to synthesize the available data and to elucidate common patterns. Of interest, frontal lobe findings were common and included focal slowing, Diffuse background slowing was the most common EEG finding reported in two-thirds (68.6%) of patients indicating that a diffuse non-specific encephalopathy was the most common brain abnormality in this condition. The earliest available report of neurological complication of SARS-COV infection was a patient with respiratory failure and seizures, although EEG was not performed.
cord-272976-pb2bjpop	2009	In a patient with acute respiratory illness (cough, sputum production, chest pain, and/or dyspnea), the need for chest imaging depends on the severity of illness, age of the patient, clinical history, physical and laboratory findings, and other risk factors. Chest radiographs seem warranted when one or more of the following are present: age ≥ 40; dementia; a positive physical examination; hemoptysis; associated abnormalities (leukocytosis, hypoxemia); or other risk factors, including coronary artery disease, congestive heart failure, or drug-induced acute respiratory failure. computed tomography (CT), depends on many factors, including the severity of the illness; the age of the patient; the presence of fever, leukocytosis, or hypoxemia; clinical history; the presence of other risk factors; and the results of physical examination. On the basis of these studies, chest radiography seems warranted in ARI when Ն1 of the following is present: age Ͼ40 years; dementia; positive results on physical examination; hemoptysis; associated abnormalities (leukocytosis, hypoxemia); or other risk factors, including coronary artery disease, congestive heart failure, or druginduced acute respiratory failure.
cord-273045-ele1cz86	2020	authors: Johnson, Claire D.; Green, Bart N.; Konarski-Hart, Karen K.; Hewitt, Elise G.; Napuli, Jason G.; Foshee, William K.; Brown, Jason W.; Kopansky-Giles, Deborah; Stuber, Kent J.; Lerede, Caterina; Charlton, Scott T.; Field, Jonathan R.; Botelho, Marcelo B.; Da Silva, Kendrah L.; Tønner, Gitte; Yap, Terrence BK.; Gkolfinopoulos, Vasileios S.; Quintero, Gabriel; Agaoglu, Mustafa H. 68 The Texas Board of Chiropractic Examiners issued guidelines on appropriateness of chiropractic care through April 30 that stated, "Licensees should only provide essential chiropractic services for patients with current or recurrent complaints of pain or disability which adversely affects the patient''s ability to engage in the essential activities of daily living or work, or adversely affects the patient''s quality of life, and with anticipation of material improvement under chiropractic care." 69 As of May 1, updated orders included that licensed chiropractors could provide wellness care but, "should continue to adhere to safety and prevention best practices specified in the most current advice from the Centers for Disease Control." 70 William Foshee.
cord-273090-fdzkfo1u	2020	In critically ill patients, the decrease of absolute value of CD4 + T cells and increase of IL-6 level are significantly correlated with the volume of lung lesions. There have been many reports that most of the 2019-nCoV patients have chest CT manifestations of pneumonia, typically showing bilateral ground-glass shadows and patchy shadows, and a few can also appear as consolidation shadows and interstitial lesions, the laboratory showed that the lymphocytes count in most patients decreased [6] [7] [8] [9] , with gradually worsened the disease, the lymphocytes absolute count continued to decline [9] , and has been There are reports in the literature that the proinflammatory cytokines IL-2, IL-6, IL-8, IL-10, and TNF-α are elevated in some 2019-nCoV patients [7] [8] . The purpose of this study is to investigate changes in lymphocytes counts and cytokines levels induced by 2019-nCoV and their effects on lung lesions, to determine the severity of the disease, and to select markers that could prompt early clinical intervention.
cord-273091-40gda9n9	2005	reviews studies that attempt to answer whether it is necessary to include antibiotics that are active against ''''atypical'''' pneumonia agents as part of the empiric therapy of CAP. Sobradillo and colleagues [55] performed a prospective randomized, double-blind study of doxycycline (Doryx) and erythromycin in the treatment of 48 patients who had Q fever pneumonia. Pneumonia requiring hospitalization: data from large retrospective studies and from observational studies Oosterheert and colleagues [68] performed a systematic review to determine the evidence for the current recommendations for the empiric antimicrobial therapy of patients hospitalized with CAP. There are no data from proper studies to answer whether it is necessary to include antibiotics that are active against atypical pneumonia agents as part of the empiric therapy of CAP. There are no data from proper studies to answer whether it is necessary to include antibiotics that are active against atypical pneumonia agents as part of the empiric therapy of CAP.
cord-273119-jfy0iviy	2020	In UK radiotherapy departments, radiation therapist (review radiographer)-led clinics moved to telephone-based clinics to reduce the time spent by patients in a hospital environment. The pandemic has forced patients to slow down and really focus on themselves which has led to picking up physical and mental health changes earlier. As a radiation therapist (therapeutic radiographer) and member of the radiotherapy review team, I see patients throughout their radiotherapy treatments to address their physical and emotional side effects. Those of us in the radiotherapy review team have changed to telephone appointments to minimize time spent by patients in a hospital environment. Telephone reviews aren''t a new process within healthcare (4); oncology teams use telephone triage when patients report treatment related side effects. In my opinion, radiotherapy reviews are more in depth than triage calls as they cover all aspects of a patient''s care and side effects to help them live with and beyond cancer.
cord-273175-bao8xxe2	2020	It assessed participants'' perception of their risk of severe illness with COVID-19; their context (i.e., work, household, contacts with external people); and their attitudes in situations involving frequent or occasional contacts with symptomatic or asymptomatic people. Results of the survey were described globally and for the subgroup of patients considered at high risk of a severe illness according to the French High Council for Public Health (Box 1). Among patients at high risk of a severe illness according to the French High Council for Public Health, 5% continued working, 15% had a household member working outside of the home and 7% reported regular contacts with people outside of their home. The only variable found associated with use of face masks with asymptomatic people (or refusal to see these people) was patients'' perception of high risk of severe infection by COVID-19 (odds ratio 1.93, 95% confidence interval 1.53-2.43).
cord-273283-gb0m6fue	2020	While the SOFA score is also predictive of mortality for COVID-19, it does not address the additional thrombotic mitigators of severe illness 11 www.nature.com/scientificreports/ development of disseminated intravascular coagulation (DIC), and now being used to help guide the use of anticoagulation for patients with COVID-19 [12] [13] [14] . This study is an observational cohort study validating a novel, simple COVID-19 in-hospital mortality score to predict inpatient mortality risk in 4711 patients with confirmed SARS-CoV-2 infection using a combination of presentation vital signs, and basic admission laboratory values. A ROC curve analysis was performed in the derivation cohort (Fig. 1) , the novel COVID-19 severity score achieved an AUC of 0.824 (95% CI 0.814-0.851) indicating a good discrimination for patients with higher risk www.nature.com/scientificreports/ www.nature.com/scientificreports/ of in-hospital mortality.
cord-273317-2e3vmdx4	2020	OBJECTIVE: To study the central nervous system (CNS) complications in patients with COVID-19 infection especially among Native American population in the current pandemic of severe acute respiratory syndrome virus (COVID-19). METHODS: Patients with confirmed COVID-19 infection at University of New Mexico hospital (UNMH) were screened for development of neurological complications during Feb 01 to April 29, 2020 via retrospective chart review. Out of seven patients, majority were Native Americans females, and developed neurological complications including subarachnoid hemorrhage (SAH), Intraparenchymal hemorrhage (IPH), Ischemic stroke (IS) and seizure. CONCLUSION: Patients with serious CNS complications secondary to COVID-19 infection were observed to be Native Americans. 4 We share a case series of seven patients, all except one of whom, were Native Americans (NA), and experienced CNS complications during the admission of COVID-19. Patients diagnosed with COVID-19 via reverse transcriptase-polymerase chain reaction (RT-PCR) from nasal swab were screened for development of neurological complications (ischemic stroke, intracerebral hemorrhage, sub-arachnoid hemorrhage, seizure, and encephalitis).
cord-273408-jtpaue0z	2020	Patient: Male, 84-year-old Final Diagnosis: Acute bronchitis • chronic multiple pain with spondylosis with radiculopathy: lumbar region • chronic renal failure CKD 4 • derailed type 2 diabetes mellitus • diabetes mellitus type 2 • eart failure • hyperuricaemia • progressive aortic stenosis • pulmonary hypertension • SARS-CoV2 Symptoms: Appetite loss • fever • pain • sore throat Medication: — Clinical Procedure: — Specialty: General and Internal Medicine OBJECTIVE: Unusual clinical course BACKGROUND: When treating patients with comorbidities who are infected with severe acute respiratory syndrome as a result of SARS-CoV-2, it is crucial to offer multidisciplinary treatment that takes into consideration all of the health conditions with which they have been diagnosed. We collected clinical and patient-reported data on quality of life, physical functions, the sensation of pain, psychological well-being, and symptoms while taking into account the degree of chronicity of the conditions, the level of the patient''s pain, and his hospitalization in an isolation ward.
cord-273426-55vu6b3u	2020	Conclusions: Severe acute respiratory syndrome coronavirus 2/ coronavirus disease 2019 frequently induces hypercoagulability with both microangiopathy and local thrombus formation, and a systemic coagulation defect that leads to large vessel thrombosis and major thromboembolic complications, including pulmonary embolism in critically ill hospitalized patients. Conclusions: Severe acute respiratory syndrome coronavirus 2/ coronavirus disease 2019 frequently induces hypercoagulability with both microangiopathy and local thrombus formation, and a systemic coagulation defect that leads to large vessel thrombosis and major thromboembolic complications, including pulmonary embolism in critically ill hospitalized patients. (Crit Care Med 2020; XX:00-00) Key Words: coagulopathy; coronavirus; coronavirus disease 2019; disseminated intravascular coagulation; hypercoagulability; thromboembolism I ncreasing communications worldwide have reported that hospitalized, critically ill coronavirus disease 2019 (COVID-19) patients are frequently developing laboratory abnormalities compatible with hypercoagulability and clinically a high prevalence of thromboembolic events (1).
cord-273567-8fp3a9h8	2020	Methods: Semi-structured telephone interviews were performed with 99 patients with Parkinson''s disease (PD) and 21 controls to explore knowledge, attitudes, practices, and burden in order to elucidate nonadherence to preventive measures. Since then, local and national governments have taken unprecedented measures in response to the outbreak of SARS-CoV-2-induced coronavirus disease in 2019 (COVID-19), including quarantining infected individuals and their family members, canceling public transportation, exit controls, travel restrictions, contact restrictions, curfews, school closures, and requiring people to wear mouth and nose masks [4, 5] . The semi-structured questionnaire consisted of 22 questions to assess the patient''s current situation and adherence to the ongoing regulations, with four of these questions examining the patient''s knowledge of preventive measures (questions 4, 5, 6, and 7), three capturing their attitude toward the virus (questions 8, 9, and 16) , and six exploring practices and behavioral changes regarding COVID-19 (questions 10, 11, 12, 13, 14, and 15 ).
cord-273587-nja58vxw	2020	By profiling mild and severe COVID-19 patients and healthy donors with flow cytometry, we demonstrate that SARS-CoV-2 is associated with broad dysregulation of the circulating immune system, characterized by the relative loss of lymphoid cells coupled to expansion of myeloid cells. While we observed no significant differences in the relative abundance of KIR receptors among COVID-19 patients with mild disease and healthy controls (Figure 3f) , a significantly higher proportion of cells expressed CD158i (NKG2A) in severe patients compared with mild or convalescent individuals. Despite the backdrop of a relative decrease in B cell numbers as disease progresses, we observed only a mild, non-significant increase in plasmacytoid cells in patients with severe COVID-19 compared with healthy donors (Figure 4a) . The resulting network of significant effects identified several clinical factors associated with specific immune cell populations, highlighting how age, sex, and disease severity jointly influence the circulating immune systems in patients with COVID-19 (Figure 6a) .
cord-273602-cq276tj8	2020	Randomized trials are urgently needed to investigate treatment modalities to reduce the incidence and mortality associated with COVID-19 related acute myocardial injury. In this concise review, we will focus on acute myocardial injury in COVID-19 infection, its prevalence, plausible pathophysiologic mechanisms, guidance on the use of cardiac biomarkers, and general management strategies. In a prospective cohort study by Du et al(11) of 179 patients with COVID-19 pneumonia, troponin I ≥0.05 ng/mL was independently associated with mortality in addition to age ≥65 years, pre-existing cardiovascular (CV) or cerebrovascular diseases and CD3+CD8+ Tcells ≤75 cells/μL. Epidemiological studies and randomized trials are urgently needed to investigate treatment modalities regulating immune function and inhibiting inflammatory responses to reduce the incidence and mortality associated with COVID-19 related acute myocardial injury. Association of Coronavirus Disease 2019 (COVID-19) With Myocardial Injury and Mortality
cord-273614-qmp2tqtb	2020	However, multiple studies that highlight the clinical features, laboratory findings, and prognosis of acute myocardial injury (AMI) in COVID-19-affected individuals have been published. The study concluded that severe respiratory illness with 2019n-CoV infection with deteriorating complications was associated with ICU admission and a higher mortality rate [24] . This study concluded that patients with very severe COVID-19 have a higher percentage of increased cTnI levels and their mortality rate can be improved by protecting them from myocardial injury [40] . The study concluded that cardiac injury is a prevalent condition among hospitalized patients with COVID-19 in Wuhan, China, and it is associated with a higher risk of in-hospital mortality [41] . Clinical characteristics of fatal and recovered cases of coronavirus disease 2019 (COVID-19) in Wuhan, China: a retrospective study (Epub ahead of print) Association of cardiac injury with mortality in hospitalized patients with COVID-19 in Wuhan, China (Epub ahead of print)
cord-273641-8l57mnjt	2020	A narrow diagnostic approach where only febrile patients with pulmonary symptoms are evaluated for a COVID-19 diagnosis will result in many missed diagnoses; so it is important that physicians are familiar with atypical and rare presentations of COVID-19, such as isolated thrombocytopenia. The emerging disease caused by a novel coronavirus with a high transmission rate, predominantly pulmonary symptoms and a reported mortality rate ranging between 2.0-4.4% has become a global pandemic [1, 7, 8] , and the infection can cause systemic involvement including respiratory, neurological and hematopoietic complications [3, 4] . In another study which observed the hematologic impacts of COVID-19, 20 % of patients showed abnormalities that included mild thrombocytopenia as severe as it has been reported in other viral infections such as dengue fever [14] . Severe thrombocytopenia has been reported in one case of COVID-19 that was associated with pulmonary symptoms as well as neurological complications [15] .
cord-273695-p5p7kvpp	2020	title: Prevalence, Characteristics, Risk Factors, and Outcomes of Invasively Ventilated COVID-19 Patients with Acute Kidney Injury and Renal Replacement Therapy BACKGROUND: There is no information on acute kidney injury (AKI) and continuous renal replacement therapy (CRRT) among invasively ventilated coronavirus disease 2019 (COVID-19) patients in Western healthcare systems. OBJECTIVE: To study the prevalence, characteristics, risk factors and outcome of AKI and CRRT among invasively ventilated COVID-19 patients. The present study aimed to assess the prevalence, patient characteristics clinical outcomes, and predictors of AKI and need of RRT in patients with COVID-19 receiving mechanical ventilation in the intensive care unit (ICU). This is the first report on the prevalence, patient characteristics, risk factors for, and outcome of AKI among COVID-19 patients receiving invasive ventilation in the ICU of a large tertiary hospital in a Western healthcare system.
cord-273758-hhd8xnve	2020	Nonetheless, it remains controversial whether diabetes could be considered an independent risk factor for greater severity of illness and death, with some studies showing a detrimental effect [5] [6] [7] and others a neutral influence [8] [9] [10] , also depending on adjustment for confounding variables. As expected, patients who experienced in-hospital death were older (78 vs 68 years, p < 0.001) and had a higher prevalence of most comorbidities including CVD (46.4% vs 32.5%, p = 0.007) and hypertension (78.1 vs 56.8%, p < 0.001), whereas only a trend was found for diabetes (23.2 vs 15.6%, p = 0.064) and no significant differences were found in gender distribution. In the present study we show that among patients hospitalized for COVID-19 in a single center in Northern Italy, a history of diabetes was associated with an increased mortality risk, which was independent from several confounding factors and comorbidities.
cord-273869-buavj9mm	2020	title: Acral lesions in a pediatric population during the COVID-19 pandemic: a case series of 36 patients from a single hospital in Spain METHODS: A retrospective descriptive study was performed collecting data on 36 patients under 14 years old, presenting suspicious acral skin manifestations for coronavirus disease 2019 (COVID-19). The management of patients presenting chilblain-like lesions and acral purpuric macules is not well established. Varicella-like exanthem as a specific COVID-19-associated skin manifestation: multicenter case series of 22 patients COVID-19) infection-induced chilblains: a case report with histopathological findings Chilblain and acral purpuric lesions in Spain during covid confinement: retrospective analysis of 12 cases Chilblain-like lesions during COVID-19 epidemic: a preliminary study on 63 patients Chilblains-like lesions in children following suspected COVID-19 infection Assessment of acute acral lesions in a case series of children and adolescents during the COVID-19 pandemic
cord-273875-vpp0l6ij	2020	title: Creating a ''safe haven'' for the most vulnerable; Early Reports of Management Strategies for Breast Cancer Patients in the UK during the COVID -19 Pandemic times Standard cancer surgical and chemotherapy treatment requiring hospitalization or daily visit had to be suspended to reduce at the minimum the exposure of these vulnerable patients to the possible infection [2] . This thus creates a conundrum in the management of this cohort of patient in the COVID-19 era, as one must aim to prevent compromise to the standard of care while sensibly employing strategies to mitigate the acquisition of the COVID-19 virus in this highly vulnerable group. Our facility''s reorganization strategies involved creating a "COVID-19 free" centre by employing rigorous screening protocols of all patients undergoing surgery as well as development of virtual teams [5] . The establishment of a COVID-19 free environment has allowed for the maintenance of the high standard of care in breast cancer patients, a highly vulnerable group [1] .
cord-273913-xem3alih	2020	In this review, we discuss these various cutaneous manifestations and skin problems related to personal protective equipment, as well as different cutaneous anti-COVID-19 drug-associated reactions. e first case infected by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) was reported in Wuhan, China, in late November 2019. ese skin lesions can guide clinicians for diagnosis if the patients present other COVID-19 symptoms; however, viral infection cannot be the only cause; mediated inflammatory responses and drug reactions can also be suspected. e aim of our literature review is to report the various cutaneous manifestations described to date associated with COVID-19, the skin problems related to personal protective equipment, and the different cutaneous anti-COVID-19 drug reactions [6, 7] . e frequency of the skin lesions associated with COVID-19 infection varies according to the series; in a Chinese study of 1099 positive cases, the incidence was only 0.2%, while in an Italian series of 88 patients it was 20.4% [42] .
cord-273929-kpcmy9x8	2020	With a fragile future, how do we conduct our day-to-day activities, and plan to retain our robust education and training programs, to educate and train the next generation of head and neck surgeons? 1 The drastic changes that have affected our work and life during the past 2 months have taught us that remote communications, education, teaching, learning and training are possible and have to be incorporated in our current systems. The IFHNOS has taken a lead on developing the first remote learning online fellowship program in head and neck surgery and oncology, which has been in existence for the past 6 years. In head and neck surgery, the stringent follow-up schedule was designed on the basis that nearly 80% of the patients who were to recur, would have recurred in the first 24 months, with a median time to recurrence of 9 months. The impact of COVID-19 on Head and Neck surgery, education, and training
cord-273945-b1lekw47	2020	title: Comment on ''Reorganisation of medical oncology departments during the novel coronavirus disease-19 pandemic: a nationwide Italian survey" by Alice Indini et al. Comment on ''Reorganisation of medical oncology departments during the novel coronavirus disease-19 pandemic: a nationwide Italian survey" by Alice Indini et al. In this scenario a multidisciplinary approach is useful because it permits a more accurate identification of SRE risk , avoiding unnecessary medical visits, orienting patients towards the right procedure/treatment, reducing contact with healthcare operators and consequently lowering the risk of COVID-19 contamination even if the multidisciplinary meeting seems to be contraindicated. However, in the present COVID-19 emergency greater emphasis is needed on risk assessment, prevention strategies and effective therapies in order to optimise oncologic resources and to guarantee the patients'' continuum of care. We believe our experience could provide a feasible model of care to manage BM patient and at the same time prevent and reduce COVID-19 infection.
cord-273996-z5vlw6nm	2020	The aims of the study were to investigate continuous glucose monitoring (CGM) metrics in children and adults with T1D during lockdown and to identify their potentially related factors. In adults, considering the changes in SDglu and TIR occurred before and during lockdown, we identified a group with improved TIR and SDglu who performed more physical activity, one with improved glucose variability who was younger than the other patients, and one with worsened glucose variability who showed higher perceived stress than others. ► Time in range and SD of glucose measured by CGM improved in adult patients with type 1 diabetes during lockdown due to the COVID-19 pandemic. To perform unsupervised clustering, we did not consider %CV among parameters of glycemic variability because it was not significantly different between the time periods before and during lockdown neither in the whole groups of patients nor in the three groups divided by age-range (children, teenagers, and adults), according to paired-samples comparison.
cord-274008-p3st70u3	2020	Here we report the outcome of a longitudinal immune profiling study in hospitalised patients during the peak of the COVID-19 pandemic in the UK and show the relationship between immune responses and severity of the clinical presentation. Although, as reported previously 4 , a higher neutrophil to lymphocyte ratio (NLR) on hospital admission was observed in those patients whose disease trajectory was ultimately severe, whereas there were no appreciable differences observed in monocytes (figure 1A, 1B and table 1). Longitudinal analysis revealed that in the majority of patients (70%) (irrespective of severity) T cell frequencies in whole blood increased prior to hospital discharge, while neutrophil frequencies reciprocally decreased (figure 1E). Severe COVID-19, on the other hand, was associated with monocytes displaying increased expression of the cell cycle marker, Ki67 (normally <5% in healthy peripheral blood), irrespective of whether monocytes were stimulated or not (figure 3C and appendix 6C), which strongly correlated with hospital data for CRP (figure 3C).
cord-274121-3w6kc0c9	2020	Objectives To prospectively investigate in patients with severe coVid-19-associated cytokine storm syndrome (css) whether an intensive course of glucocorticoids with or without tocilizumab accelerates clinical improvement, reduces mortality and prevents invasive mechanical ventilation, in comparison with a historic control group of patients who received supportive care only. Objectives To prospectively investigate in patients with severe coVid-19-associated cytokine storm syndrome (css) whether an intensive course of glucocorticoids with or without tocilizumab accelerates clinical improvement, reduces mortality and prevents invasive mechanical ventilation, in comparison with a historic control group of patients who received supportive care only. ► A strategy involving a course of high-dose glucocorticoids, followed by tocilizumab if needed, has shown to accelerate respiratory recovery, lower hospital mortality and reduce the likelihood of invasive mechanical ventilation compared with supportive care only in COVID-19-associated CSS.
cord-274184-hm516x6p	2020	From the abovementioned reasons we must deduce that: -in high SARS-CoV-2 incidence areas where PCR assays are not extensively performed, Covid-19 cannot be ruled out by simple clinical examination or epidemiological link; -the greatest amount of efforts and precautions are required to minimize the spread of the disease and to preserve medical staff from infection. In our current situation, which is characterized by high incidence of Covid-19 and relative scarcity of surveillance assays in asymptomatic subjects, for the abovementioned reasons we recommend different modalities of individual protection based on a strict clinical and epidemiological stratification of patients with potential SARS-CoV-2 infection undergoing endoscopic examination. In this setting, regardless of the classification of patients (high/low-risk, , in order to prevent the medical staff from becoming infected, we suggest high-performance personal protection equipment, i.e. a N95 or FFP2/FFP3 respirator, a hairnet, a double pair of gloves, a disposable waterproof surgical gown, a face shield (which we prefer because it allows to protect, and then spare, respirators) or goggles, and work safety clogs (Table 1) .
cord-274199-3stjueja	2020	Our aim was to assess whether the difference in the number of OHCAs between 2020 and 2019 was statistically correlated with the COVID-19 epidemic trend and to look for clinical pre-hospital elements supporting this evidence. All the Emergency Medical System (EMS) electronic records have been reanalysed and the number of patients with suspected COVID-19 (fever for at least 3 days before OHCA associated with cough and/or dyspnoea) or with a diagnostic pharyngeal swab (performed before OHCA or after death) have been computed. We highlighted an increase in medical aetiology over other types of aetiologies, and this further reinforces the hypothesis that the increase in the incidence of OHCAs is probably related to the direct (i.e. respiratory failure at home, SCD due to SARS-CoV-2 myocardial involvement or treatment) or indirect (i.e. lack of EMS activation in the case of time-dependent pathologies) effect of the COVID-19 epidemic.
cord-274245-pgfqkwqg	2020	title: Cardiopulmonary Ultrasonography for Severe Coronavirus Disease 2019 Patients in Prone Position Upon arrival to the emergency room, the patient was noted to be severely hypoxaemic by pulse oximetry (66%) and in impeding respiratory failure, so she was emergently intubated for mechanical ventilatory support. The patient''s chest X-ray at the time of admission showed diffuse bilateral pulmonary opacities consistent with multifocal pneumonia or pulmonary oedema ( Figure 1 ). Polymerase chain reaction (PCR) testing for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was sent and came back positive after 48 hours. The patient was diagnosed with severe acute respiratory distress syndrome (ARDS), so was treated with inhaled pulmonary vasodilators, neuromuscular blockade and prone-position ventilation. Forty-eight hours after initial presentation, the patient''s PCR testing for SARS-CoV-2 returned positive, confirming the diagnosis of COVID-19. Critical care ultrasonography in acute respiratory failure
cord-274250-95yzt1gj	2020	The major clinical feature of severe COVID-19 requiring ventilation is acute respiratory distress syndrome (ARDS) with multi-functional failure as a result of a cytokine storm with increased serum levels of cytokines. The kinetics and allosteric regulation of Hb nitrosylation by oxygen and pH are consistent with the physiologic mechanisms that modulate tissue blood flow, namely acidosis and hypoxemia and tissue hypoxia leads to NO generation by the RBC via SNO-protein transfer of NO activity [12] . To examine the hypothesis that NO is important in regulating vasodilation during hypoxia in these subjects we studied intracellular levels of NO in COVID-19 patients. In our study, intracellular RBC NO of COVID-19 patients is significantly higher than in healthy controls and this may enable the release of oxygen to tissues resulting in the clinical manifestation of silent hypoxia in these patients.
cord-274282-hvx5m2bx	2020	This study showed that clinical features and prognosis of the disease vary among patients of different ages and a thorough assessment of age may help clinicians worldwide to establish risk stratification for all COVID-19 patients. However, the ages related clinical characteristics, diseases courses and outcomes other than death in COVID-19 patients remain unclear. A unified observation endpoint date was set (March 7, 2020) in our study, primary outcome of the disease course and second outcome of respiratory failure rate for all COVID-19 patients in both groups were compared. In this study, we demonstrated that the clinical characteristics and outcomes of 221 COVID-19 patients were closely related to the different ages. In conclusion, the clinical features and prognosis of the disease vary among patients of different ages and a thorough assessment of age may help clinicians worldwide to establish risk stratification for all COVID-19 patients. Clinical Characteristics of 138 Hospitalized Patients With 2019 Novel Coronavirus-Infected Pneumonia in Wuhan, China
cord-274324-obhrbxu4	2020	Our systematic review and meta-analysis of 14 published articles involving 4659 patients is the first to provide a comprehensive analysis of the demographic features, comorbidities, and laboratory abnormalities that are associated with mortality in COVID-19. In this meta-analysis, we found that baseline cardiometabolic disease and evidence of increased acute inflammation and end-organ damage (cardiac, renal, liver and hematologic) on admission were associated with increased risk of mortality due to COVID-19 infection. Prevalence of Underlying Diseases in Hospitalized Patients with COVID-19: a Systematic Review and Meta-Analysis Clinical characteristics of coronavirus disease 2019 (COVID-19) in China: A systematic review and meta-analysis Prevalence of comorbidities in the novel Wuhan coronavirus (COVID-19) infection: a systematic review and meta-analysis Arterial hypertension and risk of death in patients with COVID-19 infection: systematic review and meta-analysis Association of Renin-Angiotensin System Inhibitors With Severity or Risk of Death in Patients With Hypertension Hospitalized for Coronavirus Disease 2019 (COVID-19) Infection in Wuhan, China
cord-274331-0i2opmcn	2020	Given mild symptoms, the patient was discharged. The patient was discharged 1 week later on home quarantine. The patient in this manuscript has given informed consent to publication of his case details. In our case, the patient recovered from COVID-19 before his next scheduled risankizumab dose. However, more data needs to be obtained about biologics in COVID-19 patients, in particular whether or not biologic dosage timeline should be adjusted based on resolution of infection. A database to collect information on COVID-19 patients on biologic therapy and their outcomes would be instrumental to guide clinicians on best practices for now and in future pandemics. In conclusion, this case illustrates that IL-23 inhibition via biologic therapy in COVID-19 may not correlate with severe respiratory disease. TH17 responses in cytokine storm of COVID-19: an emerging target of JAK2 inhibitor Fedratinib SARS-CoV-2 infection in a psoriatic patient treated with IL-23 inhibitor
cord-274355-6hiutrct	2020	This study investigates the transport mechanism and deposition patterns of Middle East Respiratory Syndrome Coronavirus (MERS-CoV) within a typical six bedded general inpatient ward cubicle through numerical simulation. Although it is widely assumed that increasing the air change rate (ACH) can reduce infection risks, it was shown that the risk of exposure to pathogens could increase with an increased ventilation rate under certain circumstances BUILD SIMUL https://doi.org/10.1007/s12273-020-0623-4 Satheesan et al. As the number of research studies on ventilation systems for general inpatient wards with respect to air change rate and exhaust airflow rate is limited, this study evaluates the combined impacts of these two parameters on the airflow as well as infection risk distributions of droplet nuclei of size 0.167 μm (i.e. MERS-CoV) within an air-conditioned general inpatient ward cubicle. Furthermore, the randomness associated with particle deposition rates (r w , r c , and r f ) under different air change rate conditions can be attributed to the asymmetric airflow distribution patterns and locations of the infected patients.
cord-274481-k1dp1ilv	2020	Summary of the evidence: the systematic review identified three comparative clinical trials with available data on the effects of hydroxychloroquine (HCQ) in COVID-19 patients: two open randomized clinical trials (29, 30) in a patient population with mild to moderate disease, and one cohort study. Recommendation 2 -we suggest against the routine use the hydroxychloroquine or chloroquine plus azithromycin combination for treatment of COVID-19 patients (weak recommendation; Level of Evidence very low). Recommendation 4 -We suggest the use of empirical oseltamivir treatment in patients with Severe Acute Respiratory Syndrome (SARS) or flu-like syndrome with risk factors for complications when a diagnosis of influenza cannot be ruled out (weak recommendation; Level of Evidence very low). Summary of the evidence -two randomized clinical trials assessed the use of lopinavir/ritonavir in COVID-19 patients.
cord-274494-heu6rmbt	2020	10 11 Since timely obtaining methodologically rigorous data on the prevalence of severe SARS-CoV-2 infection in our patients under different therapies is challenging at this moment, 8 we have performed an exploratory analysis of the relative prevalence of hospital-diagnosed COVID-19 in large multicentric cohorts of rheumatic patients under follow-up. All aggregated groups of patients with AI/IMID showed higher rates of COVID-19, and analyses of the different groups confirmed increased prevalence in all diagnostic groups but SLE, where it was remarkably lower than those in the other groups and similar to that in the reference population (table 1 and figure 1 ). Our systematic approach identified a significant number of patients with different rheumatic conditions and immunomodulatory therapies with SARS-CoV-2 PCR-confirmed diagnosis that allowed us to describe the prevalence of hospital COVID-19 and to identify differences between diagnostic and therapeutic groups.
cord-274542-fpzk5k79	2020	UFH should be limited to patients with CrCl < 30 mL/min An invasive "catheter"-based therapy for PE is indicated in selected cases with contraindication to anticoagulant drugs, recurrent events despite adequate anticoagulation, or when systemic fibrinolysis cannot be performed For the risk stratification of patients with VTE, monitoring of the following parameters is useful: troponin, BNP, D-dimer, blood cell count, fibrinogen, prothrombin time, activated partial thromboplastin time, and degradation products of fibrin After the initial approach, DOACs may represent an option for in-hospital treatment of a VTE episode in patients with clinical stability and decreasing inflammation After a VTE episode, DOACs should represent the therapy of choice at discharge The use of imaging techniques in diagnosing a VTE episode is complex, because of the risk of viral transmission to other patients and to healthcare workers, and must be regulated by specific in-hospital protocols aimed at limiting such risk.
cord-274556-531jlpwr	2020	key: cord-274556-531jlpwr title: Impact of COVID-19 on Peripheral Arterial Disease Treatment With the conditions of PAD patients getting more serious when they come to the hospital, it is necessary to choose appropriate treatment to control perioperative complications and mortality. Prior to this, it is more important for patients to maintain the medical treatment of PAD [3] . Also, continuity of follow-up is key [4] , it is necessary to evaluate the patient''s condition through telephone and phone application (obtain pictures of the patient''s ischemia limb), and urge them to go to hospital in time when the condition worsens. Finally, on the basis of controlling the covid-19 pandemic, daily medical activities should be resumed as soon as possible to provide reasonable treatment for more patients with PAD. Global Vascular Guidelines on the Management of Chronic Limb-Threatening Ischemia Thinking beyond the box: preparing for the end of COVID-19 outbreak in a vascular surgery department
cord-274557-2071770h	2015	i.e., cold-ethanol or ion-exchange chromatography, contaminants, route of application, i.e., intra muscular (IMIG), intravenous (IVIG), or subcutaneous (SCIG), the rate of increase of the exogenous IgG in the circulation of the recipient over time and, last but not least an eventually existing risk factor from patients'' side ( Figure 1 ) as well as incorrect handling of the concentrate are factors having a role in inducing non-infectious AEs related to administration of IgG concentrates ( Table 1) . The complement-mediated AEs were considered to be caused by aggregates in the product ("spontaneous complement activation" or anti-complementary activity or ACA) or by in vivo formation of immune complexes (ICs, patient''s condition related; e.g., subclinical infections or the unnoticed presence of anti-IgA antibodies) and therefore only IgG concentrates with low or absent ACA is accepted by authorities for human use.
cord-274563-jimw6skv	2020	During the COVID-19 (Corona Virus Disease 2019) pandemic lockdown, patients with LSDs on enzyme replacement therapy (ERT) missed their scheduled access to the Day Hospital to get their treatment. Methods: Based on the feeling that our patients were experiencing profound distress, we designed a structured telephone interview with the aim to evaluate how, and to which extent, the pandemic outbreak was changing their behavior and feelings about their chronic disease, the impact on therapies, and future expectations. Moreover, a striking similarity emerged between the groups regarding forced home reclusion and the profound feeling to be excluded by normal life, well-known to those affected by a chronic rare disease. Based on the feeling that our patients were experiencing profound distress, we designed a structured interview [3, 4] with the aim to evaluate how, and to which extent, the COVID-19 pandemic was changing our patients'' behavior and feelings about their chronic disease, the impact on therapies, and their future expectations.
cord-274632-d9z0m2l8	2020	Transplant patients are particularly at a higher risk of contracting COVID-19 because of their immunosuppressed state, and they have the propensity to develop opportunistic infections [1] . Transplant patients are particularly at a higher risk of contracting COVID-19 because of their immunosuppressed state, and they have the propensity to develop opportunistic infections [1] . Here, we describe a case of a renal transplant patient who developed COVID-19 and, unfortunately, died from the infection despite all medical management. The illness from COVID-19 in renal transplant recipients ranged from mild to severe, and few patients presented with atypical symptoms [1, 3] . Transplant patients constitute a population more vulnerable to develop COVID-19 because of their immunosuppressed state and higher risk for opportunistic infections. Case report of COVID-19 in a kidney transplant recipient: does immunosuppression alter the clinical presentation? Threatening drug-drug interaction in a kidney transplant patient with coronavirus disease 2019 (COVID-19)
cord-274666-0d8oz51l	2020	Conclusions: This study showed that LDH could be identified as a powerful predictive factor for early recognition of lung injury and severe COVID-19 cases. To assess the risk factors of the demographics, characteristics, and laboratory indicators on the severity of COVID-19 patients, logistic regression analysis was performed on the parameters of significant difference using t test. Apart from the risk factors above, patient age, white blood cell count, neutrophil count, serum AST, ALT, LDH, Urea, CRP, and D-dimer level were all associated with the severity of COVID-19 patients. As a result, serum lymphocytes (OR:0.2, 95% CI:0.04-0.96, P < 0.05), CRP (OR:1.026, 95% CI:1.006-1.046, P < 0.05), and LDH (OR:1.009, 95% CI:1.002-1.016, P < 0.05) were found to be independent risk factors for the severity of COVID-19 patients ( Table 3) . And importantly, lymphocytes, especially CD3 + , CD4 + , and CD8 + T cells in the peripheral blood of COVID-19 patients, which was relevant with serum LDH, were also dynamically correlated with the severity of the disease.
cord-274779-0emfl1e5	2020	Coronavirus disease 2019 has created unprecedented challenges for amyotrophic lateral sclerosis (ALS) clinical care and research in the United States. Most of the 133 sites surveyed between April 21, 2020 and May 1, 2020 are affiliated with academic medical centers in the United States, have multidisciplinary care teams, see large numbers of patients, and participate in a variety of ALS research studies, including clinical trials. The most commonly used measure of ALS progression in clinics and in trials, the Amyotrophic Lateral Sclerosis Functional Rating Scale-Revised (ALSFRS-R), can be obtained reliably and easily over the phone or by telemedicine. The COVID-19 pandemic has created an unprecedented challenges to ALS clinical care and research. Our combined experiences of clinician-patient interactions during this pandemic will provide us with new paradigms that will likely improve the efficiency of clinical care and availability of research participation.
cord-274782-yymo9i6r	2020	At first glance, the coronavirus disease 2019 (COVID‐19) pandemic and orthopedics may seem to be unrelated disciplines, but the provision of healthcare services to patients who require them proves that these two fields are parts of the same whole. The main purpose of this article is to discuss how orthopedic oncology clinics should be organized during the pandemic and to present the process management scheme for patients requiring orthopedic surgery, including trauma surgery, from diagnosis to treatment, together with our experiences. The main purpose of this article is to discuss how orthopedic oncology clinics should be organized during the pandemic and to present the process management scheme for patients requiring orthopedic surgery, including trauma surgery, from diagnosis to treatment, together with our experiences. We obtained data from the hospital information system regarding all oncologic orthopedics and trauma surgery patients operated on and followed between 11 March 2020, the date of the first confirmed case of coronavirus in Turkey, and 11 May 2020.
cord-274802-7ioiwsd8	2020	Proteomic and transcriptomic studies on bronchoalveolar lavage (BAL) samples from COVID-19 patients have also revealed considerable insights into the expression of SARS-CoV-2 receptors, co-receptors, immune responses, as well as risk factors for severe disease e.g. age and co-morbidities. Furthermore, treatment with a recombinant C5a antibody on 2 male COVID-19 patients aged 54 and 67 years showed significant benefit in suppressing complement hyperactivation, which contributes to the excessive immune response causing aggravated inflammatory lung injury, a hallmark of SARS-CoV-2 pathogenesis and lethality (242) . Consistent with endothelial injury, the significantly elevated levels of von Willebrand factor found in the patient with severe COVID-19 has led to the idea that the infection of the ACE2 expressing endothelium by SARS-CoV-2 induces injury and activates the complement , which sets up a feedback loop that maintains a state of inflammation (243, (268) (269) (270) . Initial clinical studies in China involving 100 SARS-CoV-2 infected patients, who were treated with Chloroquine, showed amelioration of pneumonia, shortened disease progression, increased resolution of lung lesions on CT, and a better virus-negative conversion (313, 314) .
cord-274860-7ec2jcoq	2020	title: Significantly decreased mortality in a large cohort of COVID-19 patients transfused early with convalescent plasma containing high titer anti-SARS-CoV-2 spike protein IgG We recently reported results from interim analysis of a propensity-score matched study suggesting that early treatment of COVID-19 patients with convalescent plasma containing high titer anti-spike protein receptor binding domain (RBD) IgG significantly decreases mortality. In the aggregate, the analysis confirms and extends our previous preliminary finding that transfusion of COVID-19 patients soon after hospitalization with high titer anti-spike protein RBD IgG present in convalescent plasma significantly reduces mortality. In our previous study, interim analysis revealed that, relative to matched controls, patients transfused with convalescent plasma containing high titer anti-spike protein receptor binding domain (RBD) IgG within 72 hrs of hospital admission had significantly reduced mortality at 28 days post-transfusion. The data confirm our previous findings that transfusion of patients soon after hospital admission with high titer anti-spike protein RBD IgG present in convalescent plasma significantly decreases mortality.
cord-274871-jlquvz51	2020	title: Bacterial and fungal coinfections in COVID-19 patients hospitalized during the New York City pandemic surge We observed bacterial or fungal coinfections in COVID-19 patients admitted between March 1 and April 18, 2020 (152 of 4,267, 3.6%). Few studies have addressed bacterial or fungal coinfections or the emergence of antimicrobial resistance in coronavirus disease 2019 (COVID-19) patients. Patient demographics, central venous catheter status, ICU status, mechanical ventilation status, imaging, laboratory results, administered antibiotics per days of therapy (DOT), and disposition (admitted, discharged, deceased) were obtained from the electronic medical record. We observed widespread empiric antibiotic use throughout the pandemic and clinically relevant bacterial and fungal coinfections in patients with advanced COVID-19 and multiple risk factors for nosocomial infection (mechanical ventilation, central venous catheters, treatment with corticosteroids or biologics, and prolonged hospitalization). 2,6 Moreover, 79% of coinfected patients received antibiotics in the 30 days preceding positive cultures and 98% received them during the index COVID-19 hospitalization.
cord-274934-s8xppipe	2020	PURPOSE: This descriptive investigation was undertaken at three oncology units to report queries, needs, and fears related to severe acute respiratory syndrome coronavirus 2 (COVID-19) of patients with cancer and to avoid uncontrolled treatment delays or withdrawal, behavioral mistakes, and panic. In this article, we report real-world data and a descriptive analysis of patients'' needs and fears as well as of misinformation obtained through the WhatsApp instant messaging system (WM; Facebook, Menlo Park, CA) in daily practice during the COVID-19 pandemic. To better understand how patients talk and feel about this potential critical health CONTEXT Key Objective Are instant messaging systems useful to oncologists to care for patients with cancer and to mitigate their anxieties and fears during the severe acute respiratory syndrome coronavirus 2 (COVID-19) outbreak? Knowledge Generated The WhatsApp instant messaging system is a useful and rapid tool to inform and reassure patients with cancer and to facilitate patient triage in a real-word setting of the pandemic spread of COVID-19.
cord-275004-qzg03dvg	2020	The concentration of NETs was augmented in plasma, tracheal aspirate, and lung autopsies tissues from COVID-19 patients, and their neutrophils released higher levels of NETs. Notably, we found that viable SARS-CoV-2 can directly induce the release of NETs by healthy neutrophils. The well-known similarities between sepsis and key events involved in the COVID-19 pathophysiology, such as cytokine overproduction (Mehta et al., 2020) , microthrombosis (Magro et al., 2020; Dolhnikoff et al., 2020) , and acute respiratory distress syndrome (Lai et al., 2020) , led us to hypothesize that NETs are triggered during SARS-CoV-2 infection and might contribute to tissue injury in COVID-19 patients. In summary, in the present study, we demonstrated that in COVID-19 patients, circulating and lung-infiltrating neutrophils are releasing higher levels of NETs. We also showed that SARS-CoV-2 directly stimulates neutrophils to release NETs in mechanisms dependent on ACE2 and serine protease activity axis and effective viral replication.
cord-275041-fcdwitxy	2020	The following variables were extracted for this study: age, gender, temperature, and saturation of oxygen on admission, treatment with hydroxychloroquine, azithromycin, heparin, steroids, tocilizumab, a combination of lopinavir with ritonavir, and oseltamivir, together with data on mortality. Using limited evidence and clinical experience, doctors have treated COVID-19 patients with different drugs to eliminate or reduce the presence of the virus, including hydroxychloroquine (HCQ) [9] [10] [11] [12] . The association between treatment with HCQ and mortality was examined with four different logistic regression models: model one was adjusted for age and gender; model two included age and gender, together with temperature > 37 °C, and saturation of oxygen < 90% on admission, which were both associated with mortality in an exploratory analysis; model three had all the variables previously mentioned together with treatment with azithromycin, steroids, heparin, tocilizumab, a combination of lopinavir with ritonavir, and oseltamivir; finally, to account for the change in clinical management during the study period, model four was adjusted for all the previously mentioned demographic, clinical severity measures, and drugs, together with a categorical variable for date of admission (before the 10th of March, 11-20th of March, 20-31st March, 1st-10th of April, and 11-20th of April).
cord-275110-safr9z37	2020	At this time, more than ever, the high-quality, robust, comparative evidence from ethical randomized controlled trials (RCTs) is urgently needed to assess patient-important outcomes, including mortality, morbidity, need for life support, safety, and toxicity, informing on the safe use of chloroquine or hydroxychloroquine (with and without azithromycin) in people with COVID-19. This issue of potential harmful effects and the urgent need for high-quality, methodologically robust studies also comes from a recent pre-publication (not yet peer-reviewed) of in vitro activity of hydroxychloroquine or chloroquine in combination with metformin (used in treatment of type 2 diabetes to lower blood sugar in humans) in mice (25) . The use of existing drug treatments such as chloroquine and hydroxychloroquine outside of current guidelines and recommendations may result in adverse effects, including serious illness and death, affect patients with other diseases who may benefit from its use, and hinder the ability to conduct clinical trials if there are high demands to sue these agents by clinicians and patients.
cord-275154-vwnpred5	2009	Conclusions While infection with the nvH1N1 induces a typical innate response in both mild and severe patients, severe disease with respiratory involvement is characterized by early secretion of Th17 and Th1 cytokines usually associated with cell mediated immunity but also commonly linked to the pathogenesis of autoimmune/inflammatory diseases. Conclusions While infection with the nvH1N1 induces a typical innate response in both mild and severe patients, severe disease with respiratory involvement is characterized by early secretion of Th17 and Th1 cytokines usually associated with cell mediated immunity but also commonly linked to the pathogenesis of autoimmune/inflammatory diseases. To determine if host immune responses play a potential role in the evolution of mild or severe nvH1N1 illness we performed an analysis of systemic chemokine and cytokine levels in serum from severe and mild nvH1N1 patients shortly following the onset of symptoms.
cord-275185-9br8lwma	2020	Following CP transfusion, six out of eight patients showed improved oxygen support status; chest CT indicated varying degrees of absorption of pulmonary lesions in six patients within 8 days; the viral load was decreased to a negative level in five patients who had the previous viremia; other laboratory parameters also tended to improve, including increased lymphocyte counts, decreased C-reactive protein, procalcitonin, and indicators for liver function. Herein, we performed a retrospective observational study involving eight critical or severe patients with COVID-19 from four designated hospitals in the southwest region of China, aiming to explore the potential efficacy and safety of CP therapy, and to provide more evidence for the quality control of donated plasma and reasonable clinical application of CP transfusion. 23 Assessing the effects of neutralizing activity of CP on the patients'' clinical efficacy, we found that patients treated by CP with high NAT50 (>1:640) had more obvious improvement than patients receiving low NAT50 value (≤1:640) of CP, including shorter negative conservation time of viral RNA, and higher increment of IgG level after CP transfusion.
cord-275214-mqvw0219	2020	title: Is Thrombophilic Genetic Profile Responsible for an Acute Ischemic Stroke in a COVID-19 Male Patient? presented a recent study (published in August 2020 in the Clinical and Applied Thrombosis/Hemostasis), a comprehensive review of the COVID-19 induced coagulopathy with its particular traits, the specificity of thromboembolic events and potential therapeutic interventions. In this particular context, the authors underline that the conventional clinical assessment of the risk of thrombotic events may not be efficient due to disease''s particular evolution. Three days before the neurological event, the patient presented with mild respiratory symptoms erroneously interpreted as a non-COVID-19 pulmonary infection. We strongly suspect that subtle genetic risk factors for thrombotic events may influence the COVID-19 course, might hold the key to understanding the significant heterogeneity of COVID-19 manifestations, and may prove useful in assessing the COVID-19 patients'' risk for thrombosis and severe disease. Unpuzzling COVID-19 prothrombotic state: are preexisting thrombophilic risk profiles responsible for heterogenous thrombotic events?
cord-275257-upj8mvzn	2020	Perspectives are provided on: (1) maintaining a safe environment for surgical oncology care; (2) redirecting the multidisciplinary model to guide surgical decisions; (3) harnessing telemedicine to accommodate requisite physical distancing; (4) understanding interactions between SARS CoV-2 and cancer therapy; (5) considering the ethical impact of professional guidelines for surgery prioritization; and (6) advocating for our patients who require oncologic surgery in the midst of the COVID-19 pandemic. The panel provides perspectives on: (1) creating a safe environment for surgical oncology care, (2) redirecting the multidisciplinary model to guide surgical decisions, (3) harnessing telemedicine to accommodate requisite physical distancing, (4) understanding interactions between SARS CoV-2 and cancer therapy, (5) considering the ethical impact of professional guidelines for surgery prioritization, and (6) advocating for our patients who require oncologic surgery in the midst of the COVID-19 pandemic.
cord-275260-xuhxqkyj	2020	The analysis of the data obtained on a very large population (1317 patients) provided important information, highlighting a role for BMI in disease severity, but did not correctly interpret the data on the role of hyperglycaemia at admission to hospital. Moreover, increased plasma glucose on admission to hospital was associated with poorer outcomes in patients with mild, moderate and severe COVID-19 [2] [3] [4] . To investigate the role of early glycaemic control in the outcomes of patients with COVID-19, we studied 132 consecutive hospitalised hyperglycaemic patients with moderate disease, admitted to Infectious diseases departments (Vanvitelli University, Naples Italy; San Sebastiano Caserta Hospital, Caserta, Italy). Fig. 1 (a) Blood glucose levels on admission to hospital and after 24 h for patients with (n = 60) and without severe disease (n = 72) at 20 days after hospitalisation.
cord-275266-e6omvo5x	2020	7, 8 These economic factors will influence the decision to re-start elective total joint Resuming hip and knee arthroplasty after COVID-19: ethical implications for well-being, safety and the economy arthroplasty during the COVID-19 pandemic. This specific, informed consent (IC) for elective surgery in times of COVID-19 requires further discussion with the patient about higher risk of virus transmission including from healthcare workers, the long incubation period (up to 14 days), the variable nature of the disease from mild to fatal, and discussions regarding ceilings of care and the potential need for ventilation. In this challenging time, when reinstating elective surgery in a risky scenario with limited resources, surgeons have the responsibility to follow a shared decision-making process with the patient that includes an understanding of the legal aspects of complications, and COVID-19 specific, informed consent.
cord-275272-qdg8sqpy	2020	In this context, based on a recent publication regarding patient safety in elective surgeries (9) (10) (11) , as well as on the law of access to treatment and laws related to women''s health care (23, 24) , we propose the inclusion of gynecological surgery cases, stratified as follows ( Figure 1 ): Emergency (o1h): Peritonitis by tubo-ovarian and/or pelvic abscess, necrotizing fasciitis in surgeries for pelvic and breast neoplasms; DOI: 10.6061/clinics/2020/e2063 Urgent (o24h): Postoperative infections, acute inflammatory abdomen (adnexal tortoise, myoma tortoise, ovarian cysts), hemorrhagic conditions (ovarian cysts); Elective urgent (o2 weeks): Surgeries for neoplasms of the lower genital tract and breast previously diagnosed by pathological examination; Essential Elective (42 to o3 months): Hysteroscopy for abnormal uterine bleeding (unknowledge causes, suspected malignancy, and menopausal transition), postmenopausal bleeding (suspected malignancy), cervical conization or looped electro excision procedure (to exclude neoplasm in the lower genital tract); Non-essential/elective surgery: Infertility procedures, family planning procedures (bilateral tubal ligation procedure).
cord-275340-q8d7rvnj	2020	CQ/HCQ may synergistically exert antiviral and immunomodulatory effects on COVID-19 through multiple mechanisms including hindering the receptor recognition process by influencing the affinity of ACE2 and S protein, and the affinity for sialic acid and ganglioside; inhibiting the membrane fusion process by suppressing endolysosome acidification; suppressing the p38 activation and affecting host defense machinery, and preventing MHC class II expression (block expression of CD154 on the surface of CD4 + T cell) and TLR signaling and reducing the production of cytokines through inhibiting the activation of T cells and B cells. ACE2, angiotensin-converting enzyme 2; COVID-19, coronavirus disease 2019; CQ, chloroquine; HCQ, hydroxychloroquine; CoVs, coronaviruses; MAPK, mitogen-activated protein kinase; MHC-II, major histocompatibility complex class II; TLR, toll-like receptor; cGAS, cyclic GMP-AMP synthase; IFN, interferon; IL, interleukin; TNF-α, tumor necrosis factor-α. The authors deemed that the anti-inflammatory effect of low-dose HCQ and the activity of inhibiting viral replication may have important significance in critically ill patients with COVID-19.
cord-275349-b35pt3mo	2020	The artificial intelligence algorithms predicted that baricitinib would inhibit severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection of cells [2] , (an effect later confirmed in human liver spheroids) [3] , combined with its better-known anti-inflammatory properties. Consequently, the combined potential antiviral and anti-inflammatory effects of this dually acting drug could be ideal for halting the progression of the disease in hospitalized patients, when taken for a limited duration. This new paper in the journal extends the previous published reports of baricitinib treatment in mild-tomoderate COVID19 patients and provides further evidence that baricitinib could be a potential treatment for unwell hospitalized patients with this disease, independent of severity. One would be advised to remain vigilant of such signals reflecting thromboembolic or infection risk in randomized controlled trials testing a variety of immunomodulatory therapies in COVID-19 patients, either alone or in combination, especially in view of associations between clots and SARS-CoV-2 infection [10] .
cord-275440-fl4dsu7d	2012	Generic strategies, including eliciting patient expectations, avoiding the term ''just a virus'', providing a value-for-money consultation, providing verbal and written information, empowering patients, conditional prescribing, directed education campaigns, and emphasis on symptomatic treatments, should be used as well as discussion of alternative medicines when relevant. Detailed strategies for acute sinusitis have not been worked out but restricting antibacterial prescribing to certain clinical complexes is currently recommended by several authorities because of the high natural resolution rate. Given that resistance to antibacterials in the common bacterial respiratory pathogens, especially Streptococcus pneumoniae, is increasing worldwide, [5] it is time to critically review prescribing practices in patients with URTI and find methods for not prescribing antibacterials to patients who are unlikely to benefit. [27] There is a difference between the bacteriology of previously untreated acute otitis media and that of patients with persistent infection, [28] resistant bacteria being more common in the latter.
cord-275477-blu6wjhu	2020	Fréquence de la pathologie thrombo-embolique veineuse au cours des formes modérées de J o u r n a l P r e -p r o o f Dans une étude analyse une cohorte de 1240 patients consécutifs hospitalisés en dehors des services de Réanimation pour des formes modérées de COVID-19, les auteurs ont observé une incidence d''embolie pulmonaire confirmée à l''angioscanner de 8.3% (17) . En outre, il semble que les ETEV pourraient en partie survenir de manière asymptomatique au cours de la COVID-19 dans la mesure où les études utilisant un screening systématique ont retrouvé des incidences d''ETEV allant jusqu''à près de 50% des patients hospitalisés avec formes modérées (22, 23) . Helms et al ont observé une incidence de complications thrombo-emboliques de 18 Ainsi, les patients hospitalisés pour une forme sévère de COVID-19, en service de réanimation, présentent des ETEV très fréquemment, potentialisant la sévérité de l''atteinte respiratoire.
cord-275506-3t5gf66c	2020	[45] A retrospective study of COVID-19 patients admitted to ICU identified DVT in 25% with advanced age, lower lymphocyte counts and elevated D-dimers being significant risk factors. [63] Currently, the evidence base for the clinical management of COVID-19 is mostly limited to case series and other relatively small observational studies of hospitalised patients. Similar to findings in SARS patients, [64] lymphopenia is the most commonly reported hematological abnormality in COVID-19 and recent data shows that it can be predictive of disease severity. The use of convalescent plasma may, in addition, provide neutralising antibodies against SARS-CoV-2 and a small-scale clinical trial has reported modest but encouraging results in severely-ill but not in critical COVID-19 patients. In view of the increased thrombotic risk associated with COVID-19, prophylactic anticoagulation with low Accepted Article molecular weight heparin is recommended for all hospitalised patients with the disease and clinical trials are needed to investigate the role of more intensive anticoagulation and other experimental therapies.
cord-275518-p03sl946	2020	title: Call of duty: neuro-oncology outpatient management during the COVID-19 pandemic in Milan, ITALY Our hospital''s neuro-oncological outpatient clinic is a tertiary center for brain tumor patients, with a regular workload of 15 patients/week. Since the SARS-CoV-2 outbreak reached the pandemic status, our hospital was identified as a COVID-19 referral center. Within the framework of the emergent plan re-organizing the regional health-care system, we were able to operate 3-4 patients with brain tumors per week and to guarantee neuro-oncological visits three times per week. As a further measure to limit the patients'' accesses to the outpatient clinic, we encouraged the use of e-mails, telephone, and image-transfer tools to provide continuity of care. Such a multidisciplinary effort may enhance our response to the pandemic and contribute to the development of shared guidelines for modifying the approach to patients'' follow-up, as it is already emerging in other medical fields 5 Neuro-oncology Management During the COVID-19
cord-275742-7jxt6diq	2020	Our work''s main objective (hypothesis) is two-tier: through one of the largest and most representative national health datasets for population-based surveillance, data imputations and machine learning models (such as clustering) offer preventive care pointers by grouping patients into heterogeneous clusters, and providing data-driven predictions and policies for healthcare in the US. The Center for Disease Control and Prevention (CDC) reported on those states, and presented multiple cases to help increase public trust in immunizations: "We hope this report is a reminder to healthcare professionals to make a strong vaccine recommendation to their patients at every visit and make sure parents understand how important it is for their children to get all their recommended vaccinations on time" [5, 8] . 2. We aim to collect more CDC data variables to provide more correlations and further tests for imputations, and compare with other NHANES predictive models for specific diseases such as periodontitis [39] .
cord-275828-c6d6nk7x	2016	-SBT/ABPC, intravenous drip, 3 g/3e4 times a day -CTRX, intravenous drip, 1 g/twice a day or 2 g/once a day -CTX, intravenous drip, 1e2 g/2e3 times a day -LVFX, intravenous drip, 500 mg/once a day (2) Cases of late-onset hospital-acquired pneumonia or ventilator-associated pneumonia in which the risk of resistant bacteria is high An antimicrobial drug with anti-pseudomonal activity that targets non-glucose-fermentative gram-negative rod should be administered [50, 51, 68] -To treat polymicrobial infection, the administration of an antimicrobial drug with an activity against obligate anaerobe is not always necessary [67, 70] . -SBT/ABPC, intravenous drip, 3 g/3e4 times a day -CTRX, intravenous drip, 2 g/once a day or 1 g/twice a day -CTX, intravenous drip, 1e2 g/2e3 times a day -LVFX, intravenous drip, 500 mg/once a day (2) Late-onset hospital-acquired pneumonia or cases in which there is a risk of multi-drug-resistant bacteria In addition to the above pathogens, the involvement of non-glucose-fermentative gram negative bacteria or ESBLproducing enteric bacteria must be considered. For the treatment of immunodeficiency-/blood disease-related pneumonia in children, antimicrobial drug therapy should also be basically selected, considering causative microorganisms.
cord-275913-85u6v3ib	2020	On admission, the patient underwent a computed tomography scan which demonstrated interstitial infiltration in the left lung, highly suspicious for a COVID-19 infection that could not be confirmed by reverse transcription polymerase chain reaction (RT-PCR) testing. We decided to perform transcatheter aortic valve replacement to avoid cardiopulmonary bypass with shorter operative times, presumably shorter ventilation times and duration of intensive care unit stay, and thus a lesser risk for pulmonary complications. Following discussion in the local heart team and with the consent of the patient, we decided to perform valve-in-valve transcatheter aortic valve replacement (TAVR) to prevent the potential complications of a prolonged reroot-replacement with its long operative and cardiopulmonary bypass times, which could lead to an increased time on the respirator in the ICU. Figure 1: Computed tomography scan on admission with interstitial infiltration highly suspicious for a COVID-19 infection.
cord-275979-cx2h5bsw	2020	According to the INTERSTROKE study, the 10 most frequent modifiable vascular risk factors are arterial hypertension, physical inactivity, overweight, dyslipidaemia, smoking, unhealthy diet, cardiac pathologies, diabetes mellitus, stress/depression and overconsumption of alcohol. Also, a higher rate of infection with COVID-19, severe COVID-19 and bad outcome has been demonstrated in patients with pre-existing vascular disease and vascular risk factors. A higher rate of infection with COVID-19, severe COVID-19, and worse outcome has been demonstrated in patients with pre-existing vascular disease and risk factors, compared with young and healthy persons [1, 6, 8-11, 28, 29] . Several potential mechanisms increasing this risk of COVID-19 in patients with diabetes mellitus have been proposed: (1) higher affinity of cellular binding of SARS-CoV-2 and higher levels of circulating furin facilitating virus entry, (2) increased ACE2 expression in the lungs, (3) decreased viral clearance, (4) diminished T cell function, (5) increased susceptibility to inflammation and cytokine storm syndrome and (6) co-existence of vascular disease and risk factors [5] .
cord-276090-n8c2jpr6	2020	CONCLUSION: A young man with COVID-19 and suspected immune dysregulation, complicated by a large cerebrovascular ischemic stroke secondary to vertebral artery thrombosis requiring emergent neurosurgical intervention for decompression with improved neurological outcomes. angiography, CXR denotes chest X-ray, FiO2 denotes fraction of inspired oxygen, SARS-COV-2 denotes severe acute respiratory syndrome coronavirus 2, STAT denotes statum which is Latin meaning immediately, t-PA denotes tissue plasminogen activator, WHO denotes World Health Organization. A young man with COVID-19 and suspected immune dysregulation, complicated by a large cerebrovascular ischemic stroke secondary to vertebral artery thrombosis requiring emergent neurosurgical intervention for decompression with improved neurological outcomes. COVID-19 complicated with cerebral and large vessel vasculitis and its treatment will require a need for randomized clinical trials showing benefit in outcomes and mortality. This is a report of a patient with COVID-19 immune dysregulation who developed an acute cerebellar ischemic stroke secondary to vertebral artery thrombosis.
cord-276132-tv5y1eqc	2020	The COVID-19 pandemic has imposed a critical challenge to the current oncology care and practices including late diagnoses, delayed anti-cancer treatment, and static clinical trials. Delaying anti-cancer treatment in the ongoing pandemic cannot be recommended as a sensible choice to reduce the associated infection risk in patients. The American Society of Clinical Oncology (ASCO) recommends that in cancer patients diagnosed with the infection, the immunosuppressive therapies should be withheld until the symptoms resolve like complete remission of fever without use of antipyretics along with a negative COVID-19 test. Nevertheless, contact limitation and physical distancing guidelines continue to be an important part of the cancer treatment strategies during the pandemic in order to protect the patients, health-care personnel and non-COVID-19 patients being treated in the same organization. A practical approach to the management of cancer patients during the novel coronavirus disease 2019 (COVID-19) pandemic: an international collaborative group Clinical characteristics of COVID-19-infected cancer patients: a retrospective case study in three hospitals within Wuhan
cord-276234-2nkeq4ud	2020	Indeed, ophthalmologists seem to rank among the medical specialties with the highest risk for COVID-19 infection, probably due to close patient contact during examination, e.g., at the slit lamp [4] , and possible conjunctival involvement during the course of the disease [5, 6] . In this paper, a systematic review of current COVID-19 literature relevant for ophthalmological practice is performed, with a special focus on modes of transmission, the prevention thereof, structural adjustments of clinical care required during the pandemic, and possible ocular manifestations of this novel disease. The novel coronavirus SARS-CoV 2, currently causing the COVID-19 pandemic, has severe implications for ophthalmologybe it because the eyes represent an important route of infection, most probably through lacrimal drainage into the nasal mucosa, or because of ocular manifestations, which, even if rather rare, can represent the first symptoms of this novel disease [29] .
cord-276241-4g6pa7kz	2020	Recently two European centers reported that the prevalence of SARS-CoV-2 infection among patients with systemic autoimmune diseases was comparable to that observed in the general population [8, 9] . Table 2 shows presenting symptoms, laboratory tests, length of hospital stay and management related to COVID-19. Due to parenchymal CNS involvement with a progressive relapsing course, he received several immunosuppressive agents including cyclophosphamide and Case no 3, 4, 5 and 6 had been diagnosed with COVID-19 pneumonia. Our case series suggests that BS patients are much younger and appear to have increased risk for severe outcome when infected with COVID-19 compared to the general population. In line with our observations, very recently a study from Wuhan, China, reported that respiratory failure was more commonly observed in RD patients infected with COVID-19 compared to those without RD [15] . High risk of thrombosis in patients with severe SARS-CoV-2 infection: a multicenter prospective cohort study
cord-276249-9opsg7p2	2020	Patients with critical medical illnesses are known to be at risk for neurological complications like seizures and status epilepticus; however, the evidence is substantially limited in the context of COVID-19 infection (3) . Thus, the objective of this study was to review the EEG findings in patients diagnosed with COVID-19 infection through a systematic review of published relevant articles. We considered case reports/series, cross-sectional and cohort studies that reported on descriptive EEG findings in patients diagnosed with COVID-19 infection. Other electroencephalographic findings reported in the available literature include isoelectric EEG consistent with brain death in two cases (1.1%) in one study and fast activity superimposed on slow waves in three patients (1.7%) (22, 23) . Although it is well known that critically ill patients are at high risk for seizures and Focal non-epileptic slowing is another EEG abnormality seen in a number of COVID-19 cases. EEG findings in acutely ill patients investigated for SARS-CoV2/COVID-19: a small case series preliminary report
cord-276264-wgzh3f5m	2020	Although previous studies have uncovered factors that increase risk of severe COVID-19 infection --e.g., older age, obesity, or pre-existing heart or lung disease [1] [2] [3] [4] --the clinical course and outcome of patients with COVID-19 illness remains variable and difficult for clinicians to predict. To help clinicians predict COVID-19 severity [5, 6] , we turned to robust machine learning methods to identify high-risk cancer patients based on their pre-existing conditions and initial clinical manifestations. In this study, we developed a model to predict clinical outcomes (level of oxygen support needed) in cancer patients, using only clinical variables that were available on or before COVID-19 diagnosis (called time zero). Previous machine learning studies have reported impressive performance predicting COVID-19 outcomes for non-cancer patients using only a few clinical variables. We used machine learning algorithms to identify clinical variables predictive of severe COVID-19 illness in cancer patients at time zero.
cord-276267-77903fld	2020	6 Consequently, there is a concern that IBD patients are at greater risk of developing COVID-19 and at increased risk of progressing to a more severe clinical course or even death compared to the general population. 18 Furthermore, there is a recent case report of a possible SARS-CoV-2 gastrointestinal infection causing acute haemorrhagic colitis and signalling COVID-19 disease. Clinical assessment of risk factors for infection in inflammatory bowel disease patients Protection of 318 inflammatory bowel disease patients from the outbreak and rapid spread of COVID-19 infection in Wuhan Risk of infection with methotrexate therapy in inflammatory diseases: a systematic review and meta-analysis Comparative risk of serious infections with biologic and/or immunosuppressive therapy in patients with inflammatory bowel diseases: a systematic review and meta-analysis Infection-related hospitalizations are associated with increased mortality in patients with inflammatory bowel diseases Respiratory tract infections in patients with inflammatory bowel disease: safety analyses from vedolizumab clinical trials
cord-276288-upv2o8f6	2020	The patient or consumer voice in healthcare has evolved from an aspiration to becoming an expectation, which in some developed countries is respected by inclusion in nationally auditable standards (Australian Commission on Safety and Quality in Health-Care. Understanding the characteristics of the population is key to ensuring appropriate representation of consumers in person-centred or patient involvement research methods. 4 Direct engagement of patients and other consumers in research and health service improvement activities requires careful methodological planning around desirability and feasibility and the practical implications for the involvement of patients and consumer as participants. 5 The following examples of person-centred research methods enable the authentic voice of individuals who experience health challenges to be collected. 11 Codesign using focus groups is an opportunity for patients and other consumers to consider and discuss their experiences within healthcare systems and services in a collaborative, participatory setting.
cord-276303-lgywz9ea	2020	Effect of corticosteroids on treatment failure among hospitalized patients with severe community-acquired pneumonia and high inflammatory response: a randomized clinical trial Effect of Dexamethasone on Days Alive and Ventilator-Free in Patients With Moderate or Severe Acute Respiratory Distress Syndrome and COVID-19: The CoDEX Randomized Clinical Trial Effect of Hydrocortisone on 21-Day Mortality or Respiratory Support Among Critically Ill Patients With COVID-19: A Randomized Clinical Trial Effect of Hydrocortisone on Mortality and Organ Support in Patients With Severe COVID-19: The REMAP-CAP COVID-19 Corticosteroid Domain Randomized Clinical Trial Association Between Early Treatment With Tocilizumab and Mortality Among Critically Ill Patients With COVID-19 Effect of Tocilizumab vs Usual Care in Adults Hospitalized With COVID-19 and Moderate or Severe Pneumonia: A Randomized Clinical Trial Effect of Tocilizumab vs Standard Care on Clinical Worsening in Patients Hospitalized With COVID-19 Pneumonia: A Randomized Clinical Trial
cord-276327-wyevh4xv	2020	We designed a proof‐of‐concept randomized controlled trial to evaluate whether treatment with canakinumab prevents progressive respiratory failure and worsening cardiac dysfunction in patients with SARS‐CoV2 infection, myocardial injury, and high levels of inflammation. The three C Study is a prospective, IRB approved, blinded randomized-controlled Phase II study designed to evaluate whether treatment with canakinumab prevents progressive heart and respiratory failure in patients with Covid-19 associated myocardial injury and increased inflammation. This blinded randomized controlled trial is designed as a proof of concept study to demonstrate whether IL-1β antagonism can dampen the deleterious autoinflammatory response to SARS-CoV2 infection in patients with myocardial injury and heightened inflammation. In evaluating this hypothesis, the Three C study will help inform whether targeting inappropriate activation of the innate immune system should be investigated in larger clinical trials to improve survival in patients with Covid-19 and myocardial injury.
cord-276343-sb3vd7fq	2006	[5] [6] [7] [8] Overall, lung transplant recipients with adenovirus infection appear to be at high risk for severe necrotizing pneumonitis, resulting in significant graft dysfunction and associated with high mortality. 9, 10 Infection of the allograft by adenovirus has also been associated with acute and chronic rejection and graft dysfunction in studies of lung and heart transplant recipients. 11, 12 However, recent data have suggested that adenovirus re-activation and viremia may be relatively common in transplant recipients and, in most cases, may not be associated with adverse clinical sequelae, especially if there is no evidence of allograft infection. In patients with detectable adenovirus viremia by PCR, clinical disease was attributed to adenovirus if detectable viremia was accompanied by compatible symptoms (including febrile illnesses, respiratory, gastrointestinal disease or evidence of infection of the allograft) in the absence of another defined etiology.
cord-276359-syr9av09	2020	title: Clinical presentation and initial management critically ill patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in Brescia, Italy In addition to describing the clinical management of such patients, this study details a proposed severity scale that was used to communicate with non-intensivists for management and triage, and for a step-up approach to drug therapy including antivirals, desamethasone and selective cytokine blockers. Creation of a severity scale to assess patients with COVID is of value to hospitals and physicians facing such shortages. The pandemic spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and its disease, COVID-19, has resulted in massive strain in healthcare systems in several countries. The experience of Lombardy is interesting in that despite Italy having the third most number of ICU beds per capita, after the United States and Germany, physicians have had to limit resources due to shortages [1] .
cord-276405-yfvu83r9	2020	Because EHRs are not themselves agile analytic platforms, we have been successfully building upon the open source and free i2b2 (for Informatics for Integrating Biology and the Bedside) toolkit [10] [11] [12] [13] [14] [15] [16] [17] to manage, compute, and share data extracted from EHRs. In response to COVID-19, we have organized a global community of researchers, most of whom are or have been members of the i2b2 Academic Users Group, to rapidly set up an ad hoc network that can begin to answer some of the clinical and epidemiological questions around COVID-19 through data harmonization, analytics, and visualizations. Laboratory value trajectories Our initial data extraction included 14 laboratory markers of cardiac, renal, hepatic, and immune dysfunction that have been strongly associated with poor outcomes in COVID-19 patients in previous publications.
cord-276438-nynri6my	2020	As the executive vice president of the Shanghai Proton and Heavy Ion Center (SPHIC), a tertiary cancer treatment facility on the front line against the COVID-19 epidemic responsible for patient care and infection control, our experience and opinions might be helpful for colleagues in the United States as a reference. Anyone with a body temperature over 37.3 o C and pertinent contact/travel history is transferred to a fever clinic at a designated hospital (special clinics of major general hospitals established during the 2003 SARS epidemic to triage and treat patients with fever) to rule out COVID-19 infection. From a professional point of view, I do not think it is necessary to delay chemotherapy or radiation treatment for patients with cancer because of COVID-19, unless an infection is confirmed or highly suspected or there are other medical reasons. Except for head and neck cancer treatments, all patients are required to wear a surgical mask during transportation and radiation therapy.
cord-276495-q22jnkn2	2020	This type of immunological memory or epigenetic programming to a pre-activated state allows the generation of a sustained and more effective non-specific response, even after years, although in the protocols of these studies, the innate immunity was evaluated after 3 months (2). Various clinical trials are underway to evaluate trained immunity through BCG vaccination in healthy volunteers under the coordination of Dr. Mihail Netea (Radboud University Medical Center, Nijmegen, the Netherlands). To our knowledge, there are no published articles or clinical evidences that show that BCG immunization protects against SARS-CoV-2 in Brazil. The journal The Lancet, in May 2020, published the results of an observational, longitudinal, and retrospective clinical study based on medical records of COVID-19 patient cohorts treated across 6 countries and 671 hospitals, with different technical capabilities and diverse drug protocols (13) .
cord-276524-th6eu11h	2020	His D-dimer was over 6 times the upper limit of normal (ULN) and started on intensified prophylaxis with unfractionated heparin infusion (UFH) 7500 units TID per our COVID anticoagulation protocol [4] . D-dimer was over 6 times ULN on transfer: Patient was directly placed on high intensity thromboprophylaxis with heparin 7500 SC TID and received tocilizumab on second day of admission. Additionally, the fact that thrombotic events continued to be observed despite decrease in inflammatory markers and the proactive anticoagulative approach adopted, raises more questions about the coagulative mechanisms at play in COVID-19, and the appropriate management strategy. Additionally, the fact that thrombotic events continued to be observed despite decrease in inflammatory markers and the proactive anticoagulative approach adopted, raises more questions about the coagulative mechanisms at play in COVID-19, and the appropriate management strategy.
cord-276592-dsilwfl1	2020	Now, in this new era of attention to hand hygiene and social distancing, I paranoically and abashedly attempt to reproduce the sterile technique I learned from my days in the basic science lab, expanding my alcohol wiping to doorknobs and surfaces throughout the medical center-indeed, to any possible hideout of renegade coronavirus. I have to remind myself to begin each virtual encounter with a warm hello, an explicitly stated wish that we could be meeting in person, a sound and lighting check, and a brief check-in with the patient about how they are coping with current public health recommendations. With this intentional centering, which takes a bit more effort than usual, I can hear that most of my patients describe anxiety about what they could or should do, and this response leads to prioritizing that concern on the list of topics that we collaboratively generate. He assents, and I ask, "What do you know of social distancing?" He says, "To tell you the truth, it doesn''t make a lot of sense.
cord-276621-9exp8e7h	2020	This study aims to describe the mood, well-being, distressing symptoms, and attitudes toward prolonged ventilation among PMV patients treated either at home or long-term acute care (LTAC). RESULTS: Participants were aged 61.7 ± 20.7 years, commonly suffered progressive neuromuscular disease (43.5%) or chronic lung disease (29%), were functionally dependent, treated at home (64.5%) or LTAC (35.5%), and had a mean PMV duration of 36.6 months (interquartile range 10.8-114.1). Although no significant differences were observed in the severity of the 10 r-ESAS subitem symptoms between home and LTAC, nonetheless, well-being was reported as asymptomatic or mildly impaired by 54% of home PMV patients compared with 26% among long-term care, with similar rates of severely impaired well-being reported by 10% and 11% of patients, respectively.
cord-276635-0ciy732e	2020	While PPCI remains the treatment of choice for STEMI, the number of COVID-19 cases in Wuhan and Lombardy raised sufficient concerns that thrombolysis should be considered in certain circumstances. Low-risk patients with low Global Registry of Acute Coronary Events (GRACE) scores and small troponin-rises can be stratified, and if appropriate, then early urgent angiography can be considered on an ''outpatient'' basis without inpatient stays. The treatment for ACS is well established, and while Key points ► Prompt and early revascularisation, with appropriate personal protective equipment, remains the default treatment approach for patients with acute coronary syndrome in the COVID-19 era. ► Critically unwell patients with ST-elevation myocardial infarction, without onsite catheter lab facilities or too unstable for transfer should be considered for thrombolysis and activation of services for facilitated PCI if necessary. Effect of the COVID-19 pandemic on ST-segment-elevation myocardial infarction presentations and in-hospital outcomes
cord-276641-40r4mitg	2020	The aim of this article is based on the fact that the potential threat of COVID-19 to immunocompromised cancer patients as a result of their disease or the treatment delivered is thought to be significant, so it is of great importance to study the best measures to be used by oncology centres to prevent or limit the exposure of cancer patients to COVID-19 and to provide cancer treatment to patients in need, as safely and as correctly as possible. After the appearance of COVID-19 in Egypt, it should be a must to take a rapid action by MCOD, until the arrival of national strategies from higher authorities, so the outpatients were classified into two groups: Group 1 patients under follow-up either as control or hormonal therapy (HT) and Group 2 patients under active treatments (surgery, chemotherapy (ChT), radiotherapy (RT), biological therapy or immunotherapy) either as neoadjuvant or adjuvant treatment or for metastatic disease.
cord-276676-lgt0rzob	2020	Indeed, the pandemic has already affected cardiac surgery units in multiple ways: limited number of available ICU beds and ventilation sites, necessity to postpone or cancel elective and/or complex cardiac interventional procedures, patients developing COVID-19 post cardiac surgery, coronavirus patients necessitating urgent cardiac operations, cardiac anesthetists'' in-hospital transfer to staff and support ICUs in front of the pandemic, infected health care providers with consequent shortage of medical and nursing practitioners, restrictions in clinical meetings, and cancelation of training and continuing medical education [6, 8] . Based on the current understanding of COVID-19 pathophysiology and the clinical characteristics of cardiovascular surgical patients, in this review, the authors highlight related anesthesia concerns and provide practical recommendations in reference to perioperative planning and management of patients undergoing cardiac surgery, along with a focus on disease control and prevention in the times of COVID-19 outbreak.
cord-276758-k2imddzr	2007	Activities currently assigned to ICPs in response to emerging challenges include (1) surveillance and infection prevention at facilities other than acute care hospitals (eg, ambulatory clinics, day surgery centers, LTCFs, rehabilitation centers, home care); (2) oversight of employee health services related to infection prevention (eg, assessment of risk and administration of recommended treatment after exposure to infectious agents, tuberculosis screening, influenza vaccination, respiratory protection fit testing, and administration of other vaccines as indicated, such as smallpox vaccine in 2003); (3) preparedness planning for annual influenza outbreaks, pandemic influenza, SARS, and bioweapons attacks; (4) adherence monitoring for selected infection control practices; (5) oversight of risk assessment and implementation of prevention measures associated with construction and renovation; (6) prevention of transmission of MDROs; (7) evaluation of new medical products that could be associated with increased infection risk (eg, intravenous infusion materials); (8) communication with the public, facility staff, and state and local health departments concerning infection control-related issues; and (9) participation in local and multicenter research projects.
cord-276782-3fpmatkb	2020	The objective is to assist management in anticipating the load of each care unit, such as the ICU, or ordering supplies, such as personal protective equipment, but also to retrieve key parameters that measure the performance of the health system facing a new crisis. In some hospitals, the floor might be shared by patients who are 92 recovering from COVID-19 and palliative care patients.Despite this, we will separate 93 these functional units in our model to clarify the workflow process according to what 94 each patient stage requires in terms of resources and time to deliver adequate care. Number of Staff required at each care unit per beds in reference to the Workflow of Figure 1 Let us describe the data set we are using to construct our model.
cord-276784-8lmg97zc	2020	Moreover, the management of chronic neurological diseases, such as Multiple Sclerosis (MS), underwent guided modifications, such as an Extended Interval Dose (EID) of Disease-Modifying Treatment (DMT) administration, in order to minimize patients'' exposure to the health system, thus reducing the risk of SARS-CoV-2 infection. In this review, we summarize existing evidence of key immune pathways that the SARS-CoV-2 modifies during COVID-19 and the relevant implication for MS and other autoimmune diseases with associated demyelination (such as Systemic lupus erythematosus and Antiphospholipid syndrome), including the context of potential neuroinvasion by SARS-Cov-2 and the alterations that DMT induces to the immune system. In this respect, the clinical implication of SARS-CoV-2 infection in PwMS needs to be carefully evaluated in long-term prospective studies that assess not only physical disability measurements but also cognition, patient-reported outcomes, and quality of life, thus aiming to elucidate COVID-19-related long-term effects on MS-related neurological status and beyond.
cord-276834-20lcihf4	2020	title: Lung and kidney perfusion deficits diagnosed by dual-energy computed tomography in patients with COVID-19-related systemic microangiopathy We evaluated lung and kidney perfusion abnormalities in patients with COVID-19 by dual-energy computed tomography (DECT) and investigated the role of perfusion abnormalities on disease severity as a sign of microvascular obstruction. CONCLUSIONS: We found that a large proportion of patients with mild-to-moderate COVID-19 had PDs in their lungs and kidneys, which may be suggestive of the presence of systemic microangiopathy with micro-thrombosis. KEY POINTS: • Pulmonary perfusion abnormalities in COVID-19 patients, associated with disease severity, can be detected by pulmonary DECT. Here, we aimed to evaluate lung and kidney perfusion abnormalities in COVID-19 patients by dual-energy computed tomography (DECT) and to investigate the role of perfusion abnormalities on disease severity as a sign of microvascular obstruction. Perfused blood volume (PBV) images and iodine maps were generated using DECT post-processing software ("Lung PBV" and "Virtual unenhanced" in syngo Dual Energy; Siemens Healthineers) on a dedicated workstation.
cord-276856-88d3vzbs	2020	title: Single ventilator for multiple patients during COVID19 surge: matching and balancing patients With a potential COVID19-induced ventilator shortage, supporting multiple patients on a single ventilator seems a simple solution to maximize resources. Beyond cross-contamination and increased dead space, matching patients to ensure appropriate individual ventilation peak pressures (P peak ), tidal volumes (V tidal ), and positive endexpiratory pressures (PEEP) is a concern, especially given the dynamic clinical presentation of the COVID19 patients with complicated acute respiratory distress syndrome (ARDS). One-way valves on both inspiratory and expiratory limbs ensured unidirectional flow, which both reduces functional dead space and the risk of crosscontamination between patient A and B, and seemingly also facilitated stable ventilation of B as A deteriorated. Finally, each class of ventilators requires a specific set up; if the method is considered, use the calm before the patient surge to familiarize, and ameliorate the many risks associated with sharing a ventilator. A single ventilator for multiple simulated patients to meet disaster surge
cord-276927-rxudwp2v	2012	Rapid administration of antibiotics and resuscitative measures in case of sepsis and septic shock associated with protective ventilatory strategies and early short-term paralysis associated with differential ventilatory techniques (recruitment maneuvers with adequate positive end-expiratory pressure titration, prone position, and new extracorporeal membrane oxygenation techniques) in severe ARDS can help improve its prognosis. Incorporation of modified risk factors such as acute increase of respiratory rate, presence of tachypnea, detection of pulse oximeter desaturation, increased necessity of oxygen supplementation, presence of low pH, acidosis, or hypoxemia in an arterial blood gas sample in clinical practice can improve the clinicians'' ability to perform early diagnosis and prompt therapeutic intervention in ARDS [17] .
cord-277014-iz8jo44e	2020	This study indicates that severity of the disease, the length of stay in the hospital of surviving patients, and mortality were higher among COVID-19 patients with sodium balance disorders. CONCLUSION: Sodium balance disorder, particularly hyponatremia, is a common condition among hospitalized patients with COVID-19 in Hubei, China, and it is associated with a higher risk of severe illness and increased in-hospital mortality. reported hyponatremia to be much common (50%) amongst hospitalized COVID-19 patients in the United States [13] , and recently study further suggested that serum sodium concentration was inversely correlated with IL-6, and hyponatremia was associated with a more severe outcome of COVID-19 disease [14] . The associative disorders of serum sodium balance, their clinical characteristics, severity, and outcomes in SARS-CoV-2 infected patients have not been established. It was revealed that disease severity, the length of hospital stay for surviving patients, and mortality were high among COVID-19 patients with sodium balance disorders.
cord-277096-zvb7n9wo	2018	7 cHL is characterized by a relatively small proportion of pathologic Reed-Sternberg (RS) cells within a reactive inflammatory milieu and is associated with a state of increased Clinical Practice Points ABVD (doxorubicin, bleomycin, vinblastine, and dacarbazine) is a widely used front-line regimen for the treatment of early and advanced stage classical Hodgkin lymphoma (cHL). We identified 3 patients experiencing febrile hypotensive reactions following ABVD chemotherapy at our institution with shared baseline clinical features, including stage IVB disease, high risk disease by International Prognostic Score, male gender, and Epstein-Barr virus-positive cHL. 15 Subsequent cases of fatal or life-threatening febrile, hypotensive reactions in patients with lymphoma treated with bleomycin as part of multi-agent therapy have been reported, [16] [17] [18] [19] including a patient with a febrile, hypotensive reaction following treatment with ABVD associated with tumor lysis syndrome (TLS) and markedly elevated serum IL-6.
cord-277146-4a4vz36h	2020	Multiple reports have reported the presence of deranged parameters of coagulation in patients of In this review, we will discuss the various pathophysiological mechanisms leading to COVID-19 associated coagulopathy (CAC), derangement in laboratory parameters, incidence, and risk factors of venous thromboembolism (VTE) and prevention and treatment of CAC. Pulmonary Intravascular Coagulation, its Histopathological Evidence and Contribution of Cytokine Storm COVID-19 patients have been shown to have high levels of D-dimer [8, 9] but unlike patients of sepsis, they only have a mild prolongation of prothrombin time (PT), activated partial thromboplastin time (APTT), mild thrombocytopenia [4, 9] . They recommend standard dose LMWH as most preferred agent followed by UFH then DOAC for acutely ill and critical hospitalized patients with COVID-19. High incidence of venous thromboembolic events in anticoagulated severe COVID-19 patients Anticoagulant treatment is associated with decreased mortality in severe coronavirus disease 2019 patients with coagulopathy
cord-277148-xzpuc22p	2020	Acute myocarditis (AM), a recent-onset inflammation of the heart, has heterogeneous clinical presentations, varying from minor symptoms to high-risk cardiac conditions with severe heart failure, refractory arrhythmias, and cardiogenic shock. In the last decade, the measurement of high-sensitive (hs) troponin levels for identifying myocardial injury and the use of cardiac magnetic resonance imaging (CMRI) for characterizing myocardial tissue changes, allowed to diagnose AM non-invasively and with reasonable accuracy, in a wider population of patients including low-risk subjects. Attention will be paid to contemporary outcomes and predictors of prognosis, the emerging entity of immune checkpoint inhibitors (ICI)-associated myocarditis, updated CMRI diagnostic criteria, new data on the use of temporary mechanical circulatory supports (MCS) in FM. Thus, simple factors such as clinical presentation, wide QRS, and reduced LVEF on admission can help identifying high-risk patients, in whom EMB is recommended to guide subsequent therapeutic strategies (e.g. search for specific etiologies or associated conditions, immunosuppressive regimen, short-term temporary MCS, and screening for HTx listing).
cord-277178-nbotxv35	2020	Objectives: The aim of this review was to analyse the implementation and impact of remote home monitoring models (virtual wards) during COVID-19, identifying their main components, processes of implementation, target patient populations, impact on outcomes, costs and lessons learnt. There is a paucity of published literature on the models of care developed to implement remote home monitoring across different healthcare contexts during the COVID-19 pandemic, the experiences of staff implementing these models and patients receiving care, the use of data for monitoring progress, resources required, as well as the impact of these models on clinical, process and economic outcomes. The included articles were analysed using a data extraction form developed in REDCap (Research Electronic Data Capture) that extracted data on: the design and general characteristics of the model, patient populations, main reported process and clinical outcomes and its potential economic impact.
cord-277189-fe8ego7f	2020	Preliminary data suggest that severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection is associated with higher mortality among cancer patients, particularly in those on systemic therapy. During this period, 11 patients (15%) developed symptoms consistent with coronavirus disease 2019 (COVID-19) and four (5%) tested positive. These data suggest that the higher risk of COVID-19 death associated with systemic therapy in cancer may not apply to patients on ICIs. Assessment of COVID-19 severity in these patients can be complicated by the underlying cancer and its treatment. Preliminary data suggest that severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection (coronavirus disease 2019 ) is associated with higher mortality among cancer patients [1] . Current data on COVID-19 mortality among cancer patients group treatment modalities such as immune therapy and targeted therapy (n = 7) together, which is flawed [3] . The fever and cough resolved 5 d later, and the patient resumed his cancer treatment after completion of his self-isolation period.
cord-277201-jzjxsetx	2020	We suspect that a prothrombotic inflammatory response provoked by coronavirus disease could be the culprit, acting as an additive effect on middle-aged patients with known risk factors for venous thromboembolism. In addition to coagulation factor abnormalities, other reported findings of increased D-dimers, ferritin, and lactate dehydrogenase further support the assertion that a prothrombotic response to the virus is driving the thromboembolic events among COVID-19 patients [9] . Severe COVID-19 infections have also been associated with an inflammatory prothrombotic state, also potentially playing a key role behind the increase in reported thromboembolic complications. We suspect that the existing risk factors present along with the superimposed prothrombotic state induced by COVID-19 induced inflammatory response may have precipitated the development of the venous thromboembolism resulting in PE. e CHEST Guideline and Expert Panel Report on management of venous thromboembolism (VTE) in COVID-19 patients outlines various recommendations for management of acute VTE.
cord-277207-2my86ums	2020	We also presented bone marrow aspiration pathology of three patients with delayed phase thrombocytopenia, showing impaired maturation of megakaryocytes. There were two inclusion criteria for this study: (1) each patient was confirmed by real-time reverse transcription PCR (real-time RT-PCR) and were diagnosed as having COVID-19 according to WHO interim guidance [6] ; (2) all patients underwent chest computerized tomography (CT) and complete panel of routine laboratory tests, including compete blood count, blood biochemistry, blood coagulation function, test of key inflammatory cytokines (IL-4, IL-6, IL-10, IFN-γ, TNF-α), and lymphocytes subset analysis. We collected data on age, gender, respiratory rate, smoking and comorbidities (Hepatitis B, Hepatitis C, HIV, hepatosplenomegaly, hematological system disease, rheumatic immune system disease, cardio cerebrovascular disease, endocrine system disease, respiratory system disease, digestive system disease, nervous system disease and malignant tumor), symptoms from onset to hospital admission (fever, cough, dyspnea, pharyngalgia, diarrhea, anorexia, abdominal pain, palpitation, hypodynamia, paresthesia, myalgia and dizziness), laboratory values on admission (blood routine, blood coagulation function, blood biochemistry, C-reactive protein, inflammatory cytokines and lymphocyte Subsets ), treatment (antiviral agents, antibacterial agents, antifungal agents, corticosteroids, inhaled interferon-α, All rights reserved.
cord-277210-xaj2623u	2020	• Adopt measures within cancer centres to reduce risk of nosocomial SARS-CoV-2 acquisition; support population-wide social distancing; reduce demand on acute services; ensure adequate staffing; and provide culturally safe care. Patients with cancer could be at elevated risk of severe COVID-19, while delivery of cancer therapies could be disrupted by quarantines, social distancing measures, and interruption of routine health care delivery by the pandemic. 38 Community spread of COVID-19 has the potential to diminish the donor pool, to threaten the capacity of cancer services to provide routine transfusion support, and to increase the risks that transfusion-dependent patients will come into contact with other individuals with SARS-CoV-2. We present interim guidance for clinicians caring for patients with cancer who may be particularly vulnerable both to severe COVID-19 and the potential impact of the pandemic on the provision of cancer investigations and treatment.
cord-277260-7se220oz	2020	Since the emergence of the first case in Wuhan, China, in December 2019, tremendous research efforts have been underway to understand the mechanisms of infectivity and transmissibility of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), a fatal virus responsible for abysmal survival outcomes. Data from China thus far have shown that cancer patients infected with COVID-19 are at 3.5 times the risk of requiring mechanical ventilation or ICU admission, compared to the general population [9•] . The CALAVI trial will be initiated as a randomized global clinical trial to assess the potential of acalabrutinib in the treatment of the cytokine storm associated with severely ill COVID-19 patients [86] . An exploratory meta-analysis of 32 studies showed evidence of reduced mortality after receiving various doses of convalescent plasma in patients with severe acute respiratory infections of viral etiology [92] . Risk factors associated with acute respiratory distress syndrome and death in patients with coronavirus disease 2019 pneumonia in Wuhan, China
cord-277323-jqr2hkv2	2020	key: cord-277323-jqr2hkv2 authors: Thampi, Swapna; Melvin Lee, Chang Chuan; Zhi Ng, Beatrice Hui; Anne Yap, Andrea Pek title: Considerations for resuscitation and transfer of paediatric patients with COVID-19 cord_uid: jqr2hkv2 Swapna Thampi 1* , Chang Chuan Melvin Lee 1 with severe and critical disease being more prevalent in younger children. 6 As the pandemic spreads, we will encounter more paediatric patients with COVID-19 disease who require resuscitation and transfer. A Novel Coronavirus from Patients with Pneumonia in China Early Transmission Dynamics in Wuhan, China, of Novel Coronavirus-Infected Pneumonia Characteristics of and Important Lessons From the Coronavirus Disease 2019 (COVID-19) Outbreak in China: Summary of a Report of 72 314 Cases From the Chinese Center for Disease Control and Prevention Epidemiological Characteristics of 2143 Pediatric Patients With 2019 Coronavirus Disease in China Practical recommendations for critical care and anesthesiology teams caring for novel coronavirus (2019-nCoV) patients
cord-277328-9s8fwg1h	2020	RESULTS: 22 COVID-19 patients (11 males and 11 females, with an average age of 40.7 ± 10.3) developed a solitary pulmonary lesion within 4 days after the onset of symptoms, the peak time of CT score was about 11 days (with a median CT score of 6), and was discharged about 19 days. The inclusion criteria were as follows:(1) Patients with positive detection of SARS-CoV-2 in respiratory or blood specimens; (2) initial chest CT scan appearing as solitary lesion; (3) meeting the discharge criteria in the diagnosis and treatment of COVID-19 (trial 7th edition) published by the National Health Commission of the People''s Republic of China [9] ; (4) patients underwent ≥ 3 chest CT scans before discharge, and CT imaging data were complete and accessible. Spearman rank correlation test was performed, because the discharge time and the peak CT score did not coincide with normal distribution and Spearman r and p values were provided in graphs the time of maximum lung lesions during hospitalization, among whom four were patients with severe COVID 19.
cord-277399-0w8is9xm	2020	The prolonged lockdown of health facilities providing non‐urgent gamete cryopreservation—as currently recommended by many reproductive medicine entities and regulatory authorities due to the SARS‐CoV‐2 pandemic will be detrimental for subgroups of male infertility patients. These groups include infertility patients (eg, azoospermic and cryptozoospermic) undergoing medical or surgical treatment to improve sperm quantity and quality, as well as males of reproductive age affected by inflammatory and systemic auto‐immune diseases who are about to start treatment with gonadotoxic drugs or who are under remission. Sperm banking should be considered in men with HH who respond to therapy, that is, have viable spermatozoa in the ejaculate, in particular, when the continuation of gonadotropin therapy during the SARS-CoV-2 pandemic is neither possible (eg, due to economic or logistic reasons), nor desired. We propose remedies to mitigate the consequences of a prolonged cessation of andrological services due to the SARS-CoV-2 pandemic to vulnerable subgroups of male infertility patients.
cord-277430-x02u7oh0	2020	Secondary analyses included the reporting of clinical presentation and outcomes based on the different cancer types, and the association between mortality due to COVID-19 and whether the patient was receiving ongoing active anticancer treatment (systemic therapy, local therapy, or a combination). 5, 16 Rather, in the current study cohort of 107 patients, we observed that active anticancer treatment within 1 month of a diagnosis of COVID-19 was associated with profound lymphopenia (median of 0.55 vs 1.05 for those on follow-up) and markedly elevated inflammatory markers of C-reactive protein (36.00 vs 27.40) and procalcitonin (0.17 vs 0.06). The results of the current study demonstrated the clinical characteristics and outcomes of COVID-19 in a large cohort of 107 patients with different cancer types, and suggested a high incidence of severe illness and case fatality rates compared with the community population. Clinical characteristics of COVID-19-infected cancer patients: a retrospective case study in three hospitals within Wuhan, China.
cord-277486-12uah5qi	2020	As Covid-19 can severely implicate the respiratory and cardiovascular systems, potential pulmonary, and/or cardiovascular sequelae may be anticipated in patients following severe and critical SARS-CoV-2 infection meriting coordinated post-discharge management to identify residual effects and to mitigate potential worsening of pre-existing conditions. The WHO report Interim Guidance: Clinical Management of Covid 19, released 27 May 2020 however anticipates potential sequelae in patients with severe and critical SARS-CoV-2 infection following treatment with mechanical ventilation, sedation, and/or prolonged bed rest based on evidence from general critical care populations. A coordinated post-discharge care concept for patients surviving Covid-19 is therefore warranted to identify any cardiopulmonary sequelae and to mitigate possible worsening of preexisting disease following severe and critical SARS-Cov-2 infection. Short, intermediate and long-term effects following severe and critical SARS-CoV-2 infection are unknown, and significant sequelae may be expected, especially in patient populations experiencing ARDS, sepsis, and/or multiple organ dysfunction, as well as patients with exacerbation or progression of preexisting pulmonary or cardiovascular disease.
cord-277498-hdhq99k2	2020	title: Follow-up and management of head and neck cancer patients during the 2019 novel coronavirus (SARS-CoV-2) disease pandemic These scenarios would be considered high-risk for SARS-CoV-2 transmission, and the HCW consulting the patient would require full personal protection equipment (PPE) consisting of N95 mask, surgical gowns, gloves, and goggles/face shields 16 . Following the completion of treatment any patient with direct contact with a SARS-CoV-2 infected individual or who has personally tested positive or has symptoms of COVID-19 should not be seen in an oncology clinic for a follow-up visit. When it is challenging to distinguish between post-treatment edema and residual tumor on imaging, a detailed physical exam including endoscopy may be required, and as aforementioned, full PPE is required to protect the HCW from transmission of SARS-CoV-2 through aerosolization during NPL. Herein, we focused on the impact of this pandemic on the management of head and neck cancer patients who are undergoing or have completed radiation treatment.
cord-277535-u283k70i	2020	Additionally, drugs can also modify how the liver functions and cause dysfunction or even failure of the organ both by a direct effect on the liver or by alteration in liver blood flow. Furthermore, once a patient has been recognized to be suffering with liver dysfunction or failure drug choice and dosing regime will need to be rationalized. After reading this article you should: C understand the mechanisms of drug metabolism by the liver C have an appreciation of alterations to drug choice and dosing regimens in patients with liver disease due to their altered pharmacokinetics C know the management of a patient with paracetamol overdose There are many different isoforms of CYP450, classified according to their amino acid sequencing into families, subfamilies and individual genes. NSAIDS are contraindicated for systemic use in most liver disease patients, because of increased bioavalibilty, the high risk of precipitating gastrointestinal bleeding and renal failure.
cord-277539-xt2nt11e	2020	Despite the avalanche of information that has exploded in relation to this rapidly spreading disease, there is a lack of consolidated information to guide dentists regarding clinical management including precautions to take materials to use and postprocedure care, during and after the COVID-19 pandemic. This review aims to provide a comprehensive summary from the available literature on COVID-19, its insinuation in dentistry, recommendations that have been published, and the actual in-practice implications, so a plan can be formulated and adapted to the circumstances of each dental practice during the pandemic and the times to follow. The purpose of this review is to provide a comprehensive summary from the available literature on COVID-19, its insinuation in dentistry, recommendations that have been published, and the actual in-practice implications, so a plan of measures can be formulated and adapted according to the circumstances of each dental practice during the pandemic and the times to follow.
cord-277576-3dvt6uj7	2020	INTRODUCTION: Management of COVID‐19 in kidney transplant recipients should include treatment of the infection, regulation of immunosuppression, and supportive therapy. MATERIAL AND METHODS: Kidney transplant recipients diagnosed with COVID‐19 from five major transplant centers in Istanbul, Turkey, were included in this retrospective cohort study. [1] [2] [3] [4] [5] [6] [7] Although uremia and kidney transplantation are not considered a risk factor in COVID-19, SARS-CoV-2 often causes a moderate or severe infection in kidney transplant recipients. Kidney transplant recipients diagnosed with COVID-19 from five major transplant centers in Istanbul, Turkey, were included in this retrospective cohort study. 2, 4, 5 To the best of our knowledge, the use of favipiravir and anakinra in the treatment of COVID-19 in kidney transplant recipients has not been previously reported. In conclusion, COVID-19 has been seen to more commonly cause moderate or severe pneumonia in kidney transplant recipients, possibly due to immunosuppressive therapy.
cord-277643-xh8z9v0m	2020	Pharmacists played a crucial role in direct patient care, medication information, and proper drug distribution with proactive communication among themselves and with other HCPs during the severe acute respiratory syndrome (SARS) pandemic. However, new roles including immunization, contraception, public awareness, identifying infected patients and redirecting them to hospitals and isolation centers, logistics, supplies and clinical management, and being an information hub for patients and HCPs regarding the disease, transmission, preventive measures, management approaches, and investigational medications were identified [14, 15] . Even though the various services provided by the pharmacists during different pandemics were not directly through DICs, pharmacists were actively involved in the dissemination of information on the disease and investigational World Health Organization (WHO)-approved/non-approved medications to the patients, HCPs and the public. Detailed information on COVID-19 and its effects in patients with various health conditions, such as cardiovascular disease (CVD), diabetes mellitus, neurological issues, and respiratory illnesses, can be disseminated to HCPs and patients/ public via DICs, thereby promoting the role of pharmacists in patient management.
cord-277700-nxm1jr0x	2020	(i) Two independent cohorts with quantification based on ensemble 2D & 3D consensus neural networks reaching expert-level annotations on massive evaluation, (ii) Consensus-driven bio(imaging)-marker selection on the principle of prevalence across methods leading to variables highly-correlated with outcomes & (iii) Consensus of linear & non-linear classification methods for staging and prognosis reaching optimal performance (minimum discrepancy between training & testing). The approach relied on (i) a disease quantification solution that exploited 2D & 3D convolutional neural networks using an ensemble method, (ii) a biomarker discovery approach sought to determine the share space of features that are the most informative for staging & prognosis, & (iii) an ensemble robust supervised classification method to distinguish patients with severe vs non-severe short-term outcome and among severe patients those intubated and those who did not survive.
cord-277739-eb4z3u66	2020	title: Efficacy and Safety of Lianhuaqingwen Capsules, a repurposed Chinese Herb, in Patients with Coronavirus disease 2019: A multicenter, prospective, randomized controlled trial In the latest publication, Lianhuaqingwen (LH) capsule (Shijiazhuang Yiling Pharmaceutical Co. Ltd., Shijiazhuang, China) was a manufactured product of the traditional Chinese medicine formula marketed in China that could significantly inhibit SARS-CoV-2 replication, alter the viral morphology and confer anti-inflammatory activity in vitro . On the basis of usual treatment, we sought to explore the safety and efficacy of LH capsules in patients with Covid-19 by conducting a multicenter randomized controlled trial in mainland China. Eligibility criteria consisted of the following: 1) Laboratory-confirmed cases with according to the Protocol for Diagnosis and Treatment of Novel Coronarvirus Pneumonia (4 th edition) which was issued by the National Health Commission (General Office Of The National Health And Health Commission, 2020) (Panel 1); 2) Being symptomatic (either having fever, coughing, or fatigue) plus radiologic abnormalities consistent with pneumonia; 3) Patients aged 18 years or greater of either sex.
cord-277803-7p1qu2rf	2020	Given the uncertainty regarding the effects and duration of the COVID-19 outbreak, combined with the progressive nature of obesity, diabetes, and related conditions, delaying bariatric and metabolic surgery could increase the risks for morbidity and mortality in surgical candidates.
cord-277811-j58qvyum	2011	title: Plasma proteomic profile of sulfur mustard exposed lung diseases patients using 2-dimensional gel electrophoresis Haptoglobin α1 chain isoforms (spots 21, 22 and 23) were only detected in the plasma of the severe lung diseases patients but were not detectable in healthy controls ( Figure 2B and 2C). In this study we present plasma proteome analysis of SM exposed patients compared to the healthy controls. In our recent study of BAL fluid proteomics patterns in SM exposed patients we also found that haptoglobin isoforms were significantly elevated in moderate and severe lung disease patients compared to mild and healthy controls [13] . In conclusion, this study complements our previous BAL fluid proteome analysis of patients exposed to SM gas which resulted in identification of number of differentially expressed proteins. Plasma proteomic profile of sulfur mustard exposed lung diseases patients using 2-dimensional gel electrophoresis
cord-277818-8w15dz20	2018	Hand hygiene is a well-known and effective solution to the problem of bacterial transmission within and across patients and is considered the most important and cost-effective individual intervention in the prevention of health care–associated infections in children and health care providers Compliance with the current "5 moments" World Health Organization guidelines could make a major inroad into reducing provider hand and workspace contamination. These findings have clinical implications for the risk of colonization and subsequent HCIs-for example, SSIs. This calls attention to the need to develop and enforce strict hand hygiene guidelines for personnel who are providing anesthesia care, but more importantly the need to increase compliance with environmental disinfection of the OR (between cases and terminal cleaning), and to study further the directions of the spread of pathogens in the OR and anesthesia work areas.
cord-277889-8u685f45	2020	The majority of patients infected with COVID-19 have normal or reduced white cell counts and lymphocytopenia, and those with severe disease have shown significantly elevated levels of neutrophils, dimer-D, and urea in blood, with a continuing decrease in lymphocytes. detected elevated levels of the antagonistic receptor of IL-1 (IL-1Ra) in 14 severe cases of COVID-19, and this marker has been associated with increased viral load, loss of pulmonary function, lung damage, and mortality risk [55] . observed that its expression during infection with an influenza virus had negative effects on CD8 + memory T cells [71] .Various studies of COVID-19 patients have detected elevated IL-4 levels as part of the cytokine storm associated with severe respiratory symptoms [16, 17, 43, 72] . Elevated IL-17 levels have been reported in patients with SARS-CoV-2 as part of the cytokine storm [17] , and they have been associated with the viral load and disease severity [56] .
cord-277992-49mantab	2020	The following were reported in CMR in one of the patients with myopericarditis who had ventricular systolic dysfunction : increased wall thickness with diffuse biventricular hypokinesis, especially in the apical segments, marked biventricular myocardial interstitial edema, and diffuse late gadolinium enhancement involving the entire biventricular wall 18 Cardiological Society of India recommends fibrinolytics and pharmacological therapy as treatment of choice in stable STEMI. COVID-19 patients who are diagnosed as having asymptomatic left ventricular systolic dysfunction or clinically overt heart failure should receive standard guideline directed therapy.Careful management of fluid balance, careful monitoring of electrolytes and renal function is very important.Another cardiovascular co-morbidity which can co-exist is venous thromboembolism and adequate prophylactic measures need to be undertaken 13 . Cardiac Involvement in a Patient With Coronavirus Disease 2019 (COVID-19) EPIDEMIOLOGICAL AND CLINICAL CHARACTERISTICS OF HEART TRANSPLANT RECIPIENTS DURING THE 2019 CORONAVIRUS OUTBREAK IN WUHAN, CHINA: A DESCRIPTIVE SURVEY REPORT
cord-278106-ev1nx60h	2020	The Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has become the most talked-about clinical entity in early 2020. Management presents its own set of challenges, including but not limited to, deciding whether postponing cancer treatment until the infection resolves is going to benefit the patient and how to organize all aspects of patient care when social contact is as limited as it is for patients newly diagnosed with COVID-19. found that the prevalence of cancer among patients infected with SARS-CoV-2 (COVID-19) was higher than in the general population [12] . We would strongly encourage clinicians to keep reporting any cases of cancer patients infected with SARS-CoV-2, their management, and the outcome in order to further our understanding of this complex issue. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and coronavirus disease-2019 (COVID-19): the epidemic and the challenges The treatment and outcome of a lung cancer patient infected with SARS-CoV-2
cord-278256-dmrtsxik	2020	title: Clinical and epidemiological features of 36 children with coronavirus disease 2019 (COVID-19) in Zhejiang, China: an observational cohort study INTERPRETATION: Although all paediatric patients in our cohort had mild or moderate type of COVID-19, the large proportion of asymptomatic children indicates the difficulty in identifying paediatric patients who do not have clear epidemiological information, leading to a dangerous situation in community-acquired infections. All children with COVID-19 had been infected either by close contact with adults infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) or by exposure to the epidemic area. By contrast with findings in adults, children with COVID-19 had milder clinical manifestations; nearly half of paediatric patients were asymptomatic (ie, no fever and no cough). When compared with children with SARS, paediatric patients with COVID-19 had much milder disease in terms of the prevalence of fever, cough, pneumonia, and severe case type.
cord-278300-6cr9h7no	2020	We aimed to bridge the gap between disease classification and clinical outcome in intensive care patients, data of which are scarce and such classification could help in individual evaluation and provide effective triage for treatment and management. We constructed a fully Bayesian latent variable model for integrative clustering of six data categories, including demographic information, symptoms, original comorbidities, vital signs, blood routine tests and inflammatory marker measurements. We identified four prognostic types of COVID-19 in intensive care patients, presenting a stepwise distribution in age, respiratory condition and inflammatory markers, suggesting the prognostic efficacy of these indicators. Little attention has been paid to the clinical characteristics and outcomes of intensive care patients with COVID-19, data of which are scarce but are of paramount importance to reduce mortality. We aimed to bridge the gap between disease classification and clinical outcome in intensive care patients, which could help in individual evaluation and provide effective triage for treatment and management.
cord-278319-44bvju3g	2001	Four prospective studies (1984 to 1990) examined the accuracy of patient history and physical examination for diagnosing radiographic pneumonia in adults with acute respiratory illness in outpatient and emergency department settings, and a clinical decision tool to determine the need for radiography was developed. [42] [43] [44] [45] [46] [47] [48] [49] [50] By the mid-1990s, published reviews of randomized, placebo-controlled trials 51,52 had concluded that routine antibiotic treatment of acute bronchitis does not have a consistent impact on duration or severity of illness or on potential complications, such as development of pneumonia. In epidemiologic studies, respiratory viruses, particularly influenza, appear to cause the large majority of cases of uncomplicated acute bronchitis according to culture, antibody (48) productive cough of any times daily for 10 days group (n = 24) vs. Randomized, controlled trials have demonstrated a consistent benefit of therapy with albuterol versus placebo for uncomplicated acute bronchitis in reducing the duration and severity of cough (in one study, the "placebo" was erythromycin).
cord-278325-ykcd7d59	2020	Two meta-analyses showed that a lower platelet count is associated with an increased risk of severe disease and mortality in patients with COVID-19 and may serve as a marker for progression of illness [53, 54] . Experience from previous SARS patients, caused by SARS-CoV-1, suggested that coronavirus could cause thrombocytopenia by direct viral infection of bone marrow haematopoietic stem cells via CD13 or CD66a, formation of auto-antibodies and immune complexes, disseminated intravascular coagulopathy (DIC), and consumption of platelet in lung epithelium [61, 62] . The International Society on Thrombosis and Haemostasis (ISTH) suggested all patients (including non-critically ill) who require hospital admission for COVID-19 infection should receive a prophylactic dose of LMWH unless contraindicated (Table 2 ) [102] . Clinical Course and Outcomes of Patients with Severe Acute Respiratory Syndrome Coronavirus 2 Infection: A Preliminary Report of the First 28 Patients from the Korean Cohort Study on COVID-19
cord-278332-fbksw3om	2020	As such, analyses of the impact of quality measure adherence on overall survival in esophageal cancer have relied on the NCCN definition of at least 15 lymph nodes for adequate lymphadenectomy, regardless of the use of neoadjuvant therapy. Thus, the objectives of this study were to (1) explore trends in adequate lymphadenectomy rates over time; (2) evaluate unadjusted lymphadenectomy yield in esophageal cancer based on treatment characteristics; and (3) identify independent factors associated with adequate lymphadenectomy. Considering this finding in light of the fact that many patients do not achieve adequate lymphadenectomy, we argue that the oncologic community should accept a generalized lymphadenectomy threshold regardless of the therapeutic approach, and instead focus on modifiable With regard to surgical approach, we found an increased number of examined lymph nodes with laparoscopic and robotic surgery in comparison with the open approach. However, a focus on surgical approach and esophagectomy volume, which are modifiable factors associated with adequate lymphadenectomy, may promote continuous quality improvement in esophageal cancer care.
cord-278364-58d8kfdf	2017	The medical device or the surgical instrument that comes in contact with the sterile tissue or the mucus membrane of the patient during the various processes is associated with increased risk of introduction of pathogens into the patient''s body. Moreover, there is chance of transmission of infection from patient to patient; from patient or to health care personnel, and vice versa; or from the environment to the patient through the improper sterilized or disinfected devices. Patients care equipment are divided into three categories (critical, semicritical, and noncritical) depending on the intended use and risk of transmission of infection. These items do not need sterilization; however, they should be regularly cleaned and disinfected with LLD to decrease the transmission of infective organisms (Table 59 .6). Various recommendations for the prevention of VAP include (1) appropriate cleaning, disinfection, and sterilization of ventilator equipment, (2) maintenance of ventilator circuits, and (3) routine care of patients requiring ventilation.
cord-278477-9a7gmzz3	2020	Aims This study aimed to assess whether body mass index (BMI), fasting plasma glucose (FPG) levels, blood pressure (BP), and kidney function were associated with the risk of severe disease or death in patients with COVID-19. To examine the association between baseline health status and the risk of severe disease in patients with COVID-19, we performed a case-control study, using data from the nationwide registry of COVID-19 cases and from the biennial health checkup database in South Korea. In the present study based on a nationwide COVID-19 registry combined with an independent regular health checkup data, the effect of FPG levels and eGFR on the risk of severe or fatal COVID-19 varied between sex and age groups. In our retrospective study using a nationwide health checkup database, high FPG levels and low eGFR were significantly associated with the risk of severe COVID-19 (including fatal illness among women.
cord-278536-b4eyegx5	2020	OBJECTIVES: To assess the frequency of arterial and venous thromboembolic disease, risk factors, prevention and management patterns, and outcomes in patients with COVID-19, the authors designed a multicenter, observational cohort study. CONCLUSIONS: Major arterial or venous thromboembolism, major adverse cardiovascular events, and symptomatic venous thromboembolism occurred with high frequency in patients with COVID-19, especially in the intensive care setting, despite a high utilization rate of thromboprophylaxis. Whereas the morbidity and mortality associated with COVID-19 are usually attributed to acute respiratory distress syndrome (ARDS) and end-organ failure, cardiovascular complications, including myocardial infarction (MI), ischemic stroke, and pulmonary embolism (PE), also cause disability and death in these patients (1) (2) (3) . Among those admitted to the non-ICU setting (n ¼ 229), the frequency of major arterial or venous thromboembolism, major adverse cardiovascular events, and symptomatic VTE was also elevated but lower than for those with critical illness.
cord-278547-y0hvq0qf	2020	These measures are also justified by data, suggesting patients with cancer are more susceptible to infection and respiratory complications related to COVID-19 compared to those without cancer, due to immunosuppressive state caused by malignancy and chemotherapy. If reconstruction was needed, patient was admitted on the same day of surgery in a dedicated ward and discharged the day after. In case of patient with COVID-19 and no possibility to postpone surgery, a dedicated surgical theater and ward was available. A recent paper showed a slight prevalence of male patient with diagnosis of COVID-19 and a higher fatality rate (2.8%) when compared to female (1.7%). Probable pangolin origin of SARS-CoV-2 associated with the COVID-19 outbreak A practical approach to the management of cancer patients during the novel coronavirus disease 2019 (COVID-19) pandemic: an international collaborative group Cancer patients in SARS-CoV-2 infection: a nationwide analysis in China The epidemiological characteristics of an outbreak of 2019 novel coronavirus diseases (COVID-19) -China
cord-278549-br9rr713	2020	OBJECTIVES: To compare the number of patients attending the Urology ED of Centro Hospitalar Universitário do Porto (CHUP), as well as their demographic characteristics, the reasons for admission, the clinical severity under the Manchester triage system (MTS), and the need for emergency surgery or hospitalization, during the pandemic and the equivalent period in 2019. The aim of this study was to compare the number of patients who attended the Urology emergency ward of a Portuguese Tertiary Hospital -Centro Hospitalar Universitário do Porto (CHUP), as well as their demographic characteristics and the main causes of presentation to the ED, during the COVID-19 pandemic and the equivalent period at the previous year. During the COVID-19 pandemic, on the aforementioned dates, 46.4% fewer patients visited our urological emergency service compared with the homologous period of time one year ago (122 vs. However, significantly fewer female patients sought emergency urological services during the COVID-19 pandemic period (32.7% vs.
cord-278592-67y4f9av	2008	To eradicate a hospital-wide outbreak, a coordinated strategy between March and June 2005 comprised (1) formation of a VRE task force, (2) hospital-wide screening, (3) isolation of carriers, (4) physical segregation of contacts, (5) surveillance of high-risk groups, (6) increased cleaning, (7) electronic tagging of VRE status, and (8) education and audits. 1 In 2004, a localized VRE outbreak in a hematology ward of Singapore General Hospital (SGH) involving 6 inpatients was blamed on overseas importation of the index case with breaches in infection control measures, resulting in subsequent dissemination in that ward. Patients with high-risk acquisition for VRE-like end-stage renal failure (ESRF) on dialysis, those with hematologic or oncologic malignancies, those transferred from other local or overseas hospitals, or those with hospital admissions after January 1, 2005 were defined as ''''unknowns.'''' Records of ''''contacts'''' and ''''unknowns'''' were electronically tagged to facilitate VRE screening by stool or rectal swab on 2 separate occasions at least 24 hours apart.
cord-278672-pxzsntfg	2020	During outbreaks, especially those with a pandemic character, the following key activities [1] which are updated with COVID-19 strategy [2] have been identified whose strict implementation has an impact on the reduction of number of infected people and suppression of the spread of epidemic: 6 . This paper presents the adaptation and extension of existing medical information system (MIS) as an efficient response to the rapid COVID-19 epidemic spread, mostly through influencing the reduction of social contacts and earliest possible identification of potentially infected persons. According to the research findings the integration of patient self-triage tools into electronic health record (EHR) systems has a great potential in improving the triage efficiency and preventing unnecessary visits during the COVID-19 pandemic. The developed subsystem for the use of existing data from MIS MEDIS.NET in the education of students at the Faculty of Medicine and newly employed workers, as well as for medical research [47] , enables tracking and studying the COVID-19 disease at this stage.
cord-278682-s4gfbsqy	2005	The ultimate infectivity of the tears secretion and ocular discharge from SARS patients may bring impacts on not only the daily ophthalmic practice but also the universal infection control measures practiced by general public and health-care workers. Discard gloves, wash or alcohol-rub the hands and then put on new gloves in-between case Wear glove in high-risk procedure General categories: for all patients attending the ophthalmic outpatients in which the SARS status is not certain. In a case-control study among 254 Hong Kong health-care workers with documented exposure to SARS patients, none of the 69 staff reporting use of four infection control measures, namely mask, gloves, gowns, and hand washing, was infected. Hospital Authority guideline on infection control of Severe Acute Respiratory Syndrome (SARS)
cord-278838-qraq5aho	2017	Half the patients received mechanical ventilation within 1 (1–2) day following ICU admission (the ratio of arterial oxygen partial pressure to fractional inspired oxygen (PaO(2)/FiO(2)) = 150 (80–284), 80% with acute respiratory distress syndrome (ARDS)). Sequential Organ Failure Assessment (SOFA) score on day 1 (odds ratio (OR) 1.90 (1.33–2.70); p < 0.001), oxygen flow at ICU admission (OR 1.25 (1.08–1.45); p = 0.004), and early bacterial co-infection (OR 14.94 (2.00–111.8); p = 0.009) were independently associated with the need for mechanical ventilation. Results are presented for the imputed data Candidate predictors were: age, any comorbidity, underlying immunosuppression, SOFA score at day 1, oxygen flow at ICU admission, alveolar consolidation on chest X-ray, antibiotics at ICU admission, and early bacterial co-infection CI confidence interval, ICU intensive care unit, OR odds ratio, SOFA Sequential Organ Failure Assessment In our study, the overall mortality was 24% and reached 43% in patients who received invasive mechanical ventilation.
cord-278937-lkuuftno	2020	This review aims to summarize different practices of PFT laboratory management in different countries, including patient appointments, personal protective equipment, testing room requirements and telemedicine during and immediately following the COVID pandemic. Considering that there is a possibility of disease transmission to the patients and staff from asymptomatic carriers, precautions for pulmonary function testing (PFT) laboratories have been controversial (5) . These include postponing testing in non-urgent cases, personal protective equipment (PPE) for the respiratory technicians and PFT lab room characteristics such as negative pressure and adequate ventilation, HEPA filters, extensive hygiene measures and social distancing (6) (7) (8) (9) . At some centers, a negative COVID test is required within 72 hours before performing PFTs. Patients and visitors are expected to have a face mask/covering to enter the hospital. Testing personnel: Respiratory therapists or nurses performing all types of pulmonary function testing are screened daily for COVID symptoms by questionnaires and by temperature measurement in many centers.
cord-278943-f80ucqqp	2020	Many routine tests have relatively low yield for detecting abnormal findings or modifying clinical care in asymptomatic patients.(3) Thus, it may be possible to adopt temporary measures during this pandemic which strike a balance between the early detection and prevention of cancer therapy related cardiac dysfunction (CTRCD) and risk of COVID-19 transmission. Thus, with anthracycline initiation, regardless of dose, it may be reasonable to prioritize baseline cardiac imaging for patients with: 1) established or suspected CVD based on past medical history (e.g. myocardial infarction, cardiomyopathy, arrhythmia, moderate or greater valvular disease); 2) signs or symptoms of cardiac dysfunction; 3) ≥2 risk factors for CTRCD, including age ≥ 60 years, hypertension, diabetes, dyslipidemia, smoking, or obesity. The optimal surveillance regimen during anthracycline chemotherapy remains incompletely In patients who develop CTRCD and require cardiac treatments and/or withholding of cancer therapy, repeat imaging should continue as per institutional standard of care.(10)
cord-278984-0zof6s4d	2020	Understanding both the general problems facing chronic pain patients as well as specific problems in the COVID-19 era including deconditioning, increased mental health concerns, financial burdens, and potential for medication-induced immune-suppression is vital in the appropriate management of patients. Understanding both the general problems facing chronic pain patients as well as specific problems in the COVID-19 era including deconditioning, increased mental health concerns, financial burdens, and potential for medication-induced immune-suppression is vital in the appropriate management of patients. Recent recommendations for the safe use of non-opioid analgesics, opioid analgesics, and interventional pain management procedures are vital to know and understand specifically during the pandemic era. Immunosuppression as a result of medication, whether chronic opioid therapy or the use of oral or injectable steroids (e.g., in interventional pain procedures), is especially concerning during a time of global pandemic. Telemedicine has become an effective way of providing necessary medical services to patients with chronic pain during the COVID-19 epidemic.
cord-278993-w5aa0elj	2020	We retrospectively studied consecutive critically ill patients with confirmed Covid-19 who were referred to the hospitals of the Lombardy, Veneto and Emilia-Romagna regions during the first 2 weeks of the Italian outbreak (February 24March 8, 2020) . The present study describes how the Italian health-care system of three northern Italian regions responded to the increasing need for clinical resources for critically ill patients during the first 14 days of the Covid-19 outbreak through the 28.7% increase in ICU beds and the increasing use of non-invasive respiratory support outside the ICU. Our data show that, compared to patients admitted to the ICU, patients receiving respiratory support outside the ICU were significantly older, had more comorbidities and had a higher PaO 2 /FiO 2 ratio and a lower PaCO 2 .
cord-279052-8hxdfdls	2020	Secondary outcomes will include: (a) clinical outcomes (length of hospital stay, days with oxygen supplementation, oxygen flow values to obtain a saturation by pulse oximetry [≥]90%, intensive care admission and length of stay, days on invasive mechanical ventilation or high flow oxygen, sleep quality, fatigue, major thrombotic events, the 7-level COVID ordinal outcomes scale on Day 28; mortality, safety); (b) biological outcomes (plasma inflammatory markers); and (c) health system outcomes (cost of care and cost-effectiveness). Secondary objectives: To evaluate the effect of HBOT on: (a) other clinical outcomes (i.e., length of hospital stay; days with oxygen supplementation; daily oxygen flow values required to obtain saturation values ≥90%; ICU admission; ICU length of stay; days on invasive mechanical ventilation or high flow oxygenation; major arterial and venous thrombotic events, such as stroke, pulmonary embolism, deep vein thrombosis; sleep quality; fatigue; the 7-level COVID ordinal outcomes scale assessed on Day 28, mortality, and safety; (b) biologic inflammatory markers, including markers of immune activation response and inflammation; and (c) cost of care for COVID-19 patients and cost-effectiveness of HBOT.
cord-279056-mmcoqtb5	2020	BACKGROUND: COVID‐19 had a great impact on medical approaches among dermatologist OBJECTIVE: This systematic review focuses on all skin problems related to COVID‐19, including primary and secondary COVID‐related cutaneous presentations and the experts recommendations about dermatological managements especially immunomodulators usage issues METHOD: Search was performed on PubMed, Scopus, Embase and ScienceDirect. Totally 5 article were about skin drug reactions of COVID-19 treatments; two of them were original studies as case reports that were summarized in Table 7 (in the supplement file). In overall, non-infected non-at risk patients with immune-medicated dermatologic disorders under usage of immunosuppressive immunomodulator drugs like biologic agents are not needed to be alter regimen or discontine the therapies during pandemic, even these drugs may control the deteriorating cytokine storms also prevented disease flare-ups which both were associated with poorer outcomes and more complications in COVID-19 course, although strict adherence to quarantine and personal-social preventive hygiene performances are highly recommended especially in these groups of patients.
cord-279111-jaa45kyc	2018	OBJECTIVES: To describe the role of bacteria (including bacterial resistance), viruses (including those recently described) and mixed bacterial–viral infections in adults presenting to primary care with lower respiratory tract infection (LRTI). Methods: In all, 3104 adults with LRTI were enrolled, of whom 141 (4.5%) had community-acquired pneumonia (CAP), and 2985 matched controls in a prospective study in 16 primary care networks in Europe, and followed patients up at 28e35 days. Methods: In all, 3104 adults with LRTI were enrolled, of whom 141 (4.5%) had community-acquired pneumonia (CAP), and 2985 matched controls in a prospective study in 16 primary care networks in Europe, and followed patients up at 28e35 days. Our primary objective was to describe the viral and bacterial aetiology in adult patients presenting to primary care with LRTI and in those with community-acquired pneumonia (CAP).
cord-279134-s6c7m94h	2020	Therefore, it is of significance to summarize the relevant experience of China in the prevention and control of COVID-19 infection and treatment of patients with cancer during the epidemic. The delay of surgery because of COVID-19 epidemic may significantly affect the prognosis of patients with early stage lung cancer. It''s reported that a patient with NSCLC was treated with Kaletra (lopinavir/ritonavir) and osimertinib at the same time after the diagnosis of mild COVID-19 infection; 2 weeks after Kaletra treatment, pneumonia was cured and the tumor remained stable (23) . In the early stage of the epidemic, cross-infection in hospital is one of the most risk for patients and medical workers, so it is very important to screen COVID-19 patients as soon as admission of patients for cancer hospitals.
cord-279158-dsnniuo6	2020	title: Low blood sodium increases risk and severity of COVID-19: a systematic review, meta-analysis and retrospective cohort study Through a systematic review, meta-analysis and retrospective cohort study, we found that the low blood sodium population may significantly increase the risk and severity of SARS-CoV-2 infection. In this study, we aimed to find a key risk factor for SARS-CoV-2 epidemic by investigating the relationship between the blood sodium concentration and the severity of patients with COVID-19 through a systematic reviews, meta-analysis and retrospective cohort study. For the systematic review and meta-analysis, median or mean values of serum sodium, chloride and potassium concentrations from each report were considered as an independent variable for statistical analysis, and an unpaired t-test was used to compare the differences between the groups related to the severity of disease. In this study, we found that the patients infected by SARS-CoV-2 on admission have presented the low blood sodium levels (hyponatremia) that were related to the disease severity.
cord-279197-cesemos0	2020	Not only has COVID-19 suddenly converted us to a reliance on telehealth that is likely to persist in the future, it has also highlighted the use of some integrative therapies commonly used by cancer patients that have previously been thought to be too controversial for conventional clinics, but that might bear further research attention. For instance, 3 meta-analyses of randomized trials of chemotherapy in colorectal cancer patients found that performance status predicted mortality, [12] [13] [14] in addition to treatment side effects. Along with the previously published beneficial effects of parenteral fish oil emulsions in cancer patients, 30 these vitamin C trials raise the question of the potentials of other unconventional intravenous treatments in cancer patients. Pooled safety and efficacy analysis examining the effect of performance status on outcomes in nine first-line treatment trials using individual data from patients with metastatic colorectal cancer
cord-279238-d49jvws2	2020	The severe acute respiratory syndrome coronavirus 2(SARS-CoV-2) spread rapidly from China 1 worldwide and on March 11 th 2020 the WHO declared the so-called COVID-19 a pandemic. All kind of Surgery Units stopped to treat elective cases focusing on urgent/emergent patients to minimize Intensive Care Unit beds utilization. Patients with underlying cardiovascular diseases have an increased risk of developing into the severe form of COVID-19 4 , while health-care workers are exposed to the risk of contagion or to become vectors of transmission. Emilia-Romagna is the third Region for the number of infections, after Lombardy and Piedmont, and the S.Orsola Hospital, University of Bologna, became the main regional Hub center for COVID-19. Actually, in our center, each patient undergoes nasopharingeal swab one day before the hospitalization. If there''s an emergent case, a nasopharingeal swab is performed and the patient is considered suspect until the result of the test.
cord-279299-5djtiomq	2014	The day after admission to the Jingnan District Centre Hospital of Shanghai (Shanghai, China), the patient was diagnosed with severe H7N9 avian influenza infection by nasopharyngeal swab and blood sampling detection. In the present study, the patient exhibited a rapid deterioration; however, a diagnosis of H7N9 avian influenza was only confirmed after five days of continuous fever. Considering the initial diagnosis of severe pneumonia complicated with type I respiratory failure, the patient was administered oxygen therapy and methylprednisolone to reduce the systemic inflammatory response, and biapenem (0.6 g twice daily, i.v) and azithromycin (0.5 g/day, i.v) were applied as anti-infective agents. Combining the epidemiological history and the rapid progression in the pulmonary lesions of the patient (Fig. 3) , a diagnosis of human infection with H7N9 avian influenza was considered.
cord-279357-83hisxro	2020	Clinicians need to remember that (1) systemic inflammations can increase clozapine level; (2) clozapine, by itself, can cause inflammation, particularly during titration that is too rapid for that patient; (3) clozapine may increase the risk of infection; and (4) more specifically, clozapine may be particularly strongly associated with the risk of pneumonia. 13 Therefore, based on the US 8 14 and Chinese experiences [11] [12] [13] as well as on the literature, 10 we proposed that clinicians need to be very alert regarding clozapine patients'' risk of clozapine intoxications during any kind of systemic inflammation associated with fever and/or CRP elevations. Some case reports and observational studies previously reviewed in another article 11 suggest that infections can increase the serum concentrations of antipsychotics metabolised by CYP3A4.
cord-279396-qmixem8i	2020	In addition to the relatively high numbers of COVID-19 patients developing severe respiratory failure resulting in acute respiratory distress syndrome (ARDS) and requiring intubation and ventilatory support, the current data suggests an average length of stay for COVID patients in intensive care of eight days. The critical care nurse needs to recognise that patients who develop severe COVID-19 can rapidly develop Type 1 Respiratory Failure, ARDS and therefore require ventilatory support. 18 In non COVID-19 patients with increasing respiratory failure the use of High Flow Nasal Oxygen (HFNO) or Non-Invasive Ventilation (NIV) such as Continuous Positive Airway Pressure (CPAP) may be used as a treatment strategy. 40 There is also a suggestion that an increased number of healthcare professionals is needed when providing care, particularly in critical care for procedures requiring two nurses to one patient (2:1) when PPE is worn.
cord-279435-ffgd2ets	2020	Healthcare providers, particularly ophthalmologists, are at high risk of a COVID-19 infection through unprotected contact with eye secretions during routine ophthalmic examinations that involve the use of direct ophthalmoscopy and slit-lamp examinations, which are usually performed in a setting that allows for close doctor-patient contact. In fact, ophthalmologists are at high risk of contracting the COVID-19 virus through unprotected eye contact with secretions during routine ophthalmic examinations with direct ophthalmoscopy and slit-lamp examinations, which are usually performed in a setting that has close doctor-patient contact. A three-stage control measure to reduce the transmission of the virus in the ophthalmology department in Hong Kong was based on text messaging to reschedule refill visits [6] ; a triage to identify patients with fever, conjunctivitis, and respiratory symptoms; asking those who recently traveled to areas infected with the virus to postpone their ophthalmology visits for 14 days; and the avoidance of micro-aerosol generating procedures, nasal endoscopy, and operations under general anesthesia.
cord-279456-oouylyx9	2020	European SARS-CoV-2 pandemic epicenter was detected in Northern Italy, in a little Italian town of Lodi province, the Lodi Hospital was therefore rapidly saturated, and in particularly the departments of respiratory diseases and Intensive Care Unit had been largely involved. In this paper, we describe how the first Sub-intensive Respiratory Unit in Europe completely dedicated to COVID-19 patients was organized and managed in our hospital. SARS-CoV-2 related disease, COVID-19, presents a wide spectrum of clinical manifestations, from flu-like symptoms to severe pneumonia and acute respiratory distress syndrome (ARDS) [2] . In UTISIR were admitted patients testing positive to SARS-CoV-2 throat swab with phenotype 3,4,5, ICU patients weaned from intubation, with tracheostomy and transferred from other low-intensity care departments of the hospital, when appropriated. 4. Respiratory failure with suspected ARDS or severe pneumonia: CPAP or intubation required → hospitalization in COVID-19 ICU or COVID19 UTISIR.
cord-279480-nqp1pc9v	2020	Suggested modifications include an added emphasis on avoiding general anesthesia, a strong encouragement to infected individuals to opt for early neuraxial analgesia, and the prevention of emergent cesarean delivery, whenever possible. Compared to standard care in noninfected patients, the anesthesiologist may be more likely to replace a questionably functional epidural catheter in COVID-19 infected patients, in hopes to avoid urgent situations that may increase the odds for patient adverse outcomes (e.g. accidental dural puncture during a replacement of epidural catheter, or general anesthesia if urgent cesarean delivery) or avoidable exposures for healthcare providers (rushed replacement of neuraxial analgesia/anesthesia or general anesthesia in the operating room). If there does need to be a cesarean delivery on a patient who does not have an epidural catheter and is COVID-19 positive, the anesthesia team will need to weigh the risk of general anesthesia, including the risk staff exposure, to the possible risk of delay due to placement of a neuraxial block (typically a single shot spinal).
cord-279483-gwikyux2	2020	title: Risk prediction models to guide antibiotic prescribing: a study on adult patients with uncomplicated upper respiratory tract infections in an emergency department We aim to provide an evidence-based clinical decision support tool for antibiotic prescribing using prediction models developed from local data. From 2009 to 2010, adults had the highest rate of inappropriate antibiotic use for acute respiratory tract infections (URTIs, influenza, and viral pneumonia), with 500 antibiotic prescriptions per 1000 ED visits for adults aged 20-64 years and 666 per 1000 visits for those aged > = 65 years [10] . In this study, we aim to develop prediction models based on local clinical and laboratory data to guide antibiotic prescribing for adult patients with uncomplicated URTI with the ultimate goal of deploying them as an evidencebased clinical decision support tool for routine practice. Antibiotic prescribing for patients with upper respiratory tract infections by emergency physicians in a Singapore tertiary hospital
cord-279513-m4jdc8ua	2020	A triage for patients with cancer before hospital or clinic visits was conducted by 90.5% of centres before consultations, 95.2% before day care admissions and in 100% of the cases before overnight hospitalisation by means of phone calls, interactive online platforms, swab test and/or chest CT scan. The topics investigated in the survey included preventive measures taken before and after admission to the hospital, instructions given to patients and professionals, general measures for risk reduction of virus spread, specific measures in the hospitalisation unit, general organisation of the centre, organisation of multidisciplinary meetings and activities of other healthcare professionals, staff management and antibody testing. Patients were subjected to a triage for signs of infection prior to presenting to the oncology units in the majority of the centres, notably in 19/21 institutions (90.5%) before consultations, in 20/21 (95.2%) before day care outpatient infusion room admissions and in 20/20 (100%) before overnight hospitalisation (figure 2).
cord-279550-7u2hksxm	2020	METHODS: Blood samples (n=173) were collected from 30 COVID-19 patients over a 3-month period after symptom onset and analyzed for SARS-CoV-2-specific NAbs, using the lentiviral pseudotype assay, coincident with the levels of IgG and proinflammatory cytokines. Thus, serological testing, especially to detect NAbs, is essential in determining the onset of the serological immune response, evaluating the potential capacity of the host body for viral clearance, and identifying donors for passive antibody therapy trials. 12, 13 However, the dynamics and roles of SARS-CoV-2-specific NAbs and their correlation with antibody responses have not been explored in COVID-19 patients more than two months after symptom onset. Furthermore, to determine if there was a statistical correlation between NAb levels and virus-specific IgG levels in COVID-19 patients, serum samples were grouped by time (weeks) after symptom onset. In summary, we determined the dynamics of NAb titers within 3 months after symptom onset in 30 SARS-CoV-2-infected patients and found a positive correlation between NAb titers and IgG antibodies.
cord-279557-hk77e3pp	2013	BACKGROUND: The Middle East respiratory syndrome coronavirus (MERS-CoV) is an emerging virus involved in cases and case clusters of severe acute respiratory infection in the Arabian Peninsula, Tunisia, Morocco, France, Italy, Germany, and the UK. [4] [5] [6] Here, we provide a full description of a fatal case of MERS-CoV infection imported to Munich, Germany, from Abu Dhabi, including a chronological profi le of virus concentrations in diverse body compartments. We subjected all available MERS-CoV genome sequences to phylogenetic analysis, including a correlation and regression analysis of known dates of virus isolation versus tree branch lengths (fi gure 3). Without quantitative laboratory data from well documented cases of MERS-CoV infection, most considerations had been made on the basis of an assumed analogy to severe acute respiratory syndrome (SARS). The recorded viral load profi le, with highest RNA concentrations in bronchoalveolar lavage and tracheobronchial aspirates, confi rms suggestions made in another report about the preferential use of lower-respiratory-tract samples for virus diagnostic tests.
cord-279570-lgbqpfh5	2020	In this study we aim to describe the clinical characteristics and complications of measles infection in hospitalized adults during the recent epidemic in Greece. All adult hospitalized patients (≥18 years old) with serologically confirmed and/or clinical features compatible with measles were included. In this study, we describe our experience from the recent outbreak of measles in adult hospitalized patients in Greece [8] . One obese female patient with a Grade II hepatic involvement and pneumonitis that progressed rapidly into acute respiratory distress syndrome (ARDS) requiring mechanical ventilation, died within 6 days of her admission due to high-risk pulmonary embolism (PE) despite being treated with ribavirin. In this study we describe the clinical features and outcomes of mostly healthy and young adult hospitalized patients with measles. In summary, in this study we presented the clinical characteristics of measles infection during the recent epidemic in hospitalized adults in Greece.
cord-279571-chiadufa	2020	Compared with patients without AKI, patients with AKI had more severe organ dysfunction, as indicated by a higher level of disease severity status, higher sequential organ failure assessment (SOFA) score on admission, an increased prevalence of shock, and a higher level of respiratory support. CONCLUSION: Our findings show that admission SOFA score was an independent risk factor for AKI in COVID-19 patients, and patients with AKI had higher in-hospital mortality. In particular, acute kidney injury (AKI) is a common, serious complication in critically ill patients, which may result in increased mortality, longer hospital stays, and higher medical costs [5] . The aim of this study was to evaluate the incidence, risk factors, and impact on mortality of AKI in critically ill patients with COVID-19. In our study, AKI patients had a significant higher mortality rate after adjusting for admission SOFA score, severity status, respiratory support method, and shock.
cord-279667-ikfduu2k	2020	title: Complicated COVID-19 in pregnancy: a case report with severe liver and coagulation dysfunction promptly improved by delivery Severe COVID-19 promptly improved by the termination of the pregnancy or atypical HELLP (Hemolysis, Elevated Liver Enzymes and Low Platelet Count) exacerbated by concomitant COVID-19 infection could not be ruled out. CONCLUSIONS: This case adds to the growing body of evidence which raises concerns about the possible negative maternal outcomes of COVID-19 infection during pregnancy and advocates for pregnant women to be recognized as a vulnerable group during the current pandemic. We report a case of severe COVID-19 during in third trimester pregnancy, which led to an emergency Caesarean section and preterm delivery at 32 + 6 weeks of gestational age. Atypical presentation of HELLP could not be ruled out and the importance of a multidisciplinary team in the treatment and management of severe COVID-19 during pregnancy is critical for positive patient outcome.
cord-279719-z0wuajpx	2020	Resource rationing has been necessary in the COVID-19 pandemic, and therefore consensus documents have been published for decision-making based on four fundamental ethical values: maximization of benefits, treating people equally, contributing to creating social value and giving priority to the worst off, from which specific recommendations derive: maximize benefits; prioritize health workers; do not prioritize attendance on a first-COme, first-served basis; be sensitive to scientific evidence; recognize participation in research and apply the same principles to COVID-19 patients as to non-COVID-19 patients. The aspects associated with the principle of justice expressed by Beauchamp and Childress will therefore be of key importance in resolving the ethical and medical-legal problems arising from the fair assignation of resources during the COVID-19 pandemic.
cord-279732-cea0nt8z	2020	Literature and experience from healthcare teams in the midst of the pandemic suggest that any COVID‐19 patients with respiratory compromise severe enough to warrant admission should be considered for proning. Prior studies on proning awake, non-intubated patients with hypoxemic acute respiratory failure, 1,2 as well as evolving study of similar COVID-19 patients, [3] [4] [5] [6] coupled with experience and dramatic anecdotal evidence from the COVID-19 pandemic, suggest the importance of proning all such patients with COVID-19 to improve oxygenation and reduce respiratory effort. Literature and experience from healthcare teams in the midst of the pandemic suggest that any COVID-19 patients with respiratory compromise severe enough to warrant admission should be considered for proning. All rights reserved Care Society Guidance for Prone Positioning of the Conscious COVID-19 Patient 7 includes the following absolute contraindications: acute respiratory distress (requiring higher level intervention e.g. immediate need for intubation), hemodynamic instability, agitation or altered mental status, unstable spine, thoracic injury, or recent abdominal surgery.
cord-279736-udsbcqfs	2020	As we emerge from the peak of the COVID-19 pandemic''s initial surge, we prepare for re-entry of elective neurointerventional procedures to optimize the care of patients and mitigate infectious risk, while concurrently preserving ongoing capacity to care for patients with COVID-19. Anticipated potential limitations in health care resources (personal protective equipment (PPE), ventilators, personnel, hospital space) resulted in triaged delays of non-emergent endovascular procedures and surgeries [1] [2] [3] . We discuss several aspects of care that should be considered during the neuroendovascular resumption of an elective phase including hospital bed capacity, PPE resources, pre-procedure testing and post-procedure care. While the re-introduction of neurointerventional elective procedures can expose an additional specific and related risk of infection and stress, advance preparation and the development of modified pre-procedure protocols, intra-procedural protocols (sharing similarities with acute neurological emergencies) [7] [8] [9] , and post-procedural protocols can help organize the care of the patient, optimize peri-procedural risk to both patient and health care provider, and accommodate for appropriate resource allocation.
cord-279790-zzvetjrt	2020	However, in China, there are still numerous patients with other diseases, especially trauma and cancer requiring surgical treatment. If the oral cancer patient also suffers from COVID-19 or is an asymptomatic virus carrier, check-up and treatment procedures probably cause the spread of the virus through droplets, posing a significant risk to the medical staff. During the epidemic, chemotherapy or radiotherapy can be used as the alternative to surgical treatment in some oral cancer patients. The surgical personnel during operation are required to wear standard personal protection, including N95 masks, disposable protective clothing, disposable shoe covers, goggles or face screen protection. Oral and maxillofacial surgery generally involves the upper respiratory tract, and the surgical site is often contaminated by saliva, so when the electrosurgical equipment is used, powerful suction should be applied to reduce the diffusion of surgical smoke and aerosols. Moreover, for novel coronavirus-infected patients including asymptomatic virus carriers, the virus can spread through splashing of respiratory secretions when the patients cough.
cord-279846-g0ro8pbb	2020	We highlight the successful use of half-dose anticoagulation in the treatment of right atrial thrombus in a patient with COVID-19. To our knowledge, this is a first reported case of right atrial thrombus in a COVID-19 patient who was treated successfully with half-dose anticoagulation. In another three-center retrospective study of 184 COVID-19 ICU patients from the Netherlands, the authors reported 31% incidence of thrombotic complications. Therefore, the true incidence is likely higher.Our case supports the need to think of initiating therapeutic anticoagulation early in the course of critically ill patients with COVID-19. In addition to this, our case also highlights the use of half-dose anticoagulation therapy to treat a right atrial thrombus. To our knowledge, this is the first reported case of right atrial thrombus in a COVID-19 patient that resolved with a half dose of thrombolytic therapy. We highlight the ability to treat a right atrial thrombus in a patient with COVID-19 with half-dose anticoagulation.
cord-280005-i9fp5rys	2020	title: Treatment of COVID-19 Patients with Prolonged Post-Symptomatic Viral Shedding with Leflunomide -a Single-Center, Randomized, Controlled Clinical Trial CONCLUSIONS: In COVID-19 patients with prolonged PCR positivity, no benefit in terms of the duration of viral shedding was observed with the combined treatment of leflunomide and IFN α-2a beyond IFN α-2a alone. Based on that background, we conducted a prospective randomized, controlled, open-label trial, to evaluate the efficacy and safety of oral leflunomide to treat hospitalized COVID-19 patients with prolonged post-symptomatic viral shedding. Fifty eligible patients were randomly assigned to a combination treatment group that received leflunomide (50 mg, q12h, three consecutive times, orally; then 20 mg, once a day for 8 days; a total course of 10 days) plus nebulized IFN -2a (3 million IU each time, adding 2 ml of sterilized water, atomization inhalation twice daily for 10 days), or to a control group that received nebulized IFN -2a This was an open-label, prospective randomized, controlled trial, which was conducted at East Campus, Renmin Hospital of Wuhan University.
cord-280030-neqycg6v	2014	BACKGROUND: In 2008 a nosocomial outbreak of five cases of viral hemorrhagic fever due to a novel arenavirus, Lujo virus, occurred in Johannesburg, South Africa. Distinctive treatment components of the one surviving patient included rapid commencement of the antiviral drug ribavirin and administration of HMG-CoA reductase inhibitors (statins), N-acetylcysteine, and recombinant factor VIIa. CONCLUSIONS: Lujo virus causes a clinical syndrome remarkably similar to Lassa fever. We describe the clinical features of the five recognized cases of Lujo hemorrhagic fever (LHF) in the 2008 outbreak in South Africa and summarize their clinical management, as well as providing additional epidemiologic detail, with a focus on the risks for secondary transmission. In 2008, an outbreak of a novel hemorrhagic fever virus called Lujo occurred in Johannesburg, South Africa, with secondary transmission from the index patient to four healthcare workers.
cord-280060-gzby85u9	2016	2 A International Journal of Infectious Diseases 48 (2016) 104-112 significant number of immunocompromised patients may also be migrants who may return to their countries of origin to visit friends and relatives, and may acquire travel-associated infections. 26 Cases of Chagas disease (Trypanosoma cruzi) either as a consequence of reactivation of a latent infection not identified at the time of transplant (because an unrecorded travel history or stay in an endemic area) or by transmission through the organ donor, can also be associated with a high mortality. There have also been case reports of severe disease from other travel-associated infections, such as salmonellosis, Vibrio parahaemolyticus, and visceral leishmaniasis in immunocompromised patients. Less common pathogens such as Staphylococcus aureus, avian influenza viruses such as H7N9 and H5N1, the Middle East respiratory syndrome coronavirus (MERS-CoV), and Gram-negative rods such as Burkholderia pseudomallei must also be considered, as well as a few other pathogens that do not usually cause pneumonia, such as malaria.
cord-280070-c1bkhgaz	2017	Prognosis can vary according to the type of ILD, but many exhibit gradual progression with an unpredictable clinical course in individual patients, as seen in idiopathic pulmonary fibrosis and the phenomenon of "acute exacerbation"(AE). Diagnostic evaluations of patients with suspected ILD also need to consider infections, since they can cause various histopathologic patterns commonly associated with ILDs including NSIP, LIP, organizing pneumonia, and eosinophilic pneumonia, among others (Table 1) . Richter et al 19 19 It is currently difficult to determine whether patients with IPF are more susceptible to infection or colonization due to abnormal lung parenchyma, associated traction bronchiectasis, and immunosuppressive medications (which historically have been commonly used for treatment of ILDs), or whether bacteria are involved as triggers of AE or in the pathogenesis of IPF. Histopathologic features and outcome of patients with acute exacerbation of idiopathic pulmonary fibrosis undergoing surgical lung biopsy Acute exacerbation of idiopathic pulmonary fibrosis: role of Chlamydophila pneumoniae infection
cord-280097-f7ky61ds	2011	title: Are there any differences in clinical and laboratory findings on admission between H1N1 positive and negative patients with flu-like symptoms? BACKGROUND: The World Health Organization alert for the H1N1 influenza pandemic led to the implementation of certain measures regarding admission of patients with flu-like symptoms. The aim of this study was to retrospectively examine the characteristics of all subjects admitted to the Unit of Infectious Diseases with symptoms indicating H1N1 infection, and to identify any differences between H1N1 positive or negative patients. The purpose of this study was to investigate the potential differences on admission between H1N1 positive and negative patients with flu-like symptoms. These elevated values (C-reactive protein and WBC) are known to be associated with bacterial infection and early antibiotic treatment prevents progression of the disease as reported in previous studies [19] [20] [21] . Are there any differences in clinical and laboratory findings on admission between H1N1 positive and negative patients with flu-like symptoms?
cord-280111-6hiuzkvz	2020	This literature review aims at reducing in-office appointments by providing an overview of the technologies available and their reliability in the long-distance monitoring of patients, i.e., teledentistry. As no reviews have yet been carried out on the efficacy of teleassistance in orthodontics as a way to manage patients at a distance, we would like to report on the evidence available as to the possibility of implementing new technologies in teleassistance, generally known by teleorthodontics to help during the COVID-19 pandemic to remotely monitor patients'' conditions. The attitudes toward teleassistance in orthodontics, and in general, dentistry by respective dental care professionals, was investigated in several studies which confirmed it was as an effective alternative to in-office visits for several routine procedures and to make consultations more accessible to dentists and patients [23, 38] .
cord-280129-a97rvtzl	2020	authors: Honore, Patrick M.; Barreto Gutierrez, Leonel; Kugener, Luc; Redant, Sebastien; Attou, Rachid; Gallerani, Andrea; De Bels, David title: Liver injury without liver failure in COVID-19 patients: how to explain, in some cases, elevated ammonia without hepatic decompensation Liver injury without liver failure in COVID-19 patients: how to explain, in some cases, elevated ammonia without hepatic decompensation Patrick M. Both patients were treated with classical medical therapy including lactulose, but, despite increasing doses of lactulose for 3 days, ammonia levels remained unchanged. Retrospectively, we hypothesize that the pre-admission diarrhea may have resulted in secondary carnitine deficiency, as described in the literature [3] , leading to hyperammonemia unresponsive to medical therapy [4] . As we did not measure serum carnitine levels and we did not supply the patients with carnitine supplementation, the diagnosis of carnitine deficiency in these cases remains only a hypothesis. Liver injury in critically ill patients with COVID-19: a case series
cord-280233-avmisu31	2020	In light of the COVID-19 pandemic, this commonsense approach was recently clarified in a SCCM-ASA-AARC-AACN-ASPF-CHEST consensus statement on the Society of Critical Care Medicine (SCCM) website [1] : ''We recommend that clinicians do not attempt to ventilate more than one patient with a single ventilator while any clinically proven, safe, and reliable therapy remains available (ie, in a dire, temporary emergency)'' [1] . In-parallel is a critical point, as inspiration and expiration all take place at the same time, so there is thus no change to respiratory rate (RR) and tidal volume or driving pressure are adjusted for the number of patients. Instead of the same RR and higher tidal volume or driving pressure, in-series breathing doubles the RR and keeps the other ventilator settings the same. PC driving pressure and VC tidal volume would have to be the same as ventilators currently do not have the capability to enable alternating breath settings.
cord-280241-h16s6wwm	2020	Following on from initial statements in the acute phase of the pandemic (1) (2), this update from the British Society of Thoracic Imaging group aims to provide an overview of the multisystem complications of COVID-19 with a focus on the thoracic manifestations, in particular the lung parenchymal and pulmonary vascular sequelae. The authors will also explore the British Thoracic Society (BTS) guidance on the respiratory follow-up of patients with COVID-19, including the resource implications for departments, discuss the potential use of structured reporting of follow-up imaging and outline future opportunities for longitudinal data collection and research. A perilobular pattern of organising pneumonia (32) , recognised in the acute phase of the disease, may also be present on follow-up but may dissipate on later imaging, especially if unaccompanied by signs of fibrosis (Fig. 10) .
cord-280278-gq1hnnwh	2020	Health care workers are exposed to high-risk environments when patients infected with COVID-19 require advanced airway management. However, patients cannot wear masks during positive pressure ventilation and endotracheal intubation, exposing health care workers to high-risk environments, even if effective protective measures were taken. The PVC membrane should be sufficiently large (> 100 cm × 100 cm is recommended) to cover the head of the patient and have a hole (sealed when necessary) in the center for the connection between the face mask and the circuit during oxygen inhalation and positive pressure ventilation. Before advanced airway management, the PVC membrane with an assembled face mask under the membrane is placed over the patient''s mouth and nose for the induction of intubation (Fig. 1a) . Our appliance reduces the spread of droplets and aerosols from patients, blocking the airborne transmission route of the virus to a large extent and providing a new layer of protection for health care workers during advanced airway management.
cord-280280-9jr7ekbu	2020	Ongoing studies and accumulated data are detailing the features and the effects of the new coronavirus disease 19 (COVID 19) in the adult population, and cardiovascular involvement is emerging as the most significant and life-threatening complication, with an increased risk of morbidity and mortality in patients with underlying cardiovascular disease. At present, though the limited data on the effects of COVID 19 in pediatric patients, children seem to count for a little proportion of SARS-COV 2 infection, and present with less severe disease and effects However infants and toddlers are at risk of developing critical course. Coronavirus disease 19 (COVID-19) is a severe acute respiratory syndrome for which the etiologic agent is the novel beta coronavirus SARS-CoV-2, first described in December 2019 in China in a cluster of patients presenting with pneumonia. The main presenting clinical feature of the disease is pneumonia, ranging from asymptomatic or mildly symptomatic to severe acute respiratory distress syndrome, but cardiovascular involvement is emerging as one of the most significant and life-threatening complications of SARS-CoV-2 infection (1, 2) .
cord-280348-vrnxucye	2020	Chronic obstructive pulmonary disease (COPD) represents an important leading cause of morbidity and mortality with high economic and social costs: according to the WHO, COPD is the fourth most common cause of death worldwide, and it is estimated to be the third by 2020; furthermore, the global burden of COPD is expected to increase in the coming years, due to the prevalence of smoking and aging of the world population [1] . The following clinical characteristics were evaluated: respiratory and non-respiratory disease distribution at hospital admission (according to International Classification of Diseases-Ninth Revision); cognitive status and mood disorders (by the Short-Blessed-Test [SBT] [9] and the Geriatric-Depression-Scale [GDS] [10] ,respectively; performance in activities of daily living at hospital admission (measured by means of the Barthel Index [BI] [11] ; severity and comorbidity index(assessed by the Cumulative-Illness-Rating-Scale CIRS-s and CIRS-c, respectively) [12] , glomerular filtration rate (using the Chronic Kidney Disease Epidemiology Collaboration-formula [13] ), length of hospital stay, drugs prescriptions (at admission, discharge, at 3 and 12 months follow-up), destination at discharge, in-hospital and 3-month and 1-year mortality rate.
cord-280358-ru2hv6pz	2020	title: Comparison of the clinical characteristics and outcomes of hospitalized adult COVID-19 and influenza patients: a prospective observational study Objective We compared the clinical characteristics, findings and outcomes of hospitalized patients with coronavirus disease 2019 (COVID-19) or influenza to detect relevant differences. Our prospective population-based influenza study was already recruiting hospitalized adult patients with severe acute respiratory infection (SARI), which gave us the opportunity to enroll COVID-19 patients since the beginning of the outbreak. In previous studies, along with age and other comorbidities, obesity has been a risk factor for severe disease and ICU admission in both COVID-19 and influenza, which supports our findings [30, 31] . . https://doi.org/10.1101/2020.06.29.20140632 doi: medRxiv preprint epidemic, occasionally SARS-CoV-2 detection alone was conducted without influenza testing on clinical grounds, however, of the COVID-19 patients included in this study, 21 (75%) were tested for influenza and no co-infections were found.
cord-280360-rh37d5wc	2009	title: Comparative analysis of synovial fluid and plasma proteomes in juvenile arthritis – Proteomic patterns of joint inflammation in early stage disease Comparative analysis of synovial fluid and plasma proteomes in juvenile arthritis -Proteomic patterns of joint inflammation in early stage disease 1 We initially performed a study of the proteins expressed within synovial fluid and plasma in early JIA in order to discover novel biomarkers which distinguish between local and systemic components of joint inflammation in arthritis. The simultaneous analysis of individual paired plasma and synovial fluids from ten patients ( Table 1 , study group A) was used to initially isolate joint-specific protein expression profiles, without introducing bias from inter-individual differences. A number of proteins with consistent synovial and plasma ''specific'' expression patterns are highlighted and quantified to demonstrate the ability to reliably differentiate molecular fingerprints of local and systemic disease across patient groups by this gel based approach.
cord-280431-tuzdng4h	2008	The triggers for this rapid growth have not only been recent technological developments in terms of personal computer power, but primarily clinical educators believing in the potential of simulation training approaches to help others effectively acquire life-saving skills in a safe and controlled environment. At the same time, I assumed responsibility for the development of the University of Hertfordshire''s Intensive Care and Emergency Simulation Center concentrating primarily on delivering simulation-based training to nursing and paramedical students and evaluating the teaching effectiveness of this approach [6] . Similarly, you can greatly contribute to the success of your center''s simulation programs by effectively communicating with other educators to refine scenarios provided to your participants, develop the simulation environment and new props. You might be able to use your skills and technical knowledge to further develop their ideas and improve aspects of the simulation training experience of participants.
cord-280507-1nf2ycp3	2020	Communication between all members of a research team is key to adapting the development of clinical trials to the context of the epidemiological crisis of coronavirus. Communication between all members of a research team is key to adapting the development of clinical trials to the context of the epidemiological crisis of coronavirus. These shipments of medication coincided with visits made by telephone by the investigator delegated as responsible for the research team, and by the study coordinator and/or the trial nurse. Regarding in-person visits with patients, there were two occasions where patients picked up the medication at the beginning of March at Hospital La Paz. One paediatric patient received prophylaxis by nurses because the training for the administration of the treatment had not yet taken place. All rights reserved There was another in-person visit by an adult patient for the administration of subcutaneous medication by the nurses of the centre, because he was not trained to administer it himself.
cord-280551-9hoxy5ok	2020	We performed survival analysis to identify independent predictors of all-cause mortality and COVID-19 related mortality, and multivariate logistic regression to determine the risk of severe COVID-19 in patients with CLD. The liver-specific factors associated with independent risk of higher overall mortality were alcohol-related liver disease (ALD) (hazard ratio [HR] 2.42, 95% confidence interval [CI] 1.29-4.55), decompensated cirrhosis (HR 2.91 [1.70-5.00]) and hepatocellular carcinoma (HCC) (HR 3.31 [1.53-7.16]). Future studies will be needed to analyze specific subgroups within the spectrum of alcohol liver disease (ALD) who are at higher risk for adverse outcomes with COVID-19. We identify decompensated cirrhosis, ALD, and HCC to be determinants of mortality in patients with CLD, and additionally show that Hispanic ethnicity is independently associated with severe COVID-19. In this large study of 867 patients from 21 centers across the US with CLD with COVID-19 we determine that patients with alcohol related liver disease (ALD), decompensated cirrhosis and hepatocellular carcinoma have a high risk for allcause mortality from COVID-19.
cord-280554-9jp85yzz	2020	The data obtained concerning lymphoma history included the date of diagnosis, pathological classification according to the WHO classification for lymphoid neoplasms [19] , number of treatment lines, past autologous or allogeneic stem cell transplant, chimeric antigen receptor (CAR) T-cell therapy, detailed bendamustine and anti-CD20 monoclonal antibody use (date of first and last administration), and lymphoma status at admission for Covid-19 (complete or partial remission, diagnosed at admission, under first or second line treatment, in watch and wait follow-up, or refractory/ relapsed). Covariates considered in this analysis were age ( 70 years versus below), gender, BMI ( 30 kg/m 2 versus below), smoking status, presence of comorbidities (overall or hypertension, diabetes, chronic lung disease, or past history of cancer) and ongoing antihypertensive treatment with an ACE inhibitor or angiotensin-receptor blocker (ARB), main lymphoma subtypes (Hodgkin lymphoma, B-cell non-Hodgkin lymphoma (NHL), or T-cell NHL), recent administration of corticosteroids (within one month), use of bendamustine (within one year), or anti-CD20 monoclonal antibody (within one year), time between diagnosis of lymphoma and hospitalization for Covid-19 (< 2 years versus 2 years), past history of autologous stem cell transplant, and lymphoma status (refractory/relapsed versus others).
cord-280628-ok62havd	2020	COVID-19 requires the collaboration of nearly 200 countries to curb the spread of SARS-CoV-2 while gaining time to explore and improve treatment options especially for cardiovascular disease (CVD) and immunocompromised patients, who appear to be at high-risk to die from cardiopulmonary failure. Since the coronavirus disease (COVID19) is still an emerging pandemic with more than 2.1 million confirmed cases worldwide [1] , special focus is currently directed towards the understanding of why people are hospitalized, receive intensive care, and frequently die as a consequence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. While higher mortality rates among CVD patients are also associated with other respiratory diseases (especially influenza virus-induced flu or previous SARS epidemics), the question was put forward, whether people treated for heart-related illness are more prone to SARS-CoV-2 viral infection, based on first epidemiological evidence, but particularly based on the presumed upregulation of the SARS-CoV-2 entry receptor.
cord-280794-k591vqji	2020	Because anesthesiologists must take into account the risk of meningitis or encephalitis associated with neuraxial procedures in the setting of untreated viremia, we reviewed publications reporting outcomes in COVID-19-positive pregnant women in the current pandemic in an attempt to address this concern. In general, the risk of causing meningitis or encephalitis is extremely low with neuraxial procedures, even in infected patients. Before performing a neuraxial procedure in these patients, it would be advisable to review a recent platelet count given that one-third of patients with COVID-19 infection have been reported to have thrombocytopenia compared with 7%-12% of patients during pregnancy alone. 7 In pregnant women, a platelet count of 70,000 × 10 6 /L has a low risk for spinal epidural hematoma, and lower levels should be considered in cases such as these with a high risk for respiratory compromise with general anesthesia.
cord-280821-kc0ut4oy	2020	The Italian Society of Pediatric Infectious Diseases steering and scientific committee developed a position paper on treatment of children with COVID-19, reviewing the current literature on this topic and providing indications based on the available literature data. Currently, American guidelines on COVID-19 treatment published in May 2020, recommend both in children and adults to use lopinavir/ritonavir only in the context of clinical trials, given the lack of effectiveness reported now in literature [9, 12] . The latest Chinese guidelines on SARS-Cov-2 pneumoniae do not recommend the use of a specific antiviral for the treatment of COVID-19, and nevertheless include lopinavir/ritonavir among the available therapeutic options for hospitalized patients [29] . In May 2020, following an assessment of the emergency use authorization criteria and available scientific evidence, the FDA issued an emergency use authorization allowing for the administration of remdesivir intravenously by health care providers for the treatment of COVID-19 suspected or laboratoryconfirmed in adults and pediatric patients hospitalized with severe disease [34] .
cord-280848-z0sbztkw	2020	These include protocols pertinent to safety, in-office Rhinologic procedures, the substitution of imaging for endoscopy, and understanding the appropriate role of telemedicine. There has been controversy and significant concern regarding endoscopic evaluation of patients in the office, especially nasal endoscopy and flexible laryngoscopy, since performing these procedures puts one in direct contact with the virus as it resides primarily in nose and nasopharynx. To decrease nasal endoscopy procedures and minimize risk, organizations such as the American Rhinologic Society (ARS) should consider guidelines examining when it is appropriate to go straight to CT in select cases of possible COVID-19 now and in the future. In-Office CT sinus will continue to play an important role as a point of service procedure in lieu of nasal endoscopy in patients with COVID-19 or suspected thereof. This makes nasal endoscopy and other in-office rhinologic procedures a concern for the Otolaryngologist with increased risk for infection.
cord-280944-uphs5gvl	2020	Sir, current guidance from the RCS Recommendations for paediatric dentistry during the COVID-19 pandemic is very clear: '' Access to general anaesthesia will be significantly reduced for the foreseeable future'' . Sir, prior to the COVID-19 pandemic, patients undergoing invasive procedures were subject to confirming their consent through written means, a process which is considered common within surgical fields. 1 The guidance issued by the FGDP on 1 June suggested a move towards provision of ''digital packs'' and it seems many standard operating procedures (SOPs) being issued by practices include the provision of digital information packs with consent forms to patients. With dental practices now resuming a limited level of practice and possibly experiencing the level of frustrations with lack of treatment provisions for anxious patients, oral sedation with Diazepam is an invaluable tool in enabling patients the access to care they require. Careful case selection is of course key to its successful use, and requires the triaging clinician to be thorough in ascertaining dental history and indication of sedation need.
cord-280961-fka8c69p	2020	METHODS: This was a retrospective analysis of the clinical and thoracic CT features of 120 consecutive patients with confirmed SARS-CoV-2 pneumonia admitted to a tertiary university hospital between January 10 and February 10, 2020, in Wuhan city, China. (c) Unenhanced axial CT images of a 27-year-old male doctor with a history of exposure to confirmed SARS-CoV-2 patients, initially presenting with fever (39°C), nonproductive cough, dyspnea, and myalgia (c1) who progressed to a severe case requiring oxygen supplementation (c2). (d) Unenhanced axial CT images of a 52-year-old male doctor with asthma and exposure to confirmed SARS-CoV-2 patients, initially presenting with fever (39°C), non-productive cough, dyspnea, and myalgia who rapidly progressed to a severe form requiring mechanical ventilation. In this study, we reported the clinical characteristics and chest CT findings at presentation for all types of SARS-CoV-2 pneumonia severity.
cord-280984-2j8ckz14	2020	title: Impact of home confinement during the COVID‐19 pandemic on medication use and disease activity in spondyloarthritis patients Home confinement, imposed as part of the social distancing measures in the fight against the coronavirus disease 2019 (COVID‐19), poses several problems for patients with spondyloarthritis (SpA), including the lack of physical activity, psychological factors, and the confusion related to the prescriptions of NSAIDs. We investigated the impact of confinement on the medication intake and disease activity in SpA patients in a questionnaire‐based survey. We investigated the impact of confinement on the medication intake and disease activity in SpA patients in a questionnaire-based survey. However, this is the first study providing information on therapy compliance during home confinement and the frequency of COVID-19 in SpA patients. Thus, this survey shows that home confinement linked to the COVID-19 pandemic is associated with worsening of the disease and a reduction or suspension of medication intake, in particular NSAIDs, in SpA patients.
cord-280996-anq680a1	2020	title: High-flow nasal cannula for acute hypoxemic respiratory failure in patients with COVID-19: systematic reviews of effectiveness and its risks of aerosolization, dispersion, and infection transmission Review 1: we synthesized results from randomized-controlled trials (RCTs) comparing HFNC to conventional oxygen therapy (COT) in critically ill patients with acute hypoxemic respiratory failure. Conclusions High-flow nasal cannula may reduce the need for invasive ventilation and escalation of therapy compared with COT in COVID-19 patients with acute hypoxemic respiratory failure. Conclusions High-flow nasal cannula may reduce the need for invasive ventilation and escalation of therapy compared with COT in COVID-19 patients with acute hypoxemic respiratory failure. We conducted two rapid systematic reviews commissioned by the WHO to summarize the evidence for the efficacy, safety, and risk of aerosol generation and infection transmission during HFNC use among patients with acute hypoxemic respiratory failure due to COVID-19.
cord-281003-7pdhxdzc	2020	METHODS: The present statement summarizes the key challenges concerning the management of haemoglobinopathies, with particular focus on patients with either transfusion‐dependent or non‐transfusion‐dependent thalassaemia, identifies the gaps in knowledge and suggests measures and strategies to deal with the pandemic, based on available evidence and expert opinions. The coronavirus disease 2019 (COVID-19) pandemic, caused by the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has affected millions across the world, having caused hundreds of thousands deaths. However, disease-related complications may affect multiple organs including the heart, liver, endocrine glands, lungs and the immune system, thus rendering this patient population at an increased risk to develop serious complications during COVID-19. 2, 3, 11 This is especially so in patients who receive suboptimal management and lack access to modern therapy and Thalassaemia patients do not have the same risk of pulmonary infections with sickle cell disease patients but, they may have multiple organ complications, often due to iron overload, including cardiac and hepatic, diabetes mellitus and endocrine disease.
cord-281039-a7q5nzwn	2020	Multivariate analysis showed that after adjusting for gender (males, OR: 1.5, p = 0.0001), age tertiles (second and third tertiles, OR: 2.0 and 4.7, p = 0.0001), and Charlson Comorbidity Index scores (second and third tertiles, OR: 4.7 and 8.1, p = 0.0001), hypertension was significantly predictive of all-cause mortality when this comorbidity was treated with angiotensin-converting enzyme inhibitors (ACEIs) (OR: 1.6, p = 0.002) or other than renin-angiotensin-aldosterone blockers (OR: 1.3, p = 0.001) or angiotensin II receptor blockers (ARBs) (OR: 1.2, p = 0.035). First, a previous diagnosis of HT increased the risk of all-cause death in COVID-19 patients who required hospitalization on the order of approximately 20% and independently of age and other cardiovascular comorbidities, such as HF and atrial fibrillation. Second, previous treatment with ACEIs/ARBs in hypertensive patients was not associated with a higher risk of all-cause mortality in hypertensive hospitalized COVID-19 patients compared to other antihypertensive drugs.
cord-281060-1ud5hzlh	2020	BACKGROUND: COVID‐19 cutaneous manifestations have been recently described and classified in five different clinical patterns, including acral erythema‐edema (pseudo‐chilblain), maculopapular exanthemas, vesicular eruptions, urticarial lesions, and livedo or necrosis. We decided to perform this study to describe the real prevalence and directly examine the skin findings in hospitalized patients in our institution with a confirmed diagnosis of COVID-19 disease. We performed a cross-sectional study, which included COVID19 Based on recent reports 4-16 and on the Spanish group classification in clinical patterns, 17 we included acral erythemaedema (pseudo-chilblain), maculopapular exanthemas, vesicular eruptions, urticarial lesions, and livedo or necrosis areas. All skin findings can be included in the recently described clinical patterns of cutaneous manifestations of COVID-19 disease. In our study, we did not correlate the severity of the COVID-19 disease with the different skin patterns because all of the patients we included had very similar clinical characteristics of COVID-19 (moderate-severe infection that required hospitalization).
cord-281064-b69p44uq	2020	Analysis of 11 studies regarding laboratory abnormalities in patients with COVID-19 did not mention raised blood glucose or diabetes as predictor of severe disease [12] . Previous results of complete blood count of the enrolled same non-diabetic individuals with Covid infection which were studied during their last visit to any out-patient clinic at the hospital before onset of Covid infection were yielded from the archive records via patient information management system of the hospital. The MPV values of age-and sex-matched 160 laboratory confirmed Covid patients without diabetes admitted to the Covid out-patient clinic were detected as 10.49 ± 0.96 and 10.66 ± 0.94 before and after Covid infection in these individuals, respectively (p=0.37). We thought that the statistically significant difference in MPV between diabetic patients before onset of Covid infection and healthy individuals was caused by hyperglycemia in diabetes.
cord-281106-vzb5xzza	2020	According to current data, the risk of thromboembolic events in hospitalized COVID-19 patients is significantly increased, making thrombosis prophylaxis with low molecular weight or unfractionated heparin necessary. Neben den bekannten Ursachen der Thromboseentstehung, wurden bei der COVID-Erkrankung spezielle Pathomechanismen beobachtet, die zur Bildung von Thrombosen sowohl im venösen als auch im arteriellen System beitragen können. Auch wenn die Mechanismen noch nicht in Ihrer Gesamtheit erfasst sind, so ist bereits jetzt ersichtlich, dass die thrombembolischen Komplikationen im Zusammenhang mit dem SARS-CoV-2-Virus auf eine exzessive Inflammationsreaktion, Veränderung von Blutflusseigenschaften, direkte virusbedingte Thrombozytenaktivierung und Endothelschädigung zurückzuführen sind [3] . Diese Hypothese wird von nahezu allen bisher publizierten Arbeiten zu thrombembolischen Ereignissen bei COVID-19-Patienten postuliert und könnte eine Erklärung für die deutlich erhöhte Anzahl von TVT bieten [1, 7, 17, 28, 39] . Eine einheitliche Nomenklatur besteht noch nicht, die Pu-blikationmitdergrößtenSerie benennt es als "Pediatric Inflammatory Multisystem Syndrome Temporally Associated With SARS-CoV-2" (PIMS-TS) [36] .
cord-281130-9tawihti	2020	(4) that evaluated the role of complement related pattern recognition molecules, including C-reactive protein (CRP) and Pentraxin 3 (PTX3), as markers of short-term mortality in intensive care patients. In order to evaluate the potential prognostic value of PTX3 and its correlation with the severity of SARS-CoV-2, measurement of PTX3 in serum samples of patients (n= 75, male/female 47/28, age 69 years (median) 59-75 years (IQR)) with COVID-19 microbiology proven infection (from March to May 2020) was carried out using an enzyme-linked immunosorbent assay (ELISA) (DSX, Technogenetics srl, Milano, Italy), in addition to routine laboratory tests performed at admission. Moreover, PTX3 correlated (Spearman test) with some inflammation biochemical parameters commonly evaluated in SARS-CoV-2 patients, in particular with IL-6 (r =0.69, p<0.001), PCT (r =0.52, p<0.001), PSP (r =0.52, p<0.001), LDH (r =0.62, p<0.001), CRP (r =0.59, p<0.001), and D-dimer (r =0.43, p<0.001). Taken together, data obtained from our preliminary study suggest a potential prognostic role of PTX3 in SARS-CoV-2 patients, with higher levels associated with poor outcome.
cord-281175-og3myz22	2020	The coronavirus disease 2019 (COVID-19) pandemic has shattered the meticulously developed processes by which we delivered quality care for patients with cirrhosis. We describe how this impact unfolds over 3 waves; i) an intense period with prioritized high-acuity care with delayed elective procedures and routine care during physical distancing, ii) a challenging ''return to normal'' following the end of physical distancing, with increased emergent decompensations, morbidity, and systems of care overwhelmed by the backlog of deferred care, and iii) a protracted period of suboptimal outcomes characterized by missed diagnoses, progressive disease and loss to follow-up. This includes an intensification of the preventative care provided to patients with compensated cirrhosis, proactive chronic disease management, robust telehealth programs, and a reorganization of care delivery to provide a full service of care with flexible clinical staffing. Coordination of care associated with survival and healthcare utilization in a population-based study of patients with cirrhosis
cord-281276-rffp6qe2	2020	The paper conclude that, since health authorities in some countries recommended this off-label use treatment, physicians are challenged by the requirement of veracity while providing care to their patients and the implications of such a requirement; they are facing the challenge of balancing this guideline and their own conviction. To date and after the fifth months into the novel coronavirus pandemic, no drugs have demonstrated safety and efficacy in randomized controlled trials for patients with COVID-19. This decision has raised many questions and some ethical issues related to the hydroxychloroquine treatment prescription might emerge during the Covid-19 patients'' management. Reluctancy regarding the use of this drug for the treatment of patients with Covid-19 is justified by the absence of a high level of scientific evidence namely randomized controlled clinical trials proving the superiority of this drug for this indication, as we discussed above.
cord-281283-h6yai7sx	2020	Because SARS-CoV-2 is highly infectious, and the general population is susceptible, it is difficult to effectively prevent the spread of COVID-19 based on the current instruments, medical staff, and management modes of mental health institutions. On February 13, the Wuhan epidemic prevention and control command instructed that an isolation ward should be established to treat patients with mental illnesses with confirmed or suspected of COVID-19 infection. During the outbreak, all impairmentspecific settings were replanned to allow for the most effective prevention and control of COVID-19, and the functions of the psychiatric wards were reallocated according to the following plan 9 : (1) a ward for confirmed COVID-19 patients: this ward is used for the treatment of COVID-19 patients, and the patients are classified and managed according to disease severity; secondary protections should be implemented.
cord-281298-qheq9lc8	2020	Some of the novel legal extensions aimed at aiding overloaded healthcare systems are as follows: authorisation to prepare hand and surface disinfectants, eligibility to renew chronic treatment prescriptions, as well as filling pro auctore and pro familia prescriptions by pharmacists, performing COVID-19, influenza, and Group A Streptococcus screening tests, and vaccine administration. The important role of pharmacies, which form an integral part of 43 the healthcare system, should be emphasised in the daily delivery of medicines, therapeutics, vaccines, and key health services to the public. The role of pharmacies in a crisis, such as the current pandemic, is of crucial importance because they are often the first and the last point of contact with the health care system for 48 patients who need reliable information and advice. [2] [3] [4] Pharmacists play an important role in patient care during a pandemic both in 51 community pharmacies 5, 6 and in the hospital setting.
cord-281332-5mddyv0n	2017	Interpretation: Cache Valley virus, a mosquito-borne orthobunyavirus, has only been identified in 3 immunocompetent North American patients with acute neuroinvasive disease. This report demonstrates that metagenomic next generation sequencing allows for unbiased pathogen identification, the early detection of emerging viruses as they spread to new locales, and the discovery of novel disease phenotypes. This report demonstrates that metagenomic next generation sequencing allows for unbiased pathogen identification, the early detection of emerging viruses as they spread to new locales, and the discovery of novel disease phenotypes. Here, we report the effective deployment of metagenomic next generation sequencing (mNGS) to diagnose Cache Valley virus (CVV), a mosquito-borne orthobunyavirus, 4 in an Australian patient with a primary immunodeficiency suffering from chronic meningoencephalitis. 41 Because CVV is rarely identified as a cause of human disease and has not been reported in Australia previously, there are no traditional candidate-based diagnostic tests for this virus available in Australia.
cord-281344-iswbgqqe	2020	MATERIAL AND METHODS: This is a retrospective analysis of a prospective cohort study with older patients (≥ 65 years) undergoing cancer-related surgery, who were identified for a perioperative telemonitoring study. This study is a retrospective analysis of a prospective cohort study with older patients undergoing cancer-related surgery, who were identified for a perioperative telemonitoring study (Netherlands trial registration number: NL 8253) [19] . The twelve patients who were discharged to an SNF were significantly older (mean age 79.0 versus 73.6 years old [p = 0.01]), had a higher ASA classification (ASA 3-4 58% versus 29% [p = 0.05]), used more medication (% polypharmacy 92% versus 50% [p = 0.00]) and were more often living alone or in a nursing home before surgery (50% versus 30%, 17% versus 0% [p = 0.00]). The main barriers to older adults'' participation in a perioperative telemonitoring study were lack of internet access at home, digital illiteracy, and a perceived high mental burden.
cord-281346-bjhdy8mg	2020	This new species of coronavirus has been termed 2019-nCoV and has caused a considerable number of cases of infection and deaths in China and, to a growing degree, beyond China, becoming a worldwide public health emergency. 2019-nCoV has high homology to other pathogenic coronaviruses, such as those originating from bat-related zoonosis (SARS-CoV), which caused approximately 646 deaths in China at the start of the decade. 17 Moreover, a recently published study estimated that 95% of the cases of 2019-nCoV infections in Wuhan showed symptoms before the 12th of January 2020, 18,19 a fact that, combined with the virus'' incubation period, suggests a high possibility of the disease''s travelrelated propagation. According to the WHO, a suspected case involves a patient with severe acute respiratory infection (fever, cough, requiring hospitalization) and with no other etiology that completely explains the clinical presentation, as well as a history of travel or residence in China during the 14 days before symptom onset.
cord-281391-0qkku2jd	2020	COVID-19, the disease caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus, was first identified in the Hubei Province of China in late 2019. Because of these findings, chloroquine and hydroxychloroquine were used as early therapies in the treatment of COVID-19, and its use was further propagated by a small, retrospective, biased study from France with 36 patients which showed decrease in viral burden, and improved outcomes in patients treated with hydroxychloroquine [17] . A retrospective study from the Veterans Affairs, looked at hospitalized patients who received hydroxychloroquine and showed no evidence that use of hydroxychloroquine reduced the risk of progression of disease including mechanical ventilation and death [20] . Effect of High vs Low Doses of Chloroquine Diphosphate as Adjunctive Therapy for Patients Hospitalized With Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Infection: A Randomized Clinical Trial
cord-281561-r10y2sgb	2020	Another invitro study reported that Ribavirin, analogue of guanosine nucleotide having wide spectrum of antiviral activity, used along with LPV/RTV to treat SARS-COV-2 viral infection in china (ChiCTR2000029387) . reported remdesivir shows possible efficacy better as compared to placebo group in hospitalized patients for the treatment of SARS-CoV-2 virus. The effectiveness and safety concern of darunavir/cobicistat combination is being evaluated under development of clinical trials phase 3 by enrolling 30 COVID-19 patients and estimated completion of study on December 31, 2020. Recently, retrospective cohort study showed high dose of anakinra (5 mg/kg, BD,iv) produces beneficial and efficacious effects in 72% Covid-19 infected patients associated with ARDS (Cavalli et al., 2020) . Based on case study of patients with SARS-CoV2 infection and also confirmed severe pneumonia and ARDS treated with i.v. infusion of eculizumab along with anticoagulant therapy (Enoxaparin 4000 IU/day s.c), antiviral therapy (LPV 800 mg/day + RTV 200 mg/day), hydroxychloroquine 400 mg/day, ceftriaxone 2 g/day IV, vitamin C 6 g/day for 4 days.
cord-281566-6v5zfue6	2013	12 Our group found that cultured airway epithelial cells from patients with CRSsNP had an exaggerated response to stimulation with the combination of double-stranded RNA (a Toll-like receptor [TLR] 3 agonist and surrogate for viral infection) plus cigarette smoke extract, with exaggerated production of RANTES and hBD-2. Ramanathan et al 3 showed that culturing human sinonasal epithelial cells in the presence of the T H 2 cytokines IL-4 or IL-13 for 36 hours reduced expression of antimicrobial innate immune genes by using real-time PCR, ELISA, and flow cytometry, including TLR9, hBD-2, and SP-A. This has been shown in cultured airway epithelial cells and dispersed T lymphocytes from NPs. Fungi are commonly detected in the attached mucus of sinus tissues in patients with CRS 47,165 and can induce eosinophil activation and degranulation. Th2 cytokines associated with chronic rhinosinusitis with polyps down-regulate the antimicrobial immune function of human sinonasal epithelial cells Th2 cytokines associated with chronic rhinosinusitis with polyps down-regulate the antimicrobial immune function of human sinonasal epithelial cells
cord-281729-z321pebe	2019	Three clinical cases of patients presenting severe lung disease requiring mechanical ventilation and prolonged intensive care fitted on the variable spectra of AFOP histopathology and had poor outcome: a 23 year-old women had AFOP in the context of antiphospholipid syndrome pulmonary compromise; a 35 year-old man developed a letal intensive care pneumonia with AFOP pattern registered in post-mortem biopsy; and a 79 year-old man died 21 days after intensive care unit treatment of a sub-pleural organizing pneumonia with intra-alveolar fibrin, seen in post-mortem biopsy. Reporting these three clinical cases had the purpose to highlight the acute presentation of AFOP as a particular lung disease more recently described, initially confused with pneumonia, running with severe respiratory failure and immediate need for mechanic ventilation, with no response to antibiotics or steroids.
cord-281733-bsq0ewac	2020	We report an unusual case of ovarian vein thrombosis and pulmonary embolism associated with COVID-19 presenting with abdominal pain. We report an unusual case of ovarian vein thrombosis and pulmonary embolism associated with COVID-19 presenting with abdominal pain. To our knowledge, this is the first reported case of COVID-19 with absent respiratory symptoms and presentation with venous thrombosis in an unusual location. To our knowledge, this is the first reported case of COVID-19 with absent respiratory symptoms and presentation with venous thrombosis in an unusual location. 8 9 Our patient was distinctive in terms of presentation as she lacked the common respiratory symptoms, rather acute venous thrombosis in an unusual location prompted the diagnosis of COVID-19. 1 24 In summary, we present an interesting case with an unusual presentation of COVID-19 who presented with abdominal pain and no significant respiratory symptoms and was diagnosed with thrombosis of the left ovarian vein.
cord-281752-64mrflcr	2020	Of the 26 patients studied, 5 patients had EEGs that showed Periodic Discharges (PD) consisting of high amplitude frontal monomorphic delta waves with absence of epileptic activity. However, the presence of the monomorphic biphasic high amplitude delta waves associated with occasional myoclonic muscular activity could also possibly be indicative of brain injury either related to anoxia, severe hypoxia, anesthesia, or the direct effects of COVID-19 itself. The reported onset of loss of consciousness or confusion and cognitive impairment in COVID-19 infected patients with EEGs revealing biphasic delta PDs may suggest an injury or localized brain defect attributed to encephalopathy related to a unique and acute CNS process. When hospitalized patients infected with SARS-CoV-2 (COVID-19) present with an unexplained loss of consciousness, confusion or altered mental status, impaired arousal, and abnormal paroxysmal movements (myoclonus), it is suggested that an EEG be performed as part of the diagnostic assessment of the patient to determine an etiology and to identify potentially treatable CNS disorders.
cord-281804-lhnw8jx5	2020	While video and telephonic alternatives to bedside evaluation may facilitate communication with patients while maintaining physical separation to limit healthcare worker exposure and preserve PPE, these solutions may not be as effective in older patients, who commonly have hearing and visual impairment, challenges with manual dexterity due to arthritis, and cognitive impairment, all of which impede effective use of such technology. 22 Not only will reducing variability improve adherence to isolation and other outpatient management recommendations, but providing frontline staff with comprehensive, pre-written instructions reduces the work burden associated with individual patient discharges and allows for the inclusion of extended information surrounding expected disease course, follow-up planning, and support resources for those suffering from the psychological effects of isolation or requiring local resources such as access to food.
cord-281887-b511bjdy	2020	DISCUSSION: The rational use of resources to reduce the risk of surgical cancer patients being operated on during the incubation period of a corona virus infection is important in this context. CONCLUSIONS: We present a protocol, focused on the patients'' outcomes, for safe and rational use of resources to reduce the risk of surgical cancer patients being operated on during the virus incubation period, in the context of areas with limited resources. Our objective was to present the Brazilian Society of Surgical Oncology (BSSO) protocol for rational use of resources and for reducing the risk of surgical cancer patients being operated on during the coronavirus incubation period, in the context of areas with limited resources, and focused on patient outcomes. In light of all the previous considerations, Table 3 presents our suggested protocol for the rational use of resources to reduce the risk of surgical cancer patients from being operated on during the COVID-19 incubation period, in the context of areas with limited resources.
cord-281945-jvnjzjds	2020	Survivors of critical illness and ARDS often experience neurocognitive impairment but, to date, there is scant literature correlating radiographic hypoxic brain injury to hypoxemia related to ARDS. In this case series, we describe three cases of hypoxic brain injury seen on magnetic resonance imaging (MRI) in patients with hypoxemia secondary to COVID-19-related ARDS. Of patients with severe disease, approximately 16% had acute respiratory distress syndrome (ARDS), 14.5% required invasive mechanical ventilation, and 99% had pneumonia [4] . A recent autopsy case series found evidence of hypoxic changes in the brain tissue of patients who had succumbed to COVID-19, but there was no report of whether these patients developed ARDS, duration of mechanical ventilation if required, whether extracorporeal membrane oxygenation (ECMO) was used, presence or absence of cardiac arrest, or cause of death [21] . In this case series, we describe three cases of hypoxic brain injury seen on MRI, along with clinical correlations, in patients with hypoxemia secondary to COVID-19 related ARDS.
cord-282021-m1lh7mzd	2020	In California''s COVID-19 epicenter, some Silicon Valley hospitals place emphasis on data privacy, main-El Shamy/Tran/Sharma/Ronco/ Narayanan/Uribarri Am J Nephrol 2 DOI: 10.1159/000508023 taining strict policies with strong preference for providers and patients to use hospital-approved technology. Performing monthly telehealth visits would not be possible for this patient population without the ability to remotely monitor their treatments to assess the quality of the home therapy delivered and troubleshoot any issues that may arise. To date, over 90% of Mount Sinai''s home dialysis patients have had their monthly visits conducted through telehealth without having to come to the unit for any of their needs. In less urban areas not currently affected as much by COVID-19, such as at Baylor Scott and White Healthcare in Temple, Texas, nephrologists are bracing for an onslaught and have preemptively started using telemedicine for the monthly visits with their home dialysis patients while utilizing the benefits of Sharesource to re-motely monitor, adjust, and troubleshoot their patients'' dialysis treatments.
cord-282043-cs1oyohu	2020	Both direct viral infection and indirect injury resulting from inflammation, endothelial activation, and microvascular thrombosis occur in the context of coronavirus disease 2019. Although originally believed to be a syndrome characterized by acute lung injury, respiratory failure, and death, it is now apparent that severe coronavirus disease 2019 (COVID-19) is further characterized by exuberant cytokinemia, with resultant endothelial inflammation, microvascular thrombosis, and multiorgan failure (2) . Myocardial injury can be detected in w25% of hospitalized patients with COVID-19 and is associated with an increased risk of mortality. Association of cardiac injury with mortality in hospitalized patients with COVID-19 in Wuhan, China Clinical characteristics of 138 hospitalized patients with 2019 novel coronavirus-infected pneumonia in Wuhan, China Acute myocardial injury in patients hospitalized with COVID-19 infection: a review Characteristics and clinical significance of myocardial injury in patients with severe coronavirus disease 2019
cord-282097-a1pwq4fi	2020	When examining the association between the cumulative dose of dexamethasone received during the visit and the endpoint, we found that the administration of a cumulative dose between 60 mg to 150 mg among patients who required respiratory support was significantly associated with a lower risk of death in the crude, unadjusted analysis (HR, 0.28; SE, 0.58, p=0.028), the adjusted multivariable analysis (HR, 0.24; SE, 0.65, p=0.030), and in the univariate Cox regression model in the matched analytic sample (HR, 0.32; SE, 0.58, p=0.048), whereas no significant association was observed with a different dose. When examining the association between the cumulative dose of dexamethasone received during the visit and the endpoint, we found that the administration of a cumulative dose between 60 mg to 150 mg among patients who required respiratory support was significantly associated with a lower risk of death in the crude, unadjusted analysis (HR, 0.28; SE, 0.58, p=0.028), the adjusted multivariable analysis (HR, 0.24; SE, 0.65, p=0.030), and in the univariate Cox regression model in the matched analytic sample (HR, 0.32; SE, 0.58, p=0.048), whereas no significant association was observed with a different dose.
cord-282151-mai4eggf	2015	METHODS: During October 26, 2009, and January 23, 2010, adult patients with pneumonia with laboratory-confirmed or clinically suspected A(H1N1) infections were observed for clinical characteristics, high-resolution chest CT scan, and lung function test changes during acute and 3-month convalescent phases. Multivariate Cox regression identified two independent risk factors for death: progressive dyspnea after resolution of fever (relative risk, 5.852; 95% CI, 1.395-24.541; P = .016) and a higher APACHE (Acute Physiology and Chronic Health Evaluation) II score on presentation (relative risk for each point, 1.312; 95% CI, 1.140-1.511; P < .001). 6 Many studies have been published on the clinical manifestations of A(H1N1) pneumonia during the acute phase of illness, [7] [8] [9] [10] [11] [12] [13] [14] [15] but no information has been reported on symptoms and radiographic and lung function changes in convalescence. Information recorded included demographic data, underlying medical conditions, symptoms, signs, laboratory and chest radiograph fi ndings before therapy and during follow-up, and the clinical course, treatment, and adverse events during hospital stay.
cord-282183-k0pn0ie2	2020	Interestingly, we and two other Italian groups recently reported hypercoagulable whole blood profiles in COVID-19 patients admitted to Intensive Care Units for acute respiratory failure [4] [5] [6] . Therefore, we aimed to study traditional and whole blood thromboelastometry profiles -via a ROTEM ® sigma apparatus (Instrumentation Laboratory Werfen, Barcelona, Spain) -in a group of patients consecutively admitted to Internal Medicine wards of Padova University Hospital for acute pneumonia: cases were COVID-19 patients with pneumonia and controls were patients with pneumonia from different etiology. Although several papers, including one by our group, have previously reported COVID-19-related hypercoagulability in patients admitted to Intensive Care Units 4-6 , the present study focuses more closely on the comparison of coagulation profiles between COVID-19 patients with acute pneumonia and non COVID-19 patients with acute pneumonia.
cord-282219-7kzbnymp	2020	title: The effect of massage on the quality of life in patients recovering from COVID-19: A systematic review protocol Secondary outcomes were accompanying symptoms (such as myalgia, expectoration, stuffiness, runny nose, pharyngalgia, anhelation, chest distress, dyspnea, crackles, headache, nausea, vomiting, anorexia, diarrhea) disappear rate, negative COVID-19 results rate on 2 consecutive occasions (not on the same day), average hospitalization time, clinical curative effect, and improved quality of life. CONCLUSION: The conclusion of our study will provide evidence to judge whether massage is an effective intervention on the quality of life in patients recovering. [6] Coronaviruses (CoVs), mainly targeting human respiratory system, are responsible for health-threatening outbreaks including severe acute respiratory syndrome (SARS), Middle East respiratory syndrome, and lastly coronavirus disease 2019 (COVID-19). We will include articles related to massage therapy of patients recovering from COVID-19. This article will use the evidence quality rating method to evaluate the results obtained from this analysis.
cord-282361-gje78nb1	2020	In this study it is aimed to identify the up-to-date practice patterns related to preoperative evaluation and anesthesia for stone disease interventions during COVID-19 pandemic. Information on the type of the stone related conditions, management strategies, anesthesiologic evaluation, anesthesia methods, and any alterations related to COVID-19 pandemic was collected. Rate of preoperative testing, emergency procedures, conservative approaches and topical/regional anesthesia increased after 21 days. The primary end point of the study was to collect information on the type of the stone related conditions, management strategies, anesthesiologic evaluation, anesthesia methods, and any alterations related to COVID-19 pandemic. While some guidelines suggest PCR testing in suspicious cases, the guidelines for sections with a high likelihood of virus load, such as otolaryngology, suggest that it can be performed Fig. 2 Summary of preoperative additional testing, alteration in anesthesia method and stone related procedures in the European cohort in all patients [14] .
cord-282430-u5ukqc5z	2020	The Pleural Pressure Working Group''s planned RECRUIT (Recruitment Assessed by Electrical Impedance Tomography: Feasibility, Correlation with Clinical Outcomes and Pilot Data on Personalised PEEP Selection) project (https:// www.plugwgroup.org/), which aims to compare the results of different bedside methods to titrate PEEP based on EIT, might provide us with some answers on how to titrate PEEP using EIT data. Bruni and colleagues have built the clinical care model around twice daily assessment of patients by a respiratory physician using remote monitoring (no details of how monitoring is done were included) (1). We really thank Fenton and colleagues for their interest in our article (1) and the pleasing comments regarding our telemedicine-supported hotel accommodation model for patients with coronavirus disease (COVID-19) . Electrical impedance tomography for positive end-expiratory pressure titration in COVID-19-related acute respiratory distress syndrome Effect of lung recruitment and titrated positive end-expiratory pressure (PEEP) vs low PEEP on mortality in patients with acute respiratory distress syndrome: a randomized clinical trial
cord-282474-74273qgk	2020	title: Flow controlled ventilation in Acute Respiratory Distress Syndrome associated with COVID-19: A structured summary of a study protocol for a randomised controlled trial OBJECTIVES: This study aims to demonstrate the positive effects on oxygenation of flow-controlled ventilation compared to conventionally ventilated patients in patients suffering from Acute respiratory distress syndrome (ARDS) associated with COVID-19.We define ARDS according to the "Berlin" definition integrating the oxygenation index (P/F ratio), the level of Positive End Expiratory Pressure (PEEP), radiological and clinical findings. TRIAL REGISTRATION: The protocol was registered before starting subject recruitment under the title: "Flow controlled ventilation in ARDS associated with COVID-19" in ClinicalTrials.org with the registration number: NCT04399317. Although the severely ill patients will need intubation and invasive ventilation according to ARDS treatment strategies including low tidal volumes and low end-expiratory pressures, not all patients recover their pulmonary function [3, 4] .
cord-282483-0zsvhoog	2020	While endoscopy with biopsies and radiology remain our most effective weapons to identify or manage these disorders, procedures such as high-resolution manometry (HRM) and reflux monitoring are the most specialized techniques able to clarify unclear clinical scenarios and improve patients'' management. If an appointment is necessary, the day before the visit, health care professionals (HCPs) should call the patients to confirm it and to ask questions A rapid and functional reorganization of all the activities of a motility laboratory is mandatory to maintain as good as possible the standards of care, to reduce risks for both patients and healthcare personnel and to leave resources available to tackle this pandemic. However, considering that the efficacy of herd immunity is uncertain, a vaccine is not yet available and another wave of infections may arrive, COVID-19 could become a long-term problem and therefore it is necessary to permanently integrate these services in our way of providing medical care.
cord-282504-m3npy0om	2020	Patients with light chain (AL) amyloidosis have an underlying usually low-grade plasma or B-cell malignancy causing their disease, and they receive chemotherapy (Merlini, et al 2018) , thus, being at higher risk for infections (Kristinsson, et al 2012) , including from SARS-CoV-2, and probably at higher risk for severe COVID-19 (Pietrantonio and Garassino 2020) . Treatments for AL amyloidosis have not been developed in the context of multiple randomized studies, thus, we have limited data to propose one therapy over the other or assess the importance of full vs reduced dosing of critical drugs such as bortezomib or For selected patients who have achieved a satisfactory hematologic response (for example CR or VGPR or even PR with organ response), the treating physician may discuss to complete therapy earlier or continue with a less intensive schedule (for example reduce weekly to bi-weekly bortezomib).
cord-282535-gnuhjs32	2020	title: Real‐world assessment of the clinical impact of symptomatic infection with severe acute respiratory syndrome coronavirus (COVID‐19 disease) in patients with Multiple Myeloma receiving systemic anti‐cancer therapy. . The UK index case was identified on the 31 st of January, 2020 and given the rapid spread and high mortality rate of COVID-19, it is imperative to define the impact on patients with co-existing medical conditions (3) . Multiple Myeloma (MM), the second most common haematological malignancy, is a cancer of the mature B-cell lineage and is associated with both cellular and humoral immune dysfunction that renders patients susceptible to infections, especially of the respiratory tract (4) (5) (6) (7) . This coupled with a median age at presentation of 70 years in a population with frequent co-existing medical conditions, means the outcomes of MM patients infected with COVID-19 warrants particular attention.
cord-282589-xof56j98	2020	We present the interim analysis of a single-center randomized, double-blinded, placebo controlled clinical trial of colchicine for the treatment of moderate to severe COVID-19, with 38 patients allocated 1:1 from April 11 to July 06, 2020. We conducted a randomized, double-blinded, placebo controlled clinical trial to evaluate the use of colchicine for the treatment of hospitalized patients with moderate to severe COVID-19. As secondary endpoints we assessed clinical and laboratory parameters: measures of serum CRP, serum LDH and relation neutrophil to lymphocyte of peripheral blood samples from day zero to day 7; the number, type, and severity of adverse events; frequency of interruption of the study protocol due to adverse events; and frequency of QT interval above 450 ms. Patients who received colchicine in this randomized, double-blinded, placebo controlled clinical trial presented better evolution in terms of the need for supplemental oxygen and the length of hospitalization.
cord-282610-zim7nond	2018	title: Myalgic Encephalomyelitis/Chronic Fatigue Syndrome in the Era of the Human Microbiome: Persistent Pathogens Drive Chronic Symptoms by Interfering With Host Metabolism, Gene Expression, and Immunity Intracellular pathogens, including many associated with ME/CFS, drive microbiome dysbiosis by directly interfering with human transcription, translation, and DNA repair processes. The gut microbiome can initiate and promote colorectal cancer at all stages of tumorigenesis by acting as an inducer of DNA damage, generating epigenetic changes, regulating cell growth, and modulating host immune responses (80) . If ME/CFS is driven by successive infection, treatments that support or activate the human immune system could improve microbiome health by allowing patients to better target persistent pathogens. Antibodies and/or clonal T cells identified in patients with ME/CFS are likely activated in response to many of these persistent microbiome pathogens. In ME/CFS, the immune response, metabolism, central nervous system, and human gene expression are all linked by the activity of the microbiome and its associated proteins/metabolites.
cord-282660-9x937eus	2020	title: Mortality Rates of Patients with Proximal Femoral Fracture in a Worldwide Pandemic: Preliminary Results of the Spanish HIP-COVID Observational Study All patients who were ≥65 years of age, presented to the Emergency Department of the participating hospitals during this period with a diagnosis of proximal femoral fracture, and had a minimum follow-up of 10 days were included in the cohort. Included participants were patients ‡65 years of age presenting to the Emergency Department of the participating hospitals with the clinical and radiographic diagnosis of a proximal femoral fracture (31-A and 31-B according to the OTA/AO classification 19 ) from a low-energy mechanism from March 14, 2020 (on the day that the Spanish government declared a state of national alarm due to COVID-19 and the pandemic surpassed 2,000 patients and 50 deaths from COVID-19 in Spain) until April 4, 2020, with a minimum of 10 days of follow-up.
cord-282704-qg2o0ug4	2020	title: Clinical characteristics of 25 death cases infected with COVID-19 pneumonia: a retrospective review of medical records in a single medical center, Wuhan, China Methods The clinical records, laboratory findings and radiologic assessments included chest X-ray or computed tomography were extracted from electronic medical records of 25 died patients with COVID-19 in Renmin Hospital of Wuhan University from Jan 14 to Feb 13, 2020. All 25 dead patients with COVID-19 tested positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) by use of RT-PCR on samples from there respiratory tract. In the presents study, all the patients were died of respiratory failure, which indicated that the lung is the most common target organ of SARS-CoV-2. Clinical Characteristics of 138 Hospitalized Patients With 2019 Novel Coronavirus-Infected Pneumonia in Wuhan Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study
cord-282724-zzkqb0u2	2020	Some key considerations and targets of research include: (1) feature engineering, transforming raw data into features (i.e. variables) that ML can better utilize to represent the problem/target outcome, (2) feature selection, applying expert domain knowledge, statistical methods, and/or ML methods to remove ''irrelevant'' features from consideration and improve downstream modeling, (3) data harmonization, allowing for the integration of data collected at different sites/institutions, (4) handling different outcomes and related challenges, e.g. binary classification, multi-class, quantitative phenotypes, class imbalance, temporal data, multi-labeled data, censored data, and the use of appropriate evaluation metrics, (5) ML algorithm selection for a given problem can be a challenge in itself, thus strategies to integrate the predictions of multiple machine learners as an ensemble are likely to be important, (6) ML modeling pipeline assembly, including critical considerations such as hyper-parameter optimization, accounting for overfitting, and clinical interpretability of trained models, and (7) considering and accounting for covariates as well as sources of bias in data collection, study design, and application of ML tools in order to avoid drawing conclusions based on spurious correlations.
cord-282730-pawasfh4	2020	RESULTS: At many institutions, the number of telemedicine visits dramatically increased within days following the institution of novel coronavirus pandemic restrictions on in-person clinical encounters. To minimize interruption of crucial clinical services and the associated revenue, a rapid transition from in-person outpatient visits to telemedicine encounters was implemented by many academic medical centers and adopted by surgery departments throughout the country. The Centers for Medicare and Medicaid Services (CMS) sought to decrease in-person medical visits by issuing a temporary and emergency relaxation of telemedicine rules via the 1135 waiver and the Coronavirus Preparedness and Response Supplemental Appropriations Act. Enacted on March 6, 2020, this act allowed Original Medicare enrollees the same telemedicine benefits that had been extended to Medicare Advantage enrollees in January 2020. In addition, on March 13, 2020 the FCC funded the Rural Health Care Program that aims to make telemedicine services available to geographically remote patients.
cord-282780-34j7gquo	2020	In addition, a physician can use phone visits to triage visual symptoms with a normal dilated eye examination by another provider or discuss medication compliance and tolerance, neuroimaging findings, and laboratory test results. Before COVID-19, a telemedicine visit might follow an initial in-person visit: the patient could complete local visual field testing, fundus photographs, OCT, and/or MRI, and then review the results with the neuro-ophthalmologist over phone or video as the case history is discussed. Patients who have Apple iPhone 7 Plus or who do not have an assistant available can use "Vision@home," an online test validated for both near (40 cm) and distance (2 m, assistant needed) visual acuities that is accessible free on their phone browser at www.visionathome.com.au (9) . Conceptually, technological privacy and security refer to how the user (doctor-patient), the company providing the platform (e.g., Zoom and Google), and everyone else on the internet (external parties) relate to each other (see Supplemental Digital Content 15, Figure E8 , http://links.lww.
cord-282783-ps5jyjkl	2020	The Childhood Cancer Survivor Study showed a 10-fold higher risk of pericardial disease in all CCS versus siblings (30year cumulative incidence, 3 .0%) and a dose-response relation with chest RT (11) . The literature on ECG abnormalities in large cohorts of long-term CCS is sparse (46, 47) , Data on the use of ambulatory ECG monitoring to define the prevalence of brady-and tachyarrhythmias induced by cardiotoxic cancer treatments are needed, but must be carefully weighed against the potential patient burden and clinical significance. Interestingly, a prior study in testicular cancer survivors showed that those patients who were exposed to cisplatin-based chemotherapy nearly 3 to more than 20 years ago had a more severe reduction in FMD and higher levels of circulating endothelial cells than those not exposed (13) .
cord-282867-kbyxdegu	2020	The main aim of this study is to review and summarize the evidence regarding the supportive role of physical rehabilitation techniques in managing COVID-19-associated pneumonia. In this review, we also emphasize the use of rehabilitation techniques in the management of pneumonia in COVID-19-infected patients. The purpose of this study was to review the evidence regarding the supportive role of treatment options available in physical rehabilitation to manage COVID-19 pneumonia effectively. Evidence strongly supports that many rehabilitation techniques including chest physiotherapy and physical therapy modalities can be of great support to manage COVID-19-associated pneumonia [9, 10] . Common problems identified in COVID-19 patients that could be managed by rehabilitation specialists in the postacute phase include musculoskeletal pain, joint pain, reduced range of motion, muscular weakness, neuropathy and myopathy, pulmonary dysfunction, dysphagia, dyspnea, confusion, and impaired activities of daily living.
cord-282912-jegpgqqi	2020	This phenomenon caused a significant reduction in acute coronary syndrome-related interventional procedures with a subsequent increase in critical hospitalizations and post-infarction mechanical complications. A case series of cardiac ruptures during the COVID-19 lockdown and the surgical treatment of a huge post-ischemic cardiac pseudoaneurysm complicated by a "contained" free wall rupture are presented. Serum analysis and ECG were negative for a new ACS, but the echocardiogram revealed the presence of a huge dilatation of the cardiac apex (6.5 cm x 5.2 cm) complicated by subacute rupture of its posterior wall and by organized thrombosis inside it (figure 1A). All patients were discharged in very good general state but this report, in our opinion, demonstrated and confirmed two key points of the ACS treatment: early coronary revascularization reduces significantly the incidence of the mechanical complication but COVID-19 pandemic could completely thwart these prevention strategies and change the cardiac surgery population that we will have to deal with in the next months [5] .
cord-282956-f7if9e5q	2020	BACKGROUND AND PURPOSE: With the spread of coronavirus disease 2019 (COVID-19) during the current worldwide pandemic, there is mounting evidence that patients affected by the illness may develop clinically significant coagulopathy with thromboembolic complications including ischemic stroke. METHODS: We conducted a retrospective cohort study of consecutive patients with ischemic stroke who were hospitalized between March 15, 2020, and April 19, 2020, within a major health system in New York, the current global epicenter of the pandemic. In this multi-ethnic study, we report key demographic and clinical characteristics of patients who develop ischemic stroke associated with acute severe acute respiratory syndrome CoV-2 coronavirus infection. The observed rate of imaging-confirmed acute ischemic stroke in hospitalized patients with COVID-19 of 0.9% was lower compared with prior reports from Chinese COVID-19 studies.
cord-282963-p04c5nn7	2020	DESIGN: : We present a unique case report of hospital-acquired COVID-19 in a patient on temporary mechanical circulatory support. Emphasize the importance of early advanced care planning in patients with heart failure and COVID-19 3. Over the course of 2 hours the patient developed severe hypoxemia with oxygen saturations of 70%, followed by hypotension and low flows through the Centrimag®. While predictors of rapid disease progression have yet to be elucidated, early trends of inflammatory markers may be helpful to risk stratify COVID-19 patients and identify those who are likely to become critically ill (1). Presently broad testing of asymptomatic patients and HCW for COVID-19 is not available but may have impacted disease transmission in this case. It illustrates the high risk for development of COVID-19 for vulnerable hospitalized patients. It illustrates the high risk for development of COVID-19 for vulnerable hospitalized patients. Clinical Pathology of Critical Patients with Novel Coronavirus Pneumonia (COVID-19).
cord-283141-dh8j7lyl	2020	[10] [11] [12] [13] [14] [15] [16] [17] [18] [19] [20] [21] [22] Since the parental consanguinity rate is high (23.2%) in Turkey, DOCK8 deficiency has an important place among CIDs. Here, we retrospectively evaluated the clinical and immunologic features and treatment modalities of 20 patients with DOCK8 deficiency and follow-up results of hematopoietic stem cell transplant (HSCT) in 11 patients among them as a single-center experience. clinic, DOCK8 deficiency, follow-up, hematopoietic stem cell transplantation, immunological features Hematopoietic stem cell transplantation outcomes for 11 patients with dedicator of cytokinesis 8 (DOCK8) deficiency Successful engraftment of donor marrow after allogeneic hematopoietic cell transplantation in autosomal-recessive hyper-IgE syndrome caused by dedicator of cytokinesis 8 deficiency Clinical and immunological correction of DOCK8 deficiency by allogeneic hematopoietic stem cell transplantation following a reduced toxicity conditioning regimen Successful hematopoietic stem cell transplantation after myeloablative conditioning in three patients with dedicator of cytokinesis 8 deficiency (DOCK8) related Hyper IgE syndrome
cord-283165-mdkr9qo0	2015	The aim of this study was to retrospectively evaluate the accuracy of the diagnosis of HAP in inpatients on acute internal medicine and general surgical wards receiving intravenous antimicrobials for a clinical diagnosis of HAP made by the patient''s team. This was a retrospective observational cohort study of medical and surgical inpatients receiving intravenous antimicrobials for a clinical diagnosis of HAP at a tertiary care hospital in Edinburgh, UK. To be classified as radiologically confirmed HAP in this study, chest X-ray evidence of a new or progressive lung infiltrate was required (reported by a radiologist), consistent with the 2005 ATS/IDSA guidelines. In comparison to community-acquired pneumonia, where the culture-positive rate of sputum samples at our institution has been reported as 30%, a bacterial pathogen was identified from 17 of 35 (48.6%) samples from patients with radiologically confirmed HAP and therefore has greater potential to influence management.
cord-283215-dgysimh5	2020	Prioritisation of surgical services during this pandemic must be a careful balance of patient needs and resource availability and the European Association of Urology Guidelines Office offer the following suggestions for factors that must be taken into account [3] Whilst there have been no publication of guidelines by any professional association for the management of stone surgery during the COVID-19 pandemic, there have been some guidance published by Proietti et al [48] suggesting telephone triage of patients followed by prioritisation based on stone size and location, the presence of any obstructive uropathy, patient symptoms, presence of any stents or nephrostomy tubes and any other complicating factors such as renal failure or a solitary kidney. With guidelines specific to each specialty being implemented and followed, surgeons should be able to continue to provide safe and effective care to their patients during the COVID-19 pandemic.
cord-283231-ju71zm7w	2020	title: RE: Respiratory Infectious Disease in Resource Limited Setting: Radiology Management Advice Dear Dr. Joob, Dr. Wiwanitkit, and Editors-In many countries and regions where access to health care is limited, it is important for medical institutions to develop appropriate programmes to prevent and control respiratory infections. Special examination rooms and passageways should be reserved for suspected patients. If there is no special examination room for suspected patients, try to divide the time period for the ordinary patients and suspected patients. The use of mobile X-ray machines is also a good option in emergency departments, intensive care units, and isolation rooms. It is best to use a special examination room, if not, the method of inspection by time interval is adopted (1,2). (5) Layout of radiology department: The examination room and operation room that directly contact with patients are contaminated areas, and there should be a buffer zone between contaminated areas and cleaning areas.
cord-283267-72wrzw09	2020	The recognition of the coagulopathy with COVID-19, and the early evidence that suggests that thrombosis in these patients is higher than that seen in similarly ill hospitalized patients with other respiratory infections has led to the urgent need for practical guidance regarding prevention, diagnosis, and treatment of VTE. 19 Pooled risk estimates for benefits and harms of anticoagulant thromboprophylaxis in critically ill medical patients without COVID-19 differ across meta-analyses, 19, 22, 46 but practice guidelines consistently recommend anticoagulant thromboprophylaxis with LMWH (or unfractionated heparin [UFH]) over no such therapy. Our literature search did not identify any randomized trials assessing the efficacy and safety of anticoagulants for the treatment of acute VTE in hospitalized or critically ill COVID-19 patients. Our literature search did not identify any randomized trials or prospective cohort studies assessing the efficacy or safety of any thrombolytic therapies for the management of critically ill patients with COVID-19 without objective evidence of VTE and VTE-associated hypotension.
cord-283513-3f4rsgzm	2020	title: Behavioral interventions in acute COVID-19 recovery: A new opportunity for integrated care Here, we describe how neuropsychology and consultation-liaison psychiatry have collaborated to implement interventions within this unit to facilitate patients'' recovery. Consistent with early reports [4] , we have found a high prevalence of cognitive dysfunction in COVID-19 patients on our recovery unit. To facilitate orientation and memory, all patient rooms have a large whiteboard on which providers write their names and where patients'' rehabilitation goals and progress are recorded. Psychoeducation on rehabilitation; clinician-led mindfulness; virtual reality-based mindfulness; cognitive restructuring; problem-solving; brief psychotherapy scheduled prior to PT/OT; cognitive-behavioral psychotherapy group; chair yoga. Use of room whiteboard to track date, location, names of providers, and rehabilitation goals and progress; clinicians wear large ID tags and assist in reorientation; "memory books." Early intraintensive care unit psychological intervention promotes recovery from post traumatic stress disorders, anxiety and depression symptoms in critically ill patients
cord-283517-7gd0f06m	2017	Today, we have molecular point-ofcare (mPOC) devices that can provide a rapid diagnostic answer within 20 minutes in a clinic, multiplex PCR sample-to-answer devices that can screen for >20 analytes in a single specimen in about an hour, high-volume automation that can enhance throughput and efficiency in the clinical microbiology laboratory with digital imaging, and next-generation sequencing (NGS) that can reveal a treasure trove of information in a single test. Factors may include syndrome-specific diagnostic needs, ease of use, the need for rapid results, improved sensitivity and specificity, operational needs (such as staffing and expertise), laboratory design (such as centralized versus decentralized models), cost, consumer demand, and the potential for improved patient outcomes. Considerations that go into the selection of a test or instrument platform for implementation include perceived turnaround time needs for improved patient care, sample volume requirements, number of tests expected, suitability for the intended laboratory based on available expertise and desired workflow, as well as cost.
cord-283583-pwlbrxn3	2015	A higher frequency of severe clinical outcome and nervous system manifestation were also observed in the SAFV-positive HFMD patients. A patient was considered to be infected with SAFV when positive detection was obtained in any type of the samples. Genetic characterization of SAFVs. A phylogenetic tree was constructed based on the VP1 nucleotide sequences of Saffold cardiovirus detected in clinical samples of 82 patients in the current study, and sequences downloaded from GenBank by maximum likelihood method using MEGA 6.0 (Figure 1) . Detection of SAFV in sera and CSFs. Additional 171 CSFs were collected from patients with HFMD-associated encephalitis, and six (3.5%) were found to be SAFV-positive using real-time RT-PCR, and five were further confirmed by nested RT-PCR targeting the 59-UTR. In our study, SAFVs were co-detected with other viruses in 14 (82.4%), 9 (75.0%), and 28 (32.6) specimens in ARTI, diarrhea and HFMD patients respectively.
cord-283682-4fcyoyea	1999	title: Mycoplasma pneumoniae-Associated Bronchiolitis Causing Severe Restrictive Lung Disease in Adults Report of Three Cases and Literature Review There were two with respiratory bronchiolitis, one with panbronchiolitis, one patient with bronchiolitis obliterans organizing pneumonia (BOOP), and six with acute inflammatory bronchiolitis. Conclusions In adults, Mycoplasma-associated bronchiolitis without pneumonia is rarely reported, but in hospitalized patients, it may be more common than expected and may be associated with severe physiologic disturbances. In another patient, an acute obstructive defect with hyperinflation, a diffuse and fine granular pattern on chest radiograph, and a cold agglutinin titer of 1:1,024 were found, consistent with constrictive bronchiolitis due to either a viral or Mycoplasma infection. Fraley et al 12 described a patient with respiratory failure from M pneumoniae pneumonia who had both acute necrotizing pneumonitis with consolidation and "bronchiolitis obliterans" on open lung biopsy specimen.
cord-283719-zmizyx7e	2020	An online consensus meeting of an expert panel comprising members of the Taiwan Academy of Cardiovascular and Pulmonary Rehabilitation was held to provide recommendations for rehabilitation protocols in each of the five COVID-19 stages, namely (1) outpatients with mild disease and no risk factors, (2) outpatients with mild disease and epidemiological risk factors, (3) hospitalized patients with moderate to severe disease, (4) ventilator-supported patients with clear cognitive function, and (5) ventilator-supported patients with impaired cognitive function. For patients with advanced disease severity, a well-designed rehabilitation program is even more crucial to improve pulmonary secretion clearance, ameliorates side-effects related to a prolonged bedridden state, and even prevents intensive care unit-acquired weakness. 8 Altogether, potentially significant risk factors for severe COVID-19 that should be identified and considered when designing rehabilitation programs include old age, male gender, hypertension, diabetes, respiratory disease, and CVD. 29 Chest physiotherapy strategies that promote airway clearance include the following: Another important issue in the rehabilitation of patients with moderate to severe disease is preventing deconditioning due to acute illness.
cord-283738-v3h7p297	2020	The novel coronavirus (severe acute respiratory syndrome coronavirus 2) that causes coronavirus disease 2019 was discovered in December 2019 in Wuhan, China, and has rapidly spread across the world becoming a pandemic and disrupting societies, economies, and public health. We present a patient diagnosed with coronavirus who presented with several days of GI symptoms and discuss the relevance of GI disease and liver injury in these patients. 9 We present a patient diagnosed with COVID-19 who presented with several days of GI symptoms and discuss the relevance of GI disease and liver injury in these patients. 2 Several studies have reported that patients may initially present with GI symptoms such as diarrhea and nausea a few days before developing pulmonary manifestations. We present a patient with 3 days of nausea, vomiting, and diarrhea before developing fever and acute respiratory distress syndrome from COVID-19. Digestive symptoms in COVID-19 patients with mild disease severity: Clinical presentation, stool viral RNA testing, and outcomes
cord-283779-mudwcypl	2020	The chronic increase in inflammatory cytokines, augmented by COVID-19 infection, may explain the higher tendency for "the cascade leading to pulmonary fibrosis and insufficiency and activation of clotting" and poorer clinical prognosis, especially in multimorbid older persons (4) . In case of persistent fever, higher than 37.5°C for a time longer than 3 days and peripheral oxygen level lower than 95% after starting therapy, we should consider and proceed to hospitalization especially in multimorbid older patients with cardiac, respiratory diseases and diabetes. First, patients at risk for poor outcomes and higher mortality following infection with SARS-CoV-2, namely older adults and multimorbid individuals, should be checked for malnutrition through screening and assessment. Older patients infected by COVID-19 often experience atypical and less severe symptoms in older persons, side-effects of the drugs and require specific nutritional and motor treatment for avoiding disability and death.
cord-283806-a6exd6dn	2020	From 2017 the home monitoring outpatient follow‐up service has been systematically organized mainly for the peculiar geographical features (typically mountainous, vast and with few roads) of the territory served by our hospital, making difficult for patients the access to the health care facilities. From 2017 the home monitoring outpatient follow-up service has been systematically organized mainly for the peculiar geographical features (typically mountainous, vast and with few roads) of the territory served by our hospital, making difficult for patients the access to the health care facilities. We have 454 patients (373 pts -ICDs/Cardiac resynchronization therapy defibrillators (CRT-Ds), 11 pts -PMs/Cardiac resynchronization therapy pacemaker (CRT-P) and 70 pts -ILRs) followed with home monitoring systems, with automatic and periodical transmissions regarding device setting, clinical features and alarms.
cord-283826-lgyc3sro	2010	medical science and thereby placed in the hands of the physician a victorious weapon against illness and death.'' '' Since then antibodies in multiple forms (animal and human serums, immune globulins and monoclonal antibodies) have been developed, primarily for prevention of infectious diseases, and less commonly for their treatment. Thus regular use of IVIG in antibody-deficient patients in doses of 400 to 600 mg/kg every 3 to 4 weeks or an equivalent amount given subcutaneously decreases the frequency and severity of otitis and other respiratory tract infections [27, 28] . High-dose IVIG (sufficient to increase the serum IgG levels to 1000 mg/mL) has been used successfully in immunodeficient patients with enteroviral encephalomyelitis [80] [81] [82] [83] . Because IgG represents the major defense of humoral immunity against infection, these patients also require immunoglobulin replacement therapy. Individualizing the dose of intravenous immune serum globulin for therapy of patients with primary humoral immunodeficiency
cord-283969-wqrzaxsu	2020	title: The impact of COVID-19 outbreak on urolithiasis emergency department admissions, hospitalizations and clinical management in central Italy: a multicentric analysis Introduction and objectives We aimed to evaluate how the corona virus disease of 2019 (COVID-19) outbreak influenced emergency department (ED) admissions for urolithiasis, hospitalizations and clinical management of the hospitalized Patients. 3 Urolithiasis represents a frequent cause of ED admissions, accounting for 1%---2% of emergency visits 4 : in a report from a large series of patients admitted to ED in a big Italian hospital, 16% of patients with non-traumatic abdominal pain had a diagnosis of renal or ureteral stone. We performed a multicentric retrospective analysis of ED admissions for urolithiasis in three high volume urology department (>100 surgical procedures for stone disease per year) in Rome -Italy between March and April 2020 and in the same period of 2019.
cord-284038-93s3ffoy	2020	Since the coronavirus disease 2019 (COVID-19) pandemic, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), a growing body of evidence indicates that besides common COVID-19 symptoms, patients may develop various neurological manifestations affecting both the central and peripheral nervous systems as well as skeletal muscles. Growing number of case reports and/or series indicate that a variety of neurological conditions and post-viral triggered autoimmune complications, as we discuss below, occur in association with SARS-CoV-2 infection which mainly include Guillain-Barré syndromes (GBSs) (table 2), myopathy and rhabdomyolysis (table 2) , encephalopathy, meningoencephalitis, encephalomyelitis, and myelitis (table 3) . Moreover, two cases of acute necrotizing encephalopathy (ANE) in patients with COVID-19 positivity from nasopharyngeal and oropharyngeal swab, but without CSF PCR for SARS-CoV-2 data, were reported in the literature (Poyiadji, Shahin, 2020 , Radmanesh et al.
cord-284042-awl5bb0j	2020	From the pathogenic point of view, the immune response triggered by infection with SARS-CoV-2 may result in harmful effects, such as endothelial cell dysfunction and activation of J o u r n a l P r e -p r o o f coagulation pathways; this may explain the cardiovascular and thrombotic complications that affect a subgroup of patients. 19 Vesicular lesions, usually monomorphic, appear early on and may at times precede other symptoms (in 15% of patients), 11 although in most cases, up to 79.2% in a series of 24 patents reported by Fernandez-Nieto et al., 20 they occur at the onset of other symptoms. 21 reported the case of a female patient who developed an urticarial rash, accompanied by odynophagia and arthralgia, before developing the full clinical manifestations of COVID-19.
cord-284163-3jmqzemf	2020	This narrative review will give a brief overview regarding some of the extracorporeal devices that could be used to treat COVID-19 patients, including the Seraph® 100 Microbind® Affinity Blood Filter, produced by ExThera Medical (Martinez, CA, USA), first licensed in the European Economic Area in 2019. Bacteria, viruses, fungi, and toxins have been shown to bind to the immobilized heparin in a similar way to the interaction with heparan sulfate on the cell surface. Of note, it has recently been demonstrated that SARS-CoV-2 attaches to heparin through its surface protein Spike 1 receptor-binding domain [21] . The Seraph ® 100 Microbind ® Affinity Blood Filter is an extracorporeal hemoperfusion device whose functional core, that is, polyethylene beads (diameter of 0.3 mm) with immobilized heparin bound to it, mimics a naturally mammalian cell surface (Fig. 1) . Cytokines in blood from septic patients interact with surface-immobilized heparin
cord-284175-5rre1kbn	2020	Herein, we describe the clinical course of an otherwise healthy patient who experienced persistent ventricular tachycardia and fibrillation which is believed to be directly related to inflammation, as opposed to acute myocardial injury or medications that can prolong the QT interval. One study reported ventricular tachycardia (VT)/VF in 5.9% (11/187) of COVID-19 patients (Table 2 3-9 ), with elevated troponin-T increasing risk, suggesting that myocardial injury precipitates arrhythmia 2 . Tocilizumab was shown to have a robust shortening of the QTc prolongation induced by abundant inflammatory cytokines in patients with acute rheumatoid arthritis 16 . As such, this report suggests that the hyper-inflammatory state in COVID-19 patients can induce ventricular arrhythmias, which may cease abruptly following a reduction in inflammation, in our case from convalescent serum and/or hydrocortisone therapy. QT interval prolongation and torsade de pointes in patients with COVID-19 treated with hydroxychloroquine/azithromycin
cord-284188-ujdla954	2020	To assess patient and provider data, systems effectiveness, and ability to provide care with and without admission to the ED, 17, 18 we identified the following variables from the cohort records: provider type, patient age, self-assigned gender, visit date, self-assigned race/ethnicity, 19 comorbidities, previous primary care visits (as an indirect marker of regular access to care), VUC return visits, ED referrals and spontaneous ED visits, ED and dispositions, intubations, and deaths following VUC visits. We evaluated and manually reviewed all patients identified for follow-up to assess outcomes including ED referral during follow-up screening call, hospital admission and course, presence or absence of ED referral on index VUC visit, mortality, and interval metrics. 17 While no direct comparators existed during the pandemic, when decision thresholds to present to the ED were multifactorial, to provide context for departments managing patients as outpatients, we evaluated similar outcomes of patients presenting for ED care who were discharged (not admitted) during the same time period.
cord-284251-brn5izwo	2020	We performed a retrospective cohort study of adult (age ≥ 18 years) patients admitted to the NYU Langone Health System (NYU Langone Medical Center, NYU Brooklyn, NYU Winthrop, or NYU Langone Orthopedic Hospital) who had both a positive severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) polymerase chain reaction (PCR) test result and neuroimaging performed between March 1 and April 27, 2020. We used binary logistic regression models to estimate the odds ratios and 95% confidence intervals (OR, 95% CI) of therapeutic anticoagulation use and ICH in patients hospitalized with COVID-19 adjusting for previously identified factors associated with ICH (age, gender, ethnicity, hypertension, systolic blood pressure) and might plausibly be associated with ICH in COVID-19 patients. Binary logistic regression models were used to assess for mortality in both ICH and non-ICH patients adjusting for previously reported risk factors, age [7] and maximum hospital SOFA score, [18] as a marker for disease severity.
cord-284298-tcied4l5	2020	In the present study, twenty one early career psychiatrists (9 females and 12 males) from thirteen countries, comprising at least one from five of the seven continents (Africa, Asia, Europe, North J o u r n a l P r e -p r o o f America and South America) were approached without coercion by the lead (MIO) and co-lead (RdF) authors via WhatsApp and emails to share insights and experiences about the challenges and good practices faced in the management of delirium and other psychiatric conditions manifesting in patients with COVID-19 and during the COVID-19 era. Finally, the mental health sector should use the lessons from this pandemic to develop protocols and guidelines for the management of psychiatric conditions in periods of infectious disease outbreaks to increase their level of preparedness globally (Table 4) .
cord-284332-p4c1fneh	2012	[47] Although both of these studies were conducted prior to the 1994 AECC definition, ARDS was strictly defined in the aforementioned studies, including a PaO 2 /FiO 2 ratio <150 or intrapulmonary shunt >20% in patients requiring mechanical ventilation and who had diffuse infiltrates on chest radiograph without clinical evidence of heart failure as pulmonary arterial occlusion pressures were <18 mmHg. Building on the results of these two studies, Sinuff and colleagues [48] developed practice guidelines for prophylactic ketoconazole use, and tested the implementation and efficacy of these guidelines in two ICUs (one control and one active comparator). [119] A phase II study enrolling 98 patients with ALI compared an antioxidant enteral feeding formula containing eicosapentaenoic acid, g-linolenic acid and antioxidant vitamins with placebo, and observed improved oxygenation, reduced pulmonary inflammation, fewer days of mechanical ventilation and fewer non-pulmonary organ failures in the treatment arm, although there was no difference in mortality between this approach and the control group.
cord-284365-g46myqe7	2020	Using a mixed-method triangulation design (QUAN + QUAL), this study investigated and compared the mental status and inflammatory markers of 103 patients who, while hospitalized with mild symptoms, tested positive with COVID-19 and 103 matched controls that were COVID-19 negative. Results revealed that COVID-19 patients, when compared to non-COVID controls, manifested higher levels of depression (P < 0.001), anxiety (P < 0.001), and post-traumatic stress symptoms (P < 0.001). The Patient Health Questionnaire, 9-item version (PHQ-9) (Kroenke et al., 2001) , Generalized Anxiety Disorder Assessment 7-item version (GAD-7), Perceived Stress Scale, 10-item version (PSS-10) (Barbosa-Leiker et al., 2013a) , and the PTSD Checklist for DSM-5 (PCL-5) were used to assess the levels of psychological distress of all participants (Wortmann et al., 2016) . Compared with normal controls, patients with COVID-19 presented higher levels of depression, anxiety, and post-traumatic stress symptoms.
cord-284387-cjziykrz	2020	Second, protective measures by health services, especially in public and open environments like emergency departments (EDs) where isolation of potentially infected patients is a real challenge or clinical wards is vital [10] . Clinical care of suspected patients with COVID-19 should focus on early recognition, and immediate isolation, as well as appropriate infection prevention measures and control measures with care taken to optimise supportive care. (1) An informative, coordinated campaign for public and healthcare professionals, focused on mechanisms of contagion [4] , personal protection equipment (PPE) use, and a clinical pathway for the suspected patients infected with COVID-19. (5) The development and implementation of cleaning protocols, considering that coronavirus has been isolated on inanimate objects, and healthcare workers were infected by SARS, even without direct contact with sick patients [15] . The patient, relative or general practitioner may alert the emergency number indicating that a potential case of SARS-CoV-2 infection with severe symptoms is seeking care.
cord-284454-malfatni	2020	[5] [6] [7] [8] Therefore, providing care to patients who are injured during school-associated shooting events is likely to be particularly stressful for emergency nurses. The purpose of this study was to learn how emergency nurses describe their experiences to identify themes and findings that may translate to practices for improving the mental health and wellness of emergency nurses who care for patients from a multicasualty, school-associated shooting incident. Another participant predicted that community or critical access emergency departments receiving patients from a multicasualty school shooting event may experience even greater emotional challenges because these departments are more likely to have staff who may personally know the victims or their families. Learning from emergency nurses who care for patients from a multicasualty, school-associated shooting event may promote personal and departmental preparedness and improve coping and recovery among the involved clinicians.
cord-284526-a5kgo4ct	2020	Experience from previous coronaviruses has triggered hypotheses on the role of endothelial dysfunction in the pathophysiology of SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2), which are currently being tested in preclinical and clinical studies. Recent evidence suggests that signs and symptoms of severe coronavirus disease-2019 (COVID-19) infection resemble the clinical phenotype of endothelial dysfunction and share mutual pathophysiological mechanisms [1] . Experience from previous coronaviruses has triggered studies testing hypotheses on the role of the endothelial dysfunction in patients with SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2). Α high rate of VTE (43%, mainly PE) overall was reported in another series of 150 ICU patients in which patients with COVID-19associated acute respiratory distress syndrome (ARDS) had higher rates of thrombotic complications compared with non-COVID-19-ARDS [65] . Autoantibodies against human epithelial cells and endothelial cells after severe acute respiratory syndrome (SARS)-associated coronavirus infection
cord-284545-vn60yd46	2020	Furthermore, older patients, especially those 65 years old and above who have comorbidities and are infected, have an increased admission rate into the intensive care unit (ICU) and mortality from the COVID-19 disease. This article is part of the Topical Collection on Covid-19 * Adekunle Sanyaolu sanyakunle@hotmail.com 1 Federal Ministry of Health, Abuja, Nigeria A retrospective study of middle-aged and elderly patients with COVID-19 found that the elderly population is more susceptible to this illness and is more likely to be admitted to the ICU with a higher mortality rate [3] . Authorities speculate that subjects with comorbidities were linked to a more severe disease outcome when infected with the novel coronavirus when compared with patients with no underlying disease [31] . Risk factors associated with acute respiratory distress syndrome and death in patients with coronavirus disease 2019 pneumonia in Wuhan, China
cord-284576-nemh4wdo	2020	Methods Blood samples from adult patients hospitalized with COVID-19 were analyzed using high-throughput and ultrasensitive proteomic platforms and compared with ageand sex-matched healthy controls to provide insights into differential regulation of 185 markers. Objective: To identify and characterize the host inflammatory response to SARS-CoV-2 59 infection, we assessed levels of proteins related to immune responses and cardiovascular 60 disease, in patients stratified as mild, moderate, and severe, versus matched healthy controls. Objective: To identify and characterize the host inflammatory response to SARS-CoV-2 59 infection, we assessed levels of proteins related to immune responses and cardiovascular 60 disease, in patients stratified as mild, moderate, and severe, versus matched healthy controls. Furthermore, in a limited series of patients who were sampled 69 frequently confirming reliability and reproducibility of our assays, we demonstrate that 70 intervention with baricitinib attenuates these circulating biomarkers associated with the cytokine 71 The COVID-19 pandemic created an overwhelming need to define host-derived molecular 96 mediators of disease severity evident in hospitalized patients.
cord-284804-6i5zbmm1	2020	Methods: In this case-control study, patients with severe COVID-19 in this newly established isolation center on admission between 27 January 2020 to 19 March 2020 were divided to discharge group and death event group. In the course, persistently lower lymphocyte with higher levels of CRP, PCT, IL-6, neutrophil, LDH, D-dimer, cardiac troponin I (cTnI), brain natriuretic peptide (BNP), and increased CD4+/CD8+ T-lymphocyte ratio and were observed in death events group, while these parameters stayed stable or improved in discharge group. The bivariate and multivariate logistic regressions were used to investigate the risk factors for death events involving the stratified clinical, radiographic, and laboratory parameters with significant differences between two groups on admission, and the odds ratio (OR) with 95% confidence interval (95%CI) were calculated. Besides, more abnormities of biochemical and hematological parameters were observed in death event group compared with discharge group, such as neutrophil, lymphocyte, CRP, PCT, LDH, D-dimer, cTnI, and BNP ( Table 2) .
cord-284910-vjcrhwqz	2020	Emerging evidence demonstrates a strong association with a pro-thrombotic state and we present the first patient admitted with COVID-19 and an inferior ST-segment elevation myocardial infarction (STEMI) with evidence of high intracoronary thrombus burden. We review the mechanism of the high thrombus burden, which may be driven by the significant cytokine storm, endothelial dysfunction, increase risk of coronary plaque rupture and hypercoagulability. We present the first patient admitted with inferior ST-segment elevation myocardial infarction (STEMI) with evidence of high intracoronary thrombus burden and provide a review of potential underlying mechanisms. There are emerging theories regarding the mechanism of increased thrombus burden seen in COVID-19, central to which seems to be a significant proinflammatory state (8). Plaque rupture results in an increase in tissue factor (TF), collagen and platelet activation causing increased fibrin production and a higher thrombus burden (16) .
cord-284944-hcgfe9wv	2020	Thus, we performed high dimensional flow cytometry and single cell RNA sequencing of COVID-19 patient peripheral blood cells and detected the disappearance of non-classical CD14LowCD16High monocytes, the accumulation of HLA-DRLow classical monocytes, and the release of massive amounts of calprotectin (S100A8/S100A9) in severe cases. Validating these discovery experiments, we performed mass cytometry analysis of an independent cohort of 12 patients (four in each group; control, mild and severe) ( Table S5) , which showed a lower fraction of CD14 Low CD16 High non-classical monocytes in severe compared to mild patients ( Figure 3F and 3G ). This study presents evidence that patients who develop a severe COVID-19 exhibit high levels of calprotectin and inflammatory cytokines and chemokines correlating with an emergency myelopoiesis generating ROS-and NOS-expressing immunosuppressive myeloid cells (HLA-DR Low monocytes and immature subsets of neutrophils).
cord-284979-lyt98od1	2020	We report our experience in treating the first case of COVID-19 in a HD patient in Singapore who had a severe clinical course including acute respiratory distress syndrome and propose a clinical management strategy. We also highlight the importance of early recognition and intervention for disease control, dialysis support in an acute hospital isolation facility, deisolation protocol, and discharge planning due to prolonged viral shedding. A case series of an outbreak in a dialysis center in Wuhan, where HD patients were observed to have a milder disease course or total absence of symptoms with lower levels of serum inflammatory cytokines, suggested that this is due to the inability to mount an effective cellular immune response and hence an absence of cytokine release syndrome [3] . We examined international guidelines provided by different centers [14] and proposed a workflow based on the time points of the clinical course of COVID-19 disease in ESKD patients (Fig. 3) .
cord-284983-xvtkso79	2020	title: Safety and Efficacy of Bedside Peritoneal Dialysis Catheter Placement in the COVID-19 Era: Initial Experience at a New York City Hospital INTRODUCTION: Acute kidney injury (AKI) requiring renal replacement therapy (RRT) is common in critically ill patients with COVID-19. Unparalleled numbers of patients with AKI and shortage of dialysis machines and operative resources prompted consideration of expanded use of urgent-start peritoneal dialysis (PD) and evaluation of the safety and efficacy of bedside surgical placement of PD catheters. The catheter should be flushed with heparinized saline following each critical step of the procedure to ensure adequate Insertion of the catheters in surgical clinic for ambulatory patients with CKD mimics the ICU bedside technique, with slight modifications. In our limited series, bedside placement of peritoneal dialysis catheters in the early phases of the COVID-19 pandemic offered a safe and effective option for establishment of access for renal replacement therapy.
cord-284995-8lyr3gs4	2020	Les connaissances dans ce domaine sont encore loin d''être exhaustives mais plusieurs séries publiées concernant les patients atteints de la COVID-19 retrouvent une proportion significative de troubles du rythme, dont certains pouvant potentiellement mener à une issue fatale. Sur une série de 146 patients hospitalisés pour la COVID-19, 20% avaient une atteinte myocardique (définie comme une élévation significative de troponine I, avec des signes électrocardiographiques (ECG) compatibles avec une ischémie myocardique) résultant en une J o u r n a l P r e -p r o o f mortalité de 51.2% comparée à 4.5% chez les patients sans atteinte myocardique [2] . Troubles du rythme observés à la phase aigüe : Description -Les palpitations étaient un symptôme de présentation initial de la maladie chez 7.3% des patients hospitalisés pour la COVID-19 dans une série de Wuhan en Chine [7] .
cord-285226-4ydvjmr3	2020	This leads to an examination of recent developments in the field and outlines several promising areas of future improvement in skull base surgery, per se, as well as identifying new hospital support systems needed to accommodate these changes. These include, but are not limited to advances in imaging, Raman Spectroscopy and Microscopy, 3-dimensional printing and rapid prototyping, master-slave and semi-autonomous robots, artificial intelligence applications in all areas of medicine, tele-medicine, and green technologies in hospitals. 44 45 More recent technological introductions have proceeded to revolutionize the 46 treatment of challenging skull base pathology including the introduction of 47 endoscopic surgery, advances in neuroimaging, radiosurgery and high energy 48 focused radiotherapy, the perfection of vascular bypasses for replacement of 49 major arteries and venous sinuses involved by tumors 1,2,3 , and the use of skull 50 base approaches to treat complex vascular lesions. Humanoid robotic nursing assistants 558 will be developed and widely used in future due to health care worker shortages, 559 patients'' desire to have 24x7 nursing assistance, and the needs created by 560 infectious diseases wherein human-human contact must be minimized.
cord-285291-pep4opiq	2020	T he worldwide pandemic of coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 has already resulted in critical care demands overwhelming resources in nations such as Italy (1) . Prone positioning for at least 12 hours daily in adults with severe ARDS may increase ventilator-free days, reduce in-hospital mortality, and reduce the need for rescue therapies like inhaled nitric oxide and extracorporeal membrane oxygenation (ECMO) (16, (65) (66) (67) (68) . Nonpharmacologic approaches to these modifiable risk factors include frequent environmental reorientation, cognitive stimulation, minimizing sleep interruptions, engaging familiar visitors, limiting use of sedative medications, and scheduled sedation "holidays." These strategies have consistently shown improved clinical outcomes in critically ill patients and are now considered standard of care (117) . EPVent-2 Study Group: Effect of titrating positive end-expiratory pressure (PEEP) with an esophageal pressure-guided strategy vs an empirical high PEEP-FIO 2 strategy on death and days free from mechanical ventilation among patients with acute respiratory distress syndrome: A randomized clinical trial
cord-285298-r7p44wpe	2020	The position statement complements, and should be read in conjunction with, the National Heart Foundation of Australia & Cardiac Society of Australia and New Zealand: Australian Clinical Guidelines for the Management of Acute Coronary Syndromes 2016: Section 2 ''Assessment of Possible Cardiac Chest Pain''. • Early identification of low risk patients who do not require further testing for ischaemia, either by 1) Using a single test of serum troponin level on presentation, or 2) Clinical risk stratification and serial testing of ECG and troponin only • Identification of low risk patients who can safely be discharged from ED with expedited out-patient review and consideration of further testing Whilst these criteria can be used on an individual patient basis, substantial ''system wide'' gains are possible using a strategic approach to chest pain assessment [4] .
cord-285354-bp2dozzg	2020	1097 W e read with interest the article "COVID-19 outbreak in Northern Italy: Viewpoint of the Milan area surgical community," which reported the pandemic surge response of our colleagues within tertiary hospitals in Lombardy. As surgeons operating in spoke hospitals, we have paved through the pandemic in an unusual and unexpected way, many of us having to turn from surgical specialists into coronavirus disease (COVID) ward doctors. Nonetheless, being a surgeon used to emergencies in peripheral hospitals was a valuable resource during the COVID mass casualty incident because of our commitment to patients and acute care background. 1 Our daily schedule changed dramatically when we were asked to cancel elective surgery to increase the hospital capacity in mechanical respirators and intensive care personnel for COVID-19 patients. Surgery in the coronavirus disease 2019 phase 2 Italian scenario:Lessons learned in northern Italy spoke hospitals W e thank Dr. Costanzi and colleagues for their appreciation and interesting insights about our work.
cord-285360-svczr721	2020	Treatment delays may seem inevitable with competing priorities like donning/doffing PPE, greater attention to the patient''s respiratory status with more frequent pre-emptive intubation, and a Fig. 1 During typical emergency medical scenarios like ischemic stroke, there are various factors that are immediately available ("known") at the time of decision-making for physicians, patients, and their caregivers/ proxies, whereas other factors are potentially knowable but lost to an "information bottleneck" and still others lie hidden behind a "knowledge barrier" (a). The COVID-19 pandemic has resulted in a constellation of systemic and workflow changes that have resulted in additional unique challenges in information flow for emergency medical decision-making (b). Nevertheless, by appreciating the underlying pitfalls in information flow, we can adopt a more proactive and nuanced approach to emergency decision-making and potentially mitigate the impact of COVID-19 on patient care (Fig. 1d) .
cord-285414-vd2d7db2	2020	title: Multicenter cohort study demonstrates more consolidation in upper lungs on initial CT increases the risk of adverse clinical outcome in COVID-19 patients In this study, we aimed to assess the imaging characteristics and risk factors associated with adverse composite endpoints in patients with COVID-19 pneumonia. In this study, we aimed to report the quantitative imaging characteristics and risk factors for adverse composite endpoints, including admission to ICU, acute respiratory failure occurrence, and shock during hospitalization in patients with COVID-19 pneumonia in Jiangsu province, China. In this retrospective, cohort, and AI-assisted study, we reported the imaging risk factors associated with adverse clinical composite endpoints, including admission to ICU, acute respiratory failure, and shock during hospitalization in patients with COVID-19 pneumonia in Jiangsu province, China. Our study of 421 COVID-19 patients suggested an increased pulmonary lesion in bilateral upper lungs were independent risk factors for adverse clinical outcomes, which as far as we know, has not been reported.
cord-285467-uxfk6k3c	2020	Since an effective immune response against viral infections depends on cytotoxic T cells activation (25) , experimental evidence supports the observation that overexpression of inflammatory cytokines like IL-6 during the viral immune response might be associated with a decreased viral clearance by impairing the polarization and functionality of Th1 and CD8 cells (26), contributing to the worsening of the COVID-19 symptoms, and their management may appear an intriguing therapeutical approach. Overall, the administration of drugs for the control of inflammation, inhibiting the response of the immune system, may be detrimental in the initial phases of the viral infection, reducing the ability of the body to react to the presence of SARS-CoV-2, as observed in patients chronically treated for rheumatoid arthritis (27) . All rights reserved This shall prompt orthopaedics and clinicians in general to evaluate with extreme care the clinical conditions of OA patients not only under the perspective of OA symptoms management but also for undercurrent comorbidities, naturally occurring or OA-treatment-related, that, in the era of COVID-19 pandemic, may strongly affect patients outcomes more than the net combination of SARS-CoV-2 infection and OA.
cord-285469-b61y9ezi	2020	The aim of our study is to describe the clinical characteristics, laboratory findings, neuroimaging and available pathological anatomy data, as well as the presentation, therapeutic management and clinical outcomes of patients with acute CVD in a healthcare setting with a high incidence of transmission of this virus. We registered all hospitalized patients with COVID-19 reported during this period, and included all patients diagnosed with acute CVD, both ischaemic and haemorrhagic, treated consecutively by neurology, neurosurgery and the intensive care unit. Bivariates studies were designed to contrast the main variables among CVD patients, between ischaemic/haemorrhagic subtypes within the COVID-19 group, and to assess clinical prognosis. The other three haemorrhagic cases were detected on varying days of clinical evolution because having been intubated, sedated and treated for SARS-CoV-2 infection, the neurological manifestations were masked prior to tracheal extubation, when difficulty arousing these patients was observed.
cord-285472-cj5r3xt1	2020	Patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection mainly present with upper and lower respiratory tract symptoms, with complications related to cytokine storm syndrome and acute respiratory distress syndrome. As per American Society of Hematology, some patients with severe coronavirus disease 2019 (COVID-19) have fulminant activation of coagulation and consumption of coagulation factors, which meets the criteria for disseminated intravascular coagulation as per International Society on Thrombosis and Haemostasis. Thus, complement inhibition may be a reasonable treatment for COVID-19-related systemic thrombosis by reducing the innate immune-mediated consequences of severe coronavirus infection [10] . In conclusion, we report a COVID-19 patient who developed arterial thrombosis leading to acute ischemia in the right upper extremity. Changes in blood coagulation in patients with severe coronavirus disease 2019 (COVID-19): a meta-analysis Prevalence of venous thromboembolism in patients with severe novel coronavirus pneumonia
cord-285588-ug7upa3r	2020	[23] [24] [25] TM has already been adapted into primary care, with telephone consultations and home-monitoring systems already are in regular use in general practice, however, with the adjustments made to secondary and tertiary care services in the COVID-19 era, it is unclear as to whether TM can meet the needs of complex specialities such as cardiovascular surgery. 48 While some trials show that superiority of using TM over conventional management may be debatable, the majority of the research indicates that the monitoring of clinical parameters of cardiac patients during COVID-19 is likely to be useful in not only the overall management of the changing health status of patients, but also more specifically in facilitating effective remote presurgical triaging, detecting cardiac deterioration, and managing potential postsurgical complications. Combinations of regular virtual consultations and remote monitoring of clinical parameters are feasible for cardiac surgery patients and would be useful to assess and triage before surgery.
cord-285732-xew5ar1e	2020	No spontaneous air leak case series have been described in the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) patient population thus far. We described seven spontaneous air leak cases we found in our coronavirus disease 2019 (COVID-19) positive 976-patient cohort. Air leak in hospitalized severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) patients has been sparsely published as case reports, however, the presence of non-invasive ventilation and positive airway pressure were reported prior to this finding [3] [4] . Studies of a severe acute respiratory syndrome with SARS did identify air leak as a frequent complication, often with no relation to intubation or positive pressure ventilation [1] [2] [3] [4] [5] . Of these, we found 20 cases of air leak; three traumatic/post-procedure, 10 post-intubation/mechanical ventilation, and seven spontaneous (five cases of pneumomediastinum and two isolated pneumothorax). One out of seven spontaneous air leak patients expired. Spontaneous pneumomediastinum in patients with severe acute respiratory syndrome
cord-285755-zblitbo0	2020	[Results] A total of 110 patients with confirmed (n=80) or suspected (n=30) COVID-19 were screened and 48 patients (female 31.3%, mean age 70.58{+/-}13.38 year old) among them with high-sensitivity cardiac troponin I (hs-cTnI) test within 48 hours after admission were included, of whom 17 (17/48, 35.4%) died in hospital while 31 (31/48, 64.6%) were discharged or transferred to other hospital. [Conclusions] Cardiac injury defined by hs-cTnI elevation and elevated d-dimer on admission were risk factors for in-hospital death, while higher SpO2 could be seen as a protective factor, which could help clinicians to identify patients with adverse outcome at the early stage of COVID-19. Short-term prognosis of COVID-19 patients are discrepancy and in-hospital mortality risk are high in severe cases[1] [2] Although previous study had indicated that several risk factors were independently associated with short-term mortality, such as elevated d-dimer, older age and higher Sequential Organ Failure Assessment (SOFA) score [2] , few studies focused on cardiac injury with COVID-19 patients.
cord-285757-fiqx4tll	1999	To study whether MxA protein expression is systemically upregulated during rhinovirus infection, blood specimens were collected from 40 patients with common cold and MxA expression in mononuclear cells analyzed by flow cytometry. In conclusion, expression of MxA in blood lymphocytes and an apparently systemic type I interferon response is not induced during rhinovirus infection or during most other cases of common cold in young adult patients. In the present study, the induction of a systemic IFN response as reflected by the expression of MxA protein in blood lymphocytes of patients with rhinovirus infection was examined. Our data suggests that type I IFN production in serum is not comparable to that seen in most other respiratory viral infections in vivo, since the rhinovirus-positive patients had only low or no expression of the MxA protein and no IFN-a/b was detectable in serum samples.
cord-285772-4xt4anq5	2020	This study aimed to describe the clinical characteristics of COVID-19 and identify the risk factors for severe illness of COVID-19 in Jiangsu province, China. Several studies have reported the clinical characteristics of COVID-19 patients who were hospitalized in Wuhan (the outbreak center of the infection) [4, 6, 7] . conducted a retrospective, single-center study which included 99 confirmed cases of COVID-19 in Wuhan and found that the virus was more likely to infect older men with comorbidities, and the mortality rate was as high as 11% [4] . Another single-center study which analyzed 138 hospitalized patients with confirmed COVID-19 in Wuhan, found that 26% of patients received ICU care and the mortality rate was only 4.3% [7] . In this multi-center study, we aimed to describe the clinical characteristics of COVID-19 and to identify the risk factors of severe illness among inpatients with confirmed COVID-19 in Jiangsu province, which is located in the east of China.
cord-285818-eh12luma	2020	Objective As concerns regarding neurological manifestations in COVID-19 (coronavirus disease 2019) patients increase, limited data exists on continuous electroencephalography (cEEG) findings in these patients. This high percentage of epileptiform abnormalities (EAs) in a specific brain region in COVID-19 patients behooves the question if this is a potential epileptic effect from the SARS-CoV-2 infection or if this is a limitation with the EEG requisition method itself; since patients did not receive the minimum required 21-electrode clinical EEG recommended by American Clinical Neurophysiological Society ACNS) (Sinha et al. Whilte the main goal of this study was to report cEEG findings in a cohort of critically ill COVID-19 patients, the putative associations between survival, clinical outcomes (discharge disposition), cohort characteristics (e.g. comorbidities, age, gender) and EEG findings were also explored. As such, the two COVID-19 patients with clinical acute symptomatic seizures captured on EEG from our cohort are rare findings.
cord-285867-61y4aamj	2020	Neurotoxicity is a rare complication of immune checkpoint inhibitor therapy, and facial palsy as a complication of atezolizumab therapy has only been reported in one additional study. We present the case of a 68-year-old female with a history of small cell carcinoma of the lung presenting with sudden-onset facial palsy and numbness of the distal extremities in the setting of receiving atezolizumab immunotherapy. Clinicians should be aware of this rare adverse effect in order to enact early management including temporary cessation of therapy to prevent morbidity in patients undergoing immunotherapy. 10 Facial palsy secondary to immune checkpoint inhibitor therapy is rare, occurring in only 5 of 364 patients in one retrospective study. Facial palsy is a rare side effect of immune checkpoint inhibitor therapy with atezolizumab. The diagnosis of facial palsy secondary to immune checkpoint inhibitor therapy is one of exclusion, and clinicians should be aware of this as a potential adverse event.
cord-285897-ahysay2l	2020	OBJECTIVE: To develop and validate machine-learning model based on clinical features for severity risk assessment and triage for COVID-19 patients at hospital admission. CONCLUSION: The machine-learning model, nomogram, and online-calculator might be useful to access the onset of severe and critical illness among COVID-19 patients and triage at hospital admission. Therefore, our objective is to develop and validate a prognostic machine-learning model based on clinical, laboratory, and radiological variables of COVID-19 patients at hospital admission for severity risk assessment during hospitalization, and compare the performance with that of PSI as a representative clinical assessment method. This international multicenter study analyzed individually and in combination, clinical, laboratory and radiological characteristics for COVID-19 patients at hospital admission, to retrospectively develop and prospectively validate a prognostic model and tool to assess the severity of the illness, and its progression, and to compare these with PSI scoring.
cord-285907-xoiju5ub	2005	Abstract To differentiate severe acute respiratory syndrome (SARS) from non-SARS illness, we retrospectively compared 53 patients with probable SARS and 31 patients with non-SARS who were admitted to Mackay Memorial Hospital from April 27 to June 16, 2003. SARS patients with an initially normal chest X-ray study developed infiltrates at a mean of 5 ± 3.44 days after onset of fever (21/22 SARS vs. Severe acute respiratory syndrome (SARS) is a rapidly progressive disease caused by a novel coronavirus. Initial chest X-ray studies were normal in 22 of 53 SARS patients (41%) and 5 of 31 non-SARS patients (16%) ( Table 4 ). All except 1 of the 22 SARS patients with an initially normal chest X-ray study eventually developed abnormalities (mean FD 5 Ϯ 3.44). No non-SARS patient with an initially negative chest X-ray developed abnormalities on follow-up films.
cord-286096-h275nner	2012	Methods Between April 2008 and April 2009, 408 adult patients (aged between 20 and 94 years) with community‐acquired pneumonia were tested for the presence of respiratory pathogens using bacterial cultures, real‐time PCR for viruses and bacteria, urinary antigen testing for Legionella and Pneumococci and serology for the presence of viral and bacterial pathogens. All samples were tested using real-time PCR for the presence of respiratory viruses and bacteria including adenovirus (AdV), human bocavirus (hBoV), KI-and WU polyomaviruses (KIPyV and WUPyV), human metapneumovirus (hMPV), human rhinovirus (HRV), human coronaviruses (HCoV) (OC43, NL63, HKU and 229E), parainfluenza viruses (PIV), 1-4 influenza viruses A and B (InfA, InfB), respiratory syncytial virus (RSV), Legionella pneumophila, Mycoplasma pneumoniae, Chlamydophila psittaci, Chlamydophila pneumoniae, Coxiella burnetii and Streptococcus pneumoniae. This study revealed the viral and bacterial aetiology in 263 (64AE5%) of 408 patients with community-acquired pneumonia.
cord-286227-foeb0g7u	2020	A 59-year-old male patient presented with fever of 39°C and a rash of the lower extremities in combination with hemorrhagic elements which were consistent with polymorphic cutaneous vasculitis ( Fig. 3a ,b). A 47-year-old female patient with COVID-19 pneumonia developed acral urticarial highly pruritic rash on upper and lower extremities 5 days after the laboratory diagnosis (Fig. 7a, b ). A 71-year-old male patient, 2 weeks prior to our examination, developed papulovesicular eruptions while having escalating clinical symptoms of COVID-19 infection (fever, weakness, cough, shortness of breath) (Fig. 8a,b) . A 46-year-old female patient with confirmed COVID-19 infection and bilateral pneumonia presented with papulovesicular elements in the chest area (Fig. 9) . A 56-year-old male patient with COVID-19 infection presented with skin lesions, also called "bilateral inguinal purple rash." Large pink-red plaques were observed in both inguinal folds with a transition to the inner thighs, with a brownish tint and abundance of follicular papules along the periphery (Fig. 13) .
cord-286237-x6dr6rsh	2020	-mechanical ventilation > 24 h at randomization -clinical frailty scale above 3 -active bacterial or fungal infection -unlikely to survive beyond 48h -neutrophil count below 1500 cells/microliter -platelets below 50.000/microliter -Patients enrolled in another investigational drug study -patients on high dose systemic steroids (> 8 mg methylprednisolone or equivalent for more than 1 month) for COVID-19 unrelated disorder -patients on immunosuppressant or immunomodulatory drugs -patients on current anti-IL1 or anti-IL6 treatment -signs of active tuberculosis -serum transaminase levels >5 times upper limit of normal, unless there are clear signs of cytokine release syndrome defined by LDH >300 IU/L and ferritin >700 ng/ml -history of (non-iatrogenic) bowel perforation or diverticulitis -Pregnant or breastfeeding females (all female subjects deemed of childbearing potential by the investigator must have negative pregnancy test at screening) 5.2.1.
cord-286293-f5qg7vcz	2020	Since the end of December 2019, when the first cases of novel Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) were detected in Wuhan, China, the disease has spread exponentially. [2] In up to 15% of patients, the natural course of the disease is complicated by severe interstitial pneumonia, which can lead to acute respiratory distress syndrome (ARDS), multi-organ failure including acute kidney injury, disseminated intravascular coagulation and death. [2] To our knowledge, there have been no reported cases of COVID-19 complicated by massive pulmonary embolism and right-sided heart failure. [4] A higher risk of vessel thrombosis has been correlated with the severity of the disease and multiorgan involvement, leading support to the argument of therapeutic anticoagulation of COVID-19 patients with elevated d-dimer levels. In the present case, the patient had elevated CRP and d-dimer levels with no other risk factor for pulmonary embolism, indicating COVID-19 related hypercoagulable state as possible etiology for thrombosis in the pulmonary vasculature.
cord-286334-d9v5xtx7	2020	More detailed monitoring on how these physiological parameters change over time (perhaps including more complex cytokine studies), in these severely ill, influenza A(H1N1)pdm09-infected patients admitted to ICU-ECMO units, may eventually yield data to improve their management and clinical outcomes. 5 In the current study, we characterized a new HCV subtypes among chronic hepatitis C patients in Yunnan, China, initially designated as 6xi, further analyzed its evolutionary history and investigated its baseline RAS by next generation sequencing (NGS) method. The samples met the following inclusion criteria: (1) hepatitis C antibody-positive for 6 months with normal serum alanine aminotransferase (ALT) levels; (2) subject was residing in Yunnan province and was over 18 years old; (3) complete demographic information and clinical data were available; (4) consented to the use of patient information in studies on HCV epidemics; and (5) were treatment-naïve during sampling.
cord-286403-gdkwabcj	2020	title: Diagnosis and Treatment of Pulmonary Embolism During the COVID-19 Pandemic: A Position Paper from the National PERT Consortium However, the unique aspects of this virus confound both the diagnosis and treatment of PE, and thus require modification of established algorithms.1-6 Important considerations include adjustment of diagnostic modalities, incorporation of the pro-thrombotic contribution of COVID-19, management of two critical cardio-respiratory illnesses in the same patient, and protecting patients and health care workers while providing optimal care. The National Pulmonary Embolism Response Team (PERT) Consortium, the largest organization in the world specifically dedicated to improving outcomes in PE and advancing the science around this disease, recently published consensus recommendations for the diagnosis, treatment and follow-up for patients with acute PE. Diagnosis, Treatment and Follow Up of Acute Pulmonary Embolism: Consensus Practice from the PERT Consortium Prevention, diagnosis and treatment of venous thromboembolism in patients with COVID-19: CHEST Guideline and Expert Panel Report
cord-286418-9ho5fg3h	2020	Like many academic programs before the pandemic, UCSD''s Division of Hospital Medicine emphasized interdisciplinary bedside rounding, focusing on clinical care, quality, patient experience, and teaching. SARS-CoV2, capable of spreading from presymptomatic and asymptomatic persons, 3 threatened to injure or kill high-risk hospitalized patients (i.e. elderly, or with comorbid illnesses) as well as healthcare workers (HCW), making them patients instead of caregivers during our projected surge. 8 For example, on April 9, UCSD Health had a total census of 471 patients (56% occupancy) of which only 4.2% had COVID, with 10 patients on the hospital medicine service, 8 on ventilators (5.2% of capacity), and only 3 total deaths to date. AAMC guidelines advise that medical students not be involved in patient care unless COVID risks are low and protective equipment and testing are available. 12 As we contemplate the future of hospital care and training, we continue to monitor our distancing efforts for signs of adverse effects on safety, efficiency, and experience.
cord-286477-0euaaspo	2020	This study aims to describe and compare the 141 epidemiological, demographic, clinical, laboratory and radiological characteristics as well as the 142 complications, treatment and outcomes of hospitalized patients with nonsevere and severe 143 COVID-19. Comparison of findings between nonsevere and severe cases in 223 the patients with positive viral nucleic acid test pre-admission showed essentially the similar 224 differences to that in the total patients (see Table E1 in the Online Repository). In the follow-up period, the complications of COVID-19 were assessed , including acute 297 respiratory distress syndrome (ARDS) (38.3%), cardiac injury (21.7%), liver dysfunction (19.3%), 298 acute kidney injury (17.3%), bacteremia (7.7%), diffuse intravascular coagulation (7.7%), and 299 hyperglycemia (33.2%) ( This study provided a comprehensive data on the epidemiological, demographic, clinical, 338 laboratory, and radiological characteristics as well as the complications, treatment, and outcomes 339 of hospitalized patients with nonsevere and severe COVID-19 in Wuhan.
cord-286525-0354438s	2020	One of the unexpected findings from this study was an observed lack of benefit from steroids in contrast to the RECOVERY randomized controlled trial results [4] or a recent meta-analysis of steroid trials in critically ill patients. The phase III COVACTA trial (NCT04317092) found tocilizumab did not reduce mortality in hospitalized patients with severe COVID-19 pneumonia [11] . Similarly a large trial of sarilumab (NCT04315298) in severe and critical COVID-19 was stopped by the data safety monitoring board due to lack of benefit and a potential signal for harm in non-ventilated patients [12] and a second international trial (NCT04327388) also failed to meet its primary or key secondary outcomes [13] . Reconciling their results with those from randomized control trials raises important questions about the causal effect of the hyperinflammatory response and its role in the development of severe COVID-19. Sanofi provides update on Kevzara® (sarilumab) Phase 3 trial in severe and critically ill COVID-19 patients outside the
cord-286574-t9z2ynt5	2017	Data on the economic impact of AMR in major pathogens showed that healthcare costs significantly increase in the treatment of infections caused by antibiotic-resistant strains (Maragakis et al. In principle, the major high-level goals consist of optimizing the use of such drugs in health and agriculture and minimizing environmental contamination; sustaining the development of new classes of antimicrobials drugs and other medicines and making them affordable and accessible to all who need them; and much more effective application of infection control and prevention principles. These new agents are bound to change the paradigm for the treatment of infections caused by colistin-resistant Gram-negatives, but uncertainties are still likely to remain, including which agent to use, how to optimize dosing in to maximize efficacy and minimize toxicity as well as potential for development of resistance, and whether use of more than one agent would still be needed.
cord-286607-5i406twr	2019	Kawasaki syndrome (KS) is a necrotizing vasculitis of smalland medium-sized vessels mostly affecting children under 5 years of age; a host of clinical and epidemiological data supports the notion that KS might result from an infectious disease. All studies available to date have confirmed that an imbalance in the gut microbiota might indirectly interfere with the normal function of innate and adaptive immunity, and that variable microbiota interactions with environmental factors, mainly infectious agents, might selectively drive the development of KS in genetically susceptible children. The microbiota, a microbial community of trillions of microorganisms and at least 1,000 different bacterial species, some eukaryotic fungi and viruses, and which covers every surface of the human body, plays a contributory role in many infections, immune-mediated disorders, rheumatologic diseases, and disorders of the nervous system.
cord-286611-e1i1wemo	2020	We propose the "Telehealth Ten", which is a patient-assisted clinical examination to help guide clinicians through this new territory. Observing the patient''s gait and level of effort to walk into the room and to sit up on the exam table can be useful to assess his or her functional performance. This evaluation can be enhanced using digital devices, such as wearables for heart rate and electrocardiogram (ECG) and home monitoring devices (scale, blood pressure cuff, and pulse oximeter), which are potentially available to patients. We propose the "Telehealth Ten", which is a patient-assisted clinical examination to help guide clinicians through this new territory (Table 1) . We recommend that patients use a validated, digital, upper arm blood pressure (BP) cuff to measure their BP and heart rate and an electronic scale for measuring daily body weight. Ask patients to look at their face, neck, arms including elbows, chest, abdomen, and legs.
cord-286638-bqxyb61p	2020	The disease burden of coronavirus infectious disease 2019 (COVID-19) caused by Severe Acute Respiratory Syndrome Coronavirus-2 (SARS CoV-2) has been increasing continuously with more than a million confirmed patients and more than 45 thousand deaths globally [1] . Emerging data suggests that COVID-19 is common in patients with diabetes, hypertension, and cardiovascular disease (CVD), although the prevalence rate varied in different studies as well in country-wise data. Evolving data also suggest that patients of COVID-19 with diabetes are more often associated with severe or critical disease varying from 14 to 32% in different studies [15e18, 20, 22, 24] . Though there is limited data about the association of blood glucose levels with disease course in COVID-19 at present, data from other infections like SARS and influenza H1N1 has shown that patients with poor glycemic control have increased risk of complications and death [60, 61] .
cord-286683-mettlmhz	2020	Interestingly, the increased amounts of proinflammatory cytokines in serum associated with pulmonary inflammation and extensive lung damage described both in SARS [59] and MERS diseases [60] were also reported in the early study of 41 patients with COVID-19 in Wuhan [41] . A recently published case report of a patient with mild-to-moderate COVID-19 revealed the presence of an increased activated CD4+ T cells and CD8+ T cells, antibody-secreting cells (ASCs), follicular helper T cells (TFH cells), and anti-SARS-CoV-2 IgM and IgG antibodies, suggesting that both cellular and humoral responses are important in containing the virus and inhibiting severe pathology [82] . Clinical findings in a group of patients infected with the 2019 novel coronavirus (SARS-Cov-2) outside of Wuhan, China: Retrospective case series
cord-286743-z0e5arlm	2020	Subsequently, a shift in practice by clinicians at some of our medical centers aimed to identify early COVID19-CS through laboratory abnormalities in patients with increasing O2 requirements and to initiate combined treatment with anakinra and corticosteroids occurred. Data were extracted by manual reviewing the EHR, including onset of dyspnea and other COVID-19 symptoms, age, sex, comorbidities, smoking status, tocilizumab and anakinra use, other J o u r n a l P r e -p r o o f treatments rendered for hydroxychloroquine, and/or corticosteroids) , fever (>100.4F), hypotension requiring pressors, dates of admission, intubation, extubation, discharge and/or death. The primary purpose of analyses was to describe clinical outcomes among tocilizumab-or anakinra-treated COVID-19 patients and to examine whether differences in outcomes could be accounted for by COVID19-CS severity and/or duration at the time of treatment initiation (baseline).
cord-286843-8qh1pblc	2018	Univariate and multivariate logistic regression showed that serum procalcitonin, APACHE II severity score and mixed viral-bacterial infection were associated with increased risk of hospital mortality. Postulated prohibitive factors against the routine performance of viral diagnostics tests in patients with severe CAP may include a lack of clear clinical guidelines, perceived low cost-effectiveness and the paucity of effective anti-viral therapies for respiratory viruses other than influenza. Our primary hypothesis was that respiratory viruses were important causative pathogens in severe CAP and was associated with increased mortality when present with bacterial pathogens in mixed viral-bacterial co-infections. performed a prospective observational study on physician practices in the use of respiratory virus diagnostics demonstrating that despite clinical guideline recommendations on testing of respiratory viruses during influenza season, less than half of patients admitted to the intensive care unit with pneumonia were tested for viral pathogens [14] .
cord-286853-9gbel3pq	2020	BACKGROUND: Coronavirus disease 2019 (COVID-19) is a growing pandemic that confers augmented risk for right ventricular (RV) dysfunction and dilation; the prognostic utility of adverse RV remodeling in COVID-19 patients is uncertain. OBJECTIVES: The purpose of this study was to test whether adverse RV remodeling (dysfunction/dilation) predicts COVID-19 prognosis independent of clinical and biomarker risk stratification. Cardiac injury has also been reported to predict prognosis among COVID-19-infected patients, as evidenced by outcomes data that troponin elevation was present in 46% of nonsurvivors as opposed to 1% of survivors (5) and was associated with a >10-fold increased risk of mortality among hospitalized COVID-19 patients (6) . Related to this, it is important to note that whereas our results demonstrate adverse RV remodeling to strongly predict mortality in critically ill patients with COVID-19, available study data was insufficient to establish the mechanism for RV dilation or dysfunction.
cord-287048-5od0ssyk	2020	Summary Community transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2 or COVID-19) in the United States on February 26, 2020, and the rapid spread that followed forced patients, providers, payors, and policy makers to adapt to an unprecedented, nearly instant, and enormous demand for virtual care. The arrival of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2, or COVID-19) obliterated these barriers as executive orders forced patients, providers, and payors to adapt to an unprecedented, nearly instant, and enormous demand for virtual care. Regarding the use of synchronous patient-to-provider virtual visits (SPPVV) in pediatric ophthalmology, we have pooled our collective experience at three academic practices across the country to describe initial workflows, technology solutions, use cases, and barriers to care. Regarding the use of synchronous patient-to-provider virtual visits (SPPVV) in pediatric ophthalmology, we have pooled our collective experience at three academic practices across the country to describe initial workflows, technology solutions, use cases, and barriers to care.
cord-287102-o19uwryp	2020	The factors associated with outcomes of critically ill patients with coronavirus disease 2019 (Covid-19) who required treatment in an intensive care unit (ICU) are yet to be determined. The recorded data included the following: age, sex, medical comorbidities (i.e., smoking status, hypertension, diabetes, ischemic heart disease, chronic heart failure, cancer, chronic kidney disease, immunosuppression, cirrhosis, and dementia), medication history, vital signs, chest X-rays, laboratory studies on admission to the ICU, anti-Covid-19 pharmacological therapy in the ICU (antimalarials, antivirals, anti-inflammatories, and plasma from recovered patients), respiratory support method (invasive or noninvasive mechanical ventilation and oxygen mask), renal replacement therapy, nutrition methods (enteral and total parenteral nutrition), the use of extracorporeal membrane oxygenation (ECMO), complications, and outcome. In this nation-based registry study of critically ill patients with Covid-19 who were admitted to ICUs in Israel, the majority of patients were 55 years and older men, and a large proportion required mechanical ventilation.
cord-287117-3v9nyagt	2020	OBJECTIVE: The objective of this study was to report the benefit of a therapeutic approach consisting of intravenous (IV) continuous anakinra (recombinant human interleukin‐1 receptor antagonist) infusions in treating severely ill adult patients with secondary hemophagocytic lymphohistiocytosis or macrophage activation syndrome (MAS). The diagnosis of MAS was made using the HLH-2004 criteria, which require five of the eight following findings: fever greater than or equal to 38.5°C, splenomegaly; peripheral blood cytopenias (at least two of the following: hemoglobin level less than 9 g/dl, platelet count less than 100 000 cells per μl, and absolute neutrophil count less than 1000 cells per μl); hypertriglyceridemia (fasting triglyceride level greater than 265 mg/dl) and/or hypofibrinogenemia (fibrinogen level less than 150 mg/dl); hemophagocytosis in the bone marrow, spleen, lymph node, or liver; low or absent natural killer cell activity; ferritin level greater than 500 ng/ml; and elevated soluble CD25 levels (sIL-2Rα) two SDs above age-adjusted laboratory-specific norms.
cord-287161-hqrql1lh	2020	A retrospective, descriptive study of all patients tested for SARS-CoV2 on admission for illness to a community hospital in Iowa from 3/21/20 thru 6/14/20 consisted of evaluation as to demographics, presentation and hospital course. Overall survival of the COVID-19 patients was 88%, 77% in the critically ill, 59% of those mechanically ventilated and 33% of those requiring new dialysis. In this case series, we aim to describe epidemiological, clinical, laboratory, and treatment outcomes of confirmed COVID-19 patients admitted 3/21/2020 thru 6/14/2020 to UPH St. Luke''s Hospital, one of the two hospitals in Cedar Rapids. This early peak in ICU resources is a reflection of transitioning from an early intubation intervention for COVID-19 related acute hypoxic respiratory failure to a strategy of utilizing high flow nasal cannula and noninvasive ventilation(i.e BiPAP) as supported in the literature 15 . In addition, our data indicates a significant portion of the critically ill patients whom were mechanically ventilated required hemodialysis support, 47%(9 of 19).
cord-287210-sars5dmi	2005	However, the clinical and molecular epidemiological features of CoV-HKU1–associated pneumonia are unknown MethodsProspectively collected (during a 12-month period) nasopharyngeal aspirates (NPAs) from patients with community-acquired pneumonia from 4 hospitals were subjected to reverse-transcription polymerase chain reaction, for detection of CoV-HKU1. All prospectively collected NPAs from patients with community-acquired pneumonia that were sent to the clinical microbiology laboratories of 4 hospitals in Hong Kong during a 12-month period (22 March 2003 [the beginning of the SARS epidemic in Hong Kong] to 21 March 2004) for detection of SARS-CoV and were found to be negative for SARS-CoV RNA, by reverse-transcription polymerase chain reaction (RT-PCR) [20] , were included in the study. Sequence analysis revealed 0%-2% nucleotide differences between the sequences of the fragments and the sequence of the pol gene from The epidemiological, clinical, and radiological characteristics of the 10 patients with CoV-HKU1-associated community-acquired pneumonia are summarized in table 2.
cord-287222-wojyisu0	2020	Of the first 99 laboratory-confirmed patients, 49 (49%) had been exposed to HSWM, which was reported to be the possible initial source of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) [5] . New Coronavirus Infection Diagnosis and Treatment Scheme (Trial Version) published by Military Support Hubei Medical Team also put forward that for mild to moderate COVID-19 patients, corticosteroids should not be given principally and highdose corticosteroid pulse therapy was not recommended. Clinical findings in a group of patients infected with the 2019 novel coronavirus (SARS-Cov-2) outside of Wuhan, China: retrospective case series Clinical course and outcomes of critically ill patients with SARS-CoV-2 pneumonia in Wuhan, China: a single-centered, retrospective, observational study Clinical pathology of critical patient with novel coronavirus pneumonia (COVID-19)
cord-287367-1sdt9zz8	2017	title: Multiplex PCR point of care testing versus routine, laboratory-based testing in the treatment of adults with respiratory tract infections: a quasi-randomised study assessing impact on length of stay and antimicrobial use Consequently, though respiratory viruses are frequently isolated in community acquired pneumonia (CAP) [2] and are reported to be responsible for 12.8% of CAP cases admitted to UK hospitals [3] , the decision to manage as a viral RTI or treat for bacterial infection including Mycoplasma pneumoniae or Chlamydia pneumoniae (''atypical bacteria'') is based upon the clinical scenario and severity criteria such as the CURB-65 score. We undertook a study to assess the FilmArray® RP panel as a POC test compared to routine, laboratory-based detection methods in order to assess the impact on length of stay and antibiotic utilization. The aim of the study was to determine whether in adults presenting with upper respiratory tract infection (URTI)/ influenza-like illness (ILI) +/− lower respiratory tract infection (LRTI), FilmArray® RP panel POC testing, when compared to the routine, laboratory-based RP testing was associated with length of hospital stay or antimicrobial use.
cord-287373-7xjn05k8	2020	key: cord-287373-7xjn05k8 title: Under the coronavirus disease 2019(COVID-19) pandemic circumstance, how to administrate cancer patients with fever during radiotherapy cord_uid: 7xjn05k8 2.The screen process of patient with fever during radiotherapy in the center. All fever patients were screened by fever clinic with COVID 2019 nucleic acid, Patients with fever had been suspended from radiation therapy until the outcome of negative screen test results and the relive of fever symptoms, the average duration of suspension was 5.5 days (3-11), see figure 2 for details. It is suggested that fever patients with anti-tumor therapy during COVID-19 epidemic should carefully be concerned. Scientific and reasonable arrangements for the treatment and strict screen procedure for fever patient will ensure the maximization of the rights and interests of cancer patients. Risk of COVID-19 for patients with cancer COVID-19 outbreak and cancer patient management: viewpoint from radio-oncologists
cord-287376-wxldnlih	2020	Finally, the choice of surgical method, whether open surgery or minimally invasive procedures, is critical in determining how many colleagues are exposed to the risk of infection from COVID-19 patients, sometimes for hours. Here, robot-assisted surgery can comply with the pandemic''s requirement to "keep your distance" in a unique way, since the surgeon can operate at virtually any distance from the surgical site, at least with regard to aerosol formation and exposure. There were two central factors in the German hospital landscape that led to the restrictions described below: First, the call by the German Federal Ministry of Health to substantially increase the number of intensive care beds which would allow invasive ventilation of patients by temporarily postponing elective procedures; and second, the shortage of personal protective equipment (PPE), which is mainly produced in China, that accompanied the beginning of the pandemic.
cord-287468-e5h4tmy6	2020	The primary objective of our study was to assess the effects of hydroxychloroquine according to its plasma concentration in ICU patients. reported that hydroxychloroquine and azithromycin was associated with viral load reduction in nasopharyngeal samples in patients after six days of treatment [6] . The Surviving Sepsis Campaign guidelines on the management of Covid-19 patients concluded there was insufficient evidence to recommend the use of antiviral drugs and hydroxychloroquine in ICU patients [7] . Confirmed Covid-19 patients with acute respiratory failure were included in the study if they completed the criteria: i) age of 18 or older and; ii) polymerase chain reaction (PCR) documented SARS-CoV-2 in nasopharyngeal samples upon ICU admission. In conclusion, our results showed that there was no association between the plasma concentration of hydroxychloroquine and the viral and clinical evolution of ICU patients admitted for Covid-19.
cord-287497-93oiiqqi	2020	The objectives of this survey were to examine the impact of COVID-19 outbreak on the perception of Italian physicians involved in the administration of ICIs about SARS-CoV-2 related risks in cancer patients receiving these therapies, and their attitudes towards the management of ICIs in oncology. The perception of respondents regarding the potential increased risk of severe events related to SARS-CoV-2 infection in cancer patients treated with ICIs is displayed in Figure 1B . 17 Moreover, besides the overlapping between cancer-related signs/symptoms or side effects of oncological treatments (including irAEs) and COVID-19 manifestations, additional issues could emerge from the differential diagnosis between radiological findings of lung involvement from SARS-CoV-2 and pneumonitis induced by ICIs. 9, 24 To the best of our knowledge, this is the first study exploring the perception of physicians towards these unsolved issues, and whether the outbreak has modified the clinical practice in managing the treatment with ICIs in oncology.
cord-287505-ihqzpdar	2020	Patients were subdivided into six groups—no immunomodulatory treatment (standard of care) and five groups that received either corticosteroids, anti-interleukin 6 antibody (tocilizumab) or anti-interleukin-1 therapy (anakinra) alone or in combination with corticosteroids. Furthermore, corticosteroid use either alone or in combination with tocilizumab or anakinra was associated with reduced hospital mortality for patients with COVID-19 cytokine storm compared to standard of care. In this retrospective study, we leveraged this natural experiment to compare mortality in patients meeting criteria for CCS who received different combinations of these immunomodulatory drugs. Primary objective: To compare in-hospital mortality among COVID-19 patients with CCS who received combinations of immunomodulatory treatments versus SoC. Our study is the largest retrospective analysis to date reporting on outcomes comparing the use of immunomodulatory therapies such as corticosteroids, tocilizumab and anakinra in the treatment of COVID-19 CCS. Corticosteroid use, either alone or in combination with tocilizumab or anakinra, was associated with lower hospital mortality compared to standard of care.
cord-287508-133inel2	2020	• Stethoscopes are clinically valuable and integral to the doctor-patient connection; • Technological advancement will augment the utility of the stethoscope; • The stethoscope has high utility for assessment of COVID-19 patients; • Pathogen contamination in light of COVID-19 is a concern for the stethoscope; • Innovations in stethoscope hygiene will allow safe auscultation. During times of increased concern about contamination and spread of infections, physicians may opt to forgo their stethoscopes due to a lack of clear guidance on cleaning, lack of access to proper hygiene materials, or inconvenience with current personal protective equipment guidelines. Rather than forgoing a tool that might be useful in the prognostication of infected patients with cardiopulmonary abnormalities, it is important that novel hygienic and technological interventions be investigated to allow safe usage of the stethoscope. Advances in stethoscope technology will improve the auscultatory capabilities of health care workers and allow less contact with patients in transmission-based precautions.
cord-287515-oe7adj91	2020	Prior experience with viral pneumonia, including influenza and MERS-coronavirus, suggest that steroids can contribute to higher mortality, increase viral replication with longer periods of viral clearance and more superinfections (including invasive pulmonary aspergillosis, as already reported in the Wuhan cohort) [5, 6] . Another difference is that most COVID-19 infected patients were diagnosed with viral pneumonia, whereas acute exacerbations of COPD or bronchospasm or myocarditis were more common in influenza. Use of noninvasive ventilation is controversial, showing limited efficacy in MERS and is associated with very high levels of aerosol spread, exposing staff at much greater risk of infection [11, 12] . Clinical course and outcomes of critically ill patients with SARS-CoV-2 pneumonia in Wuhan, China: a singlecentered, retrospective, observational study High-flow nasal therapy in adults with severe acute respiratory infection: a cohort study in patients with 2009 influenza A/H1N1 v
cord-287520-51kmd2ds	2020	Therefore, most worldwide authorities are recommending to avoid, as much as possible, patient''s elective visits to hospitals, as well as a judicious use of the operating room in order to mitigate the strain put on the health system. If it is not possible to separate an entire surgical block, we suggest designating specific rooms for the care of patients with COVID-19 that will not be used for regular cases. The gold standard test for investigation of the upper urinary tract is uro-tomography, but in times when we need to consider the use of resources, ultrasound could potentially be used since many imaging services are overloaded due to the frequent indication of thoracic CTs for the diagnosis and follow-up of patients with Sars-Cov-2. -In Intermediate-risk and high-risk non--muscle-invasive bladder cancers: Clinically fit patients with no major comorbidities should receive induction therapy followed by at least 1-year maintenance BCG.
cord-287538-qbf5lv7d	2020	The following eligibility criteria were used for article inclusion: population: patients with latex allergy and/or at risk for anaphylaxis; intervention: any approaches or protocols that incorporated a strategy for latex allergy and anaphylaxis management; comparator: any studies irrespective of whether there was a comparator included in the study design; outcomes: any related to prevalence, diagnostics, and treatments including primary prevention and immunotherapy; and study design: experimental studies and observational studies. 65 On the other hand, only a small case series of nine patients has described the efficacy of accelerator-free medical gloves in the secondary prevention of allergic contact dermatitis (ACD) caused by rubber accelerators in HCWs. 66 Gentili et al 67 showed that an effective and exemplary example of secondary prevention of latex allergy is feasible for infants born with spina bifida.
cord-287544-n32iscmr	2020	title: Nifedipine and Amlodipine Are Associated With Improved Mortality and Decreased Risk for Intubation and Mechanical Ventilation in Elderly Patients Hospitalized for COVID-19 A retrospective review was conducted on CCB use in hospitalized patients in search of any difference in outcomes related to specific endpoints: survival to discharge and progression of disease leading to intubation and mechanical ventilation. Nifedipine and amlodipine were found to be associated with significantly improved mortality and a decreased risk for intubation and mechanical ventilation in elderly patients hospitalized with COVID-19. Nifedipine and amlodipine were found to be associated with significantly improved mortality and a decreased risk for intubation and mechanical ventilation in elderly patients hospitalized with COVID-19. A retrospective review of patients on either nifedipine or amlodipine was conducted in search of any difference in outcomes, including survival to discharge and progression of disease leading to intubation and mechanical ventilation.
cord-287558-yc8aw2pg	2020	Telemedicine and remote monitoring will make it easier to frequently reach patients to optimize risk factor control, titrate medications, assess diets and physical activity levels, and integrate reminders to meet daily goals, among other capabilities. Besides health implications, the economic effect of the COVID-19 pandemic will be enormous and preventive cardiologists will need to adapt to a landscape of potential economic recession, with some patients facing financial hardship. The same will be true for research on patient-and context-level determinants associated with adverse cardiovascular outcomes during lockdowns and on opportunities to improve these. Marked advances in telemedicine in the post-COVID-19 era will provide an opportunity to enhance the care of primary and secondary prevention patients, with implications not only for CVD outcomes but also for reducing the burden of complications and deaths in current and future viral outbreaks.
cord-287648-nhsn4cru	2020	Therefore, the use of echocardiography, according to the safety local protocols and ensuring the use of personal protective equipment, could be useful firstly to discriminate between primary cardiac disease or COVID‐19–related myocardial damage, and then for assessing and monitoring COVID‐19 cardiovascular complications: acute myocarditis and arrhythmias, acute heart failure, sepsis‐induced myocardial impairment, and right ventricular failure derived from treatment with high‐pressure mechanical ventilation. 7 In two studies by Shi et al 8 and Guo et al, 9 among 460 and 187 patients hospitalized for COVID-19, respectively, 20% and 28% had acute myocardial injury, which was associated with higher mortality and incidence of complications, such as acute respiratory distress syndrome (ARDS), malignant arrhythmias, acute renal injury, and coagulopathy. 21 Accordingly, current reports suggest that the majority of COVID-19 patients with myocardial injury without evidence of epicardial coronary artery thrombosis, show imaging data supporting the diagnosis of acute myocarditis 21, 22 ; also, cases of fulminant myocarditis and fatal arrhythmias have been described.
cord-287732-abzpfdcu	2020	These variables have implications for nutritional interventions: [1] older patients are at-risk for pre-existing disease and sarcopenia which increases their risk for pre-existing malnutrition and increased risk of refeeding syndrome, [2] severe acute respiratory distress syndrome (ARDS) with refractory hypoxemia may require prone-positioning and/or extracorporeal membrane oxygenation (ECMO), [3] circulatory failure and concomitant feeding may increase the risk of gut ischemia and feeding intolerance, [4] multiple organ failure (MOF) and the need for early enteral nutrition (EN) to attenuate or mitigate gut derived inflammation, and [5] cytokine release syndrome which alters nutrient utilization (especially lipids). Recommendation 1: We recommend all healthcare providers, including dietitians, nurses, and physicians follow PPE standards set forth by the CDC and/or the WHO and adhere to their institutional guidelines when conducting bedside nutritional assessments for all patients with confirmed or suspected COVID-19 disease.
cord-287742-y1j9x5ne	2020	Therefore, we performed a systematic review and meta-analysis of currently available epidemiological, clinical, and laboratory data related to both stroke and COVID-19 infection. We, therefore, performed a systematic review and metaanalysis involving the epidemiological, clinical presentation, imaging characteristics, and laboratory finding related to both stroke and COVID-19 infection. The following data were extracted from every study: the last name of the first author, year of publication, country, severity status, study design, patient characteristics (ethnicity composition, gender, and mean age), comorbidities (diabetes, hyperlipidemia, hypertension, ischemic heart disease, heart failure, previous stroke, chronic kidney disease/end-stage renal disease, number of stroke patients per overall participants, any information relevant to strokes such as the location of stroke [arterial or venous]), types of stroke (ischemic or haemorrhagic), classification of stroke, mortality rate, and blood parameters. The aim of this current study is to perform a systematic review and meta-analysis concerning the epidemiological, clinical presentation, imaging characteristics, and laboratory findings related to both stroke and COVID-19 infection.
cord-287758-da11ypiy	2020	The increase in studies related to SARS-CoV-2 during the first semester in 2020 has allowed the rather speedy identification of promising therapeutic targets for both developing immunotherapies and producing/identifying antiviral drugs. 5, 64 So far, structural proteins and enzymes that participate actively in the process of viral replication are the most investigated targets for the development of molecules for anti-CoVs therapies (FIG. Based on results from previous studies as well, nelfinavir was considered a likely therapy for COVID-19 after its indication for clinical trials as a promising anti-SARS drug. 218 In addition to this well-known antitumor effect, imatinib has also shown in-vitro antiviral properties against several virus, such as infectious bronchitis virus (a viral model for studying the role of tyrosine kinase activity during CoV infection), by interfering with virus-cell fusion, 219 and other RNA viruses including coxsackie virus, 220 hepatitis C virus, 221 Ebola, 222 among others, mainly by blocking viral entry or egress from the host cell.
cord-287765-nsdequl9	2020	To this end, a remote smart home healthcare support system (ShHeS) is proposed for monitoring patients'' health status and receiving doctors'' prescriptions while staying at home. In this paper, we propose a mobile application-based prototype smart home healthcare system for efficient and effective health monitoring for the elderly and disabled for their convenient and independent living while at home. Smart home automation as an emerging area of IoT has been applied in various areas such as: easy and assisted daily living especially for the provision of support to humans [17] , remote control of home appliances [18, 19] , detection of movement in the house [20] , energy management in the home [21] and security [22] , and provision of healthcare services to out-patients, disabled and elderly persons [10, 23, 24] . The proposed system described in our work is intended to perform a dual function of controlling home appliances as well as monitoring and recording the patient''s physiological data such as blood pressure, body temperature, pulse rate, body weight and sugar level and other symptoms related to a specific virus.
cord-287786-zfe0el8i	2020	title: Activation of the Renin-angiotensin-aldosterone system is associated with Acute Kidney injury in COVID-19 Abstract The pathophysiology of acute kidney injury (AKI) in COVID-19 patients is still poorly understood. Characterisation and understanding of COVID-19 renal injury would improve the management of patients admitted to the intensive care unit (ICU). Here, we describe the renal response of patients with COVID-19 patients admitted to an intensive care unit (ICU), with a particular focus on the activation of the renin-angiotensin-aldosterone system. Patients admitted to the ICU of St-Louis Hospital (Paris) between March 22 and April 15, 2020 for acute respiratory distress syndrome (Berlin Definition [7] ) with acute kidney injury (AKI, defined according to the Kidney Disease-Improving Global Outcome criteria [8] and using the admission serum creatinine as the baseline) were screened. Patients with AKI showed direct (increased plasma renin and aldosterone concentration) and indirect (low urine sodium concentration) markers of activation of the RAAS [3] .
cord-287874-wl0wlxh6	2020	From 31 January 2020 to 10 February 2020, the patient was given quadruple therapy, including lopinavir/ritonavir tablets (400/100 mg every 12 h), arbidol tablets (0.2 g every 8 h), Lianhuaqingwen granules (a Chinese patent medicine, 6 g every 8 h) orally, and recombinant human interferon-α2b injection via aerosol (6.0 × 10 6 IU with 2 ml of sterilized water for injection every 12 h). • Quadruple therapy, which is lopinavir/ritonavir tablets, arbidol tablets, Lianhuaqingwen granules, and recombinant human interferon-α2b (IFN-α2b) injection via aerosol, is a common regimen for patients with COVID-19 in China. From 31 January 2020 to 10 February 2020, the patient was treated with four drugs, which are oral administration of lopinavir/ritonavir tablets (400/100 mg every 12 h), arbidol tablets (0.2 g every 8 h), and Lianhuaqingwen granules (a Chinese patent medicine, 6 g every 8 h) and atomization inhalation of recombinant human interferon-α2b injection (6.0 × 10 6 IU with 2 ml of sterilized water for injection every 12 h).
cord-287895-63wy5ztb	2020	title: Use of a new face shield for patients of the endoscopy unit to avoid aerosol exchange in the COVID-19 era Because these procedures are performed in a contaminated environment, there is a higher risk that patients and health workers will be infected. Although there is an absence of new data about transmission of the virus as an aerosol, a previous study revealed that health workers who are exposed to this kind of procedure have a 4.66 times greater probability (95% confidence interval, 3.1-6.9) of infection in comparison with others. Our current interest in the Colombia University endoscopic unit is to decrease as much as possible aerosol contamination from patients and health workers. In conclusion, we have found that wearing the face shield we have specially designed results in less contact between the patient and the environment and yields an important decrease in the quantity of droplets and aerosols produced during the procedure. Aerosol generating procedures and risk of transmission of acute respiratory infections to healthcare workers: a systematic review
cord-287901-56goaqir	2020	Costs for the same procedure can vary widely, e.g., the "Getting it Right First Time" (GIRFT) Vascular Surgery report noted that reported cost for elective endovascular aortic repair (EVAR) varied between £2,251 and £19,690 for no apparent reason and with no indication that lower cost procedures were less effective 2,4 ; CES encompass a wider societal perspective than just the clinician''s or patient''s point of view alone, helping demonstrate equitable resource allocation in a publicly funded service 3 ; CES allow evaluation of short-and long-term costs and benefits, which are often under-or overestimated; and 4 CES provide an explicit and accountable framework for decision making, which can be re-examined as data accumulate, particularly important with evolving techniques and experience as in interventional radiology (IR).
cord-287953-prn8cnvo	2017	However, a number of hypotheses were generated to explain the spread, including: excessive patients'' freedom in seeking medical care at only large hospitals, inadequate quarantine, questionable government transparency, such as belated reports of infected hospital names, and the cultural social norm of visiting patients as standard etiquette ( Choe, 2015a ( Choe, , 2015b ; Korea Centers for Disease Control and Prevention, 2015 ) . Using a macro-level system dynamics modeling approach, our study intends to investigate the effect of operational decisions, such as patient-room design, occupancy control at emergency room and patient-visitor management, on the patient-care performance, such as number of infected patients (secondary infections) and financial burden on patients. The model illustrated in Fig. 3 depicts a high-level overview dynamics model of causal relationships between operational decisions (patient room designs, occupancy control at emergency room, patient-visitor management) and patient care performance (number of infected patients and average cost per patient).
cord-287957-diyz54qy	2020	title: Patient Satisfaction and Associated Factors During COVID-19 Pandemic in North Shoa Health Care Facilities Therefore, this study aimed to assess patient satisfaction and associated factors among chronic patients who had a follow-up in North Shoa healthcare facilities. Therefore, this study aimed to assess patient satisfaction and associated factors during the COVID-19 pandemic among chronic patients who had follow-up at public health facilities in the North Shoa Zone, Oromia region, Ethiopia. Patients who maintained and observed better social distancing at the registration place, waiting for the outpatient department, laboratory, and pharmacy services as a means of the COVID-19 prevention in the healthcare facilities were significantly associated with patient satisfaction. Availability of sign and direction indicators, availability of ordering drugs, social distancing status in the healthcare facility, availability of alcohol, and sanitizer for hand cleaning at the healthcare facility entrance to prevent and control COVID-19 were factors associated with the satisfaction of patients with chronic diseases.
cord-287991-10jz1dz2	2020	Conclusion: Our results indicate a similar rate of asymptomatic COVID19 infection in cancer patients and healthcare workers in a longitudinal study throughout the pandemic time. During the study interval, there was no documented symptomatic case of COVID19 among the recruited participants, nor in the general patient population of the cancer center or in the healthcare workers cohort. Furthermore, when analyzing the myeloid lineage, we found a substantial increase in myeloid cells in cancer patients compared to healthcare workers (both SARS-CoV-2 IgG-), in line with previous studies [11, 12] . Our results may indicate that due to differential immune cell profile of cancer patients who are treated with immunomodulatory agents, the host response to the SARS-COV2 may lessen symptom severity. Our results may indicate that due to differential immune cell profile of cancer patients who are treated with immunomodulatory agents, the host response to the SARS-COV2 may lessen symptom severity.
cord-288009-8i3gsq9p	2020	Medical Hypotheses journal homepage: www.elsevier.com/locate/mehy Bosentan is a dual endothelin-receptor antagonist approved for the treatment of pulmonary arterial hypertension (PAH) in New York Heart Association functional classification (NYHA) II-IV and in scleroderma patients [10] . Guo et al [13] described a case of 57-year-old man with influenza A (H7N9) virus infection initially treated with empirical antibacterial therapy and oseltamivir with progression to acute respiratory distress syndrome and mechanical ventilation. Ritonavir and lopinavir, given together to sup-press HIV-replication, have been associated with bosentan to treat PAH in HIV-infected patients without dosage adjustment of protease inhibitors with good tolerability [14] . In conclusion, we think bosentan could be considered, in association with other approved drugs, in the treatment of SARS-CoV-2 to improve hemodynamics, potentiate antiviral effects and to prevent lung fibrosis. Antiviral effect of Bosentan and Valsartan during coxsackievirus B3 infection of human endothelial cells
cord-288033-9xu1ujcq	2020	Combined with epidemiological history and body temperature screening, if suspected of SARS-CoV-2 infection, they will be admitted to the hospital isolation ward for rapid nucleic acid test. Patients suspected or diagnosed with SARS-CoV-2 infection should be isolated and begin thrombolytic therapy immediately, if within reperfusion time. High-risk patients with contraindications for thrombolysis need to assess the risk of infection and the benefit of PCI. In case of patients within the reperfusion time window and no contraindication to thrombolysis, thrombolytic therapy is performed in an isolation ward. Patients within the reperfusion time window with contraindications for thrombolysis or failure of thrombolysis need to comprehensively evaluate the risks of PCI and infection control. comprehensively evaluate the risks of PCI and infection control. The confirmed case should be transferred to the isolation ward until patient recovery and then it was assessed whether further invasive interventions are needed.
cord-288040-uuqfvvmk	2020	Synchronous telemedicine can be further divided into encounters scheduled for the provider by a scheduler, with the patient being given specific instructions as to how to join a virtual clinic room at a given time or can be triggered by a patient wanting advice or an examination as the need arises, with a provider team available 24/7. The medical records of patients to be seen at the Ophthalmology Department of UPMC Children''s Hospital of Pittsburgh between March 21 and April 10 were reviewed by a provider (MP, KKN, PP, EM, CL EK), and all visits in the study period were categorized as follows: (1) requiring an in-person visit, (2) face-to-face visit that could be postponed, and (3) consultation required but could be virtual. To ensure that patients were consistently informed that their physician deemed the visit to be necessary and that it could be completed via telemedicine, a standardized script was used by schedulers.
cord-288051-wp8v2mc5	2020	Seven days after the clinical onset, the risk of transmission decreases in mildsymptomatic patients, but it may be extended over 24 days in severe cases [11•, 15] . The clinical spectrum of SARS-CoV-2 infection varies widely, including asymptomatic infection, mild upper respiratory tract illness, severe viral pneumonia with respiratory failure, and even death [9, 11•] (Fig. 1) . Corticosteroids are recommended in the treatment of septic shock, exacerbation of chronic obstructive respiratory disease and these COVID-19''s patients with respiratory deterioration and quick radiological progression associated with sings of cytokine storm (cytopenia, maintained fever, an increase of inflammatory reactants: D-dimer > 1000 ng/mL, ferritin > 1000 ng/mL, fibrinogen > 100 ng/mL, IL-6 > 40 pg/mL) [6, 23••] . Results from 237 patients, 158 assigned to remdesivir, showed no differences in time to clinical improvement, 28day mortality, oxygen support, hospitalization, or viral load. Clinical management of severe acute respiratory infection (SARI) when COVID-19 disease is suspected. Effective treatment of severe COVID-19 patients with tocilizumab
cord-288067-36amafub	2020	Data on potential source of exposure, demographic, clinical, and paraclinical features, therapy outcome, and post-discharge follow-up were analyzed. The most common presenting symptoms are non-specific, so attention should be made on broader testing, especially in age groups with the greatest risk and younger individuals who can serve as carriers of the disease. We reported detailed information about the potential source of exposure, household contact information, outcomes of potential therapies, and post-discharge follow-up, as well as demographic, clinical, and paraclinical characteristics. Patients who came to the hospital were examined by an infectious-disease specialist, and classified into three groups according to disease severity based on Iran''s national guideline for the diagnosis and treatment of COVID-19 in outpatients and inpatients (Figure1). We compared demographic characteristics, hospitalization data, and potential treatment outcomes in critically ill and non-critically ill patients. 12 Recent potential exposures, household contact information, demographics, clinical characteristics, laboratory, and radiologic findings, and patients'' outcomes were extracted as shown in table1.
cord-288102-iom6lu7o	2020	The clinical characteristics of patients with COVID-19 were analysed to determine the factors influencing the prognosis and virus shedding time to facilitate early detection of disease progression. The clinical characteristics of 185 patients with COVID-19 diagnosed in Tianjin were analysed retrospectively to determine the factors affecting their prognoses and the duration of viral shedding with the aim of facilitating early treatment and improving patient prognosis. We found that a lower PaO 2 /FiO 2 at the time of admission is a risk factor for a poor prognosis in patients with severe COVID-19. In our study, univariate analysis results showed that age was a risk factor for prolonged viral shedding duration, but no significant difference was found in the multivariate Cox analysis. This study showed that diabetes mellitus, age, the time from symptom onset to treatment and PaO 2 /FiO 2 can predict the prognosis of patients with COVID-19.
cord-288158-6gicgsj8	2020	title: Imaging of Neurologic Disease in Hospitalized Patients with COVID-19: An Italian Multicenter Retrospective Observational Study Of 725 consecutive hospitalized patients with coronavirus disease 2019, 108 (15%) had acute neurologic symptoms necessitating neurologic imaging. Imaging of Neurologic Disease in Hospitalized Patients with COVID-19: An Italian Multicenter Retrospective Observational Study E271 10 had acute ischemic infarcts and two had intracranial hemorrhage. The main neurologic imaging hallmark was acute ischemic infarcts, which were present in 34 of the 108 patients (31%) (30 [28%] on CT scans and four [20%] on MRI scans). Our study demonstrated that the neurologic imaging features of hospitalized patients with COVID-19 were variable, without a specific pattern but dominated by acute ischemic infarcts and intracranial hemorrhages. Currently, we have a poor mechanistic understanding of the neurologic symptoms in patients with COVID-19, whether these are arising from critical illness or from direct central nervous system invasion of severe acute respiratory syndrome coronavirus 2 (10).
cord-288181-9thl46oe	2020	The authors report a high incidence of presumed invasive pulmonary aspergillosis (6 of 31; 19.4%) among patients with coronavirus disease (COVID-19) admitted to intensive care. The association between aspergillosis and COPD is well known; in a recent prospective study, 14% of patients with COPD exacerbations had respiratory samples with Aspergillus spp. We thank Fekkar and colleagues for their thoughtful comments on our case series of patients with coronavirus disease (COVID-19)-associated pulmonary aspergillosis (CAPA) (1). Cohort studies in patients with influenza-associated pulmonary aspergillosis (IAPA) in the ICU demonstrated that any indication of Aspergillus through positive culture or galactomannan (GM) detection is highly indicative of invasive aspergillosis (2) . Reports of presumed CAPA cases that survive without antifungal therapy, such as those presented by Fekkar and Alanio, are very informative and suggest that in patients with COVID-19, Aspergillus colonization is more common compared with in patients with influenza (5) .
cord-288197-drto66xt	2020	METHODS: Clinical records, laboratory results, and chest CT scans were retrospectively reviewed for nine pregnant women with laboratory-confirmed COVID-19 pneumonia (ie, with maternal throat swab samples that were positive for severe acute respiratory syndrome coronavirus 2 [SARS-CoV-2]) who were admitted to Zhongnan Hospital of Wuhan University, Wuhan, China, from Jan 20 to Jan 31, 2020. Findings from this small group of cases suggest that there is currently no evidence for intrauterine infection caused by vertical transmission in women who develop COVID-19 pneumonia in late pregnancy. Evidence of vertical transmission was assessed by testing for the presence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in amniotic fluid, cord blood, breastmilk, and neonatal throat swab samples from six of nine patients. Based on data from this small group of patients, there is currently no evidence of vertical transmission in pregnant women who develop COVID-19 pneumonia in the third trimester.
cord-288222-8fqfbys2	2020	The aim of this prospective study was therefore to describe the longitudinal changes in hemostasis parameters assessed daily in 21 COVID-19 patients during their intensive care unit (ICU) stay. Our main findings were that (i) daily standard measurements consistent with a prothrombotic state persisted over the first days and improved thereafter, but did not normalize in all patients; (ii) increased thrombin potential (hypercoagulability) and decreased fibrinolysis were frequent and (iii) a high inter-patient variability was observed. Patients initially were in a high inflammatory state (median CRP levels of 204 mg/dL during the first ten days after ICU admission); CRP levels progressively decreased over time thereafter. In light of these results and of the current knowledge on hemostasis disturbances of COVID-19 patients, we suggest that a close monitoring of a sensible set hemostatic parameters would be useful to assess individual thrombotic risk.
cord-288255-p8uzrsbd	2020	authors: Goossens, Gijs H.; Dicker, Dror; Farpour-Lambert, Nathalie J.; Frühbeck, Gema; Mullerova, Dana; Woodward, Euan; Holm, Jens-Christian Evidence from studies in humans indicates that people with obesity are characterized by systemic low-grade inflammation, higher susceptibility to infections, dampened immune response to infectious agents, as well as higher morbidity and mortality associated with infections, and demonstrate an impaired immune response to vaccinations and antimicrobial treatment [25] [26] [27] [28] . Together, these findings imply that evaluation of cytokine profiles and immune cell subsets in patients with SARS-CoV-2 infection, and a deeper understanding of the underlying processes, will significantly contribute to better treatment strategies and clinical management of COVID-19 [37] . At the same time, the rapidly emerging clinical data require ongoing scrutiny to understand not only the risks and benefits of single drugs to tackle COVID-19, but also the interaction with pharmacological agents commonly used in people with obesity and related NCDs, including type 2 diabetes and cardiovascular diseases, who are especially at risk of or hospitalized with SARS-CoV-2 infection.
cord-288271-p074ffpt	2020	In this report, we present a 77‐year old patient with a heart transplant under relevant immunosuppressive therapy who was tested positive for SARS‐CoV‐2 after several days of dyspnoea, dry cough and light general symptoms. All rights reserved Diagnosis: SARS-CoV-2-Infection with viral pneumonia in a patient with heart transplant due to coronary artery disease with ischemic cardiomyopathy In this case the combination of radiologic signs of viral pneumonia and the supposed high-risk state of severe immunosuppression led to the decision to start an antiviral therapy immediately after receiving the positive rtPCR-results although the patient presented only mild symptoms. [13] A second question is whether patients with a solid organ transplant who receive immunosuppressive medication are at greater risk for a severe manifestation of a SARS-CoV 2-Infection or might even benefit from a reduced immunologic reaction. For SARS-CoV 2 we found two cases of patients with a heart transplant of which one had only mild manifestations and one required mechanical ventilation but survived [9] .
cord-288371-uyj4iske	2020	Long-term Follow-up on NRG Oncology RTOG 0915 (NCCTG N0927): A Randomized Phase 2 Study Comparing 2 Stereotactic Body Radiation Therapy Schedules for Medically Inoperable Patients With Stage I Peripheral Non-Small Cell Lung Cancer Durvalumab plus platinum&#x2013;etoposide versus platinum&#x2013;etoposide in first-line treatment of extensive-stage small-cell lung cancer (CASPIAN): a randomised, controlled, open-label, phase 3 trial. Phase III study of the Eastern Cooperative Oncology Group (ECOG 2597): induction chemotherapy followed by either standard thoracic radiotherapy or hyperfractionated accelerated radiotherapy for patients with unresectable stage IIIA and B non-small-cell lung cancer Usefulness of serum carcinoembryonic antigen (CEA) in evaluating response to chemotherapy in patients with advanced non small-cell lung cancer: a prospective cohort study Randomized phase III trial of single-agent pemetrexed versus carboplatin and pemetrexed in patients with advanced non-small-cell lung cancer and Eastern Cooperative Oncology Group performance status of 2 Carboplatin-or cisplatin-based chemotherapy in first-line treatment of small-cell lung cancer: the COCIS meta-analysis of individual patient data
cord-288509-l6yn2er7	2020	As a result, even in the absence of a good evidence base, online video consultation platforms such as Attend Anywhere have been implemented across secondary care, with a national licence for NHS trusts from April 2020. 2 In this paper we review current technical, medical and legal guidelines for video consulting to assist hospital doctors who are conducting remote consultations as a result of COVID-19. Although observational studies and randomised control trials of video consultation in primary, secondary and tertiary care generally report a positive patient and clinician experience with remote consultation technology 8, 10, [16] [17] [18] [19] , studies of specific platforms are limited. Evidence regarding the use of telemedicine in secondary care is currently limited but is likely to grow in the post-COVID era as organisations such as the GMC are already conducting surveys of remote consultation and prescribing.
cord-288552-7lp07v5i	2020	CONCLUSION: This study revealed the beneficial effect of the short-term use of low-dose prednisolone in combination with azithromycin, naproxen and lopinavir/ritonavir (regimen I), in decreasing ALOS compared to regimen II. Therefore, the present study aimed to evaluate short-term effects of regimen I (azithromycin, prednisolone, naproxen, and lopinavir/ritonavir) in group I patients in comparison to regimen II (meropenem, levofloxacin, vancomycin, hydroxychloroquine, and oseltamivir) in group II patients in the treatment of COVID-19 infection. The patients'' medical information including demographic data, COVID-19 test using a real-time RT-PCR via throatswab specimens, clinical features, routine laboratory tests, chest CT scans (before and after discharge) according to the WHO interim guidance [23] , treatment measures, comorbidities and data on the outcomes were extracted independently by two physicians through a standard case record form provided by the hospital.
cord-288558-rthnj6wd	2004	The role of severe acute respiratory syndrome (SARS) coronavirus as an enteric pathogen was investigated in a cohort of 142 patients with SARS who were treated with a standard treatment protocol. The role of severe acute respiratory syndrome (SARS) coronavirus as an enteric pathogen was investigated in a cohort of 142 patients with SARS who were treated with a standard treatment protocol. A higher mean virus load in nasopharyngeal specimens obtained on day 10 after the onset of symptoms was significantly associated with the occurrence of diarrhea (3.1 log 10 vs. A higher mean virus load in nasopharyngeal specimens obtained on day 10 after the onset of symptoms was significantly associated with the occurrence of diarrhea (3.1 log 10 vs. In this retrospective study, we attempt to correlate the virus load of SARS coronavirus shedding from the nasopharynx, the upper end of the aerodigestive tract, with the presence of diarrhea in a cohort of patients with SARS.
cord-288575-srpc68t8	2020	As anesthesiologists, our work in operating rooms, emergency departments, and/or intensive care units often brings us in close proximity to the patient''s airway, exposing us to their aerosolized respiratory secretions. Wen X and Li Y briefly, but adequately, described anesthesia procedures for emergency surgery in patients with suspected or confirmed COVID-19 in their letter [4] . [25] described the anesthetic management of cardiac surgical patients in their literature; we, could not, however, find any further information regarding this, especially in relation to cardiac anesthesia. Anesthesia procedure of emergency operation for patients with suspected or confirmed COVID-19 Anesthetic management of patients with COVID 19 infections during emergency procedures Anesthesia management and perioperative infection control in patients with the novel coronavirus Recommendations for anesthesia in patients suspected of COVID-19 coronavirus infection Chinese society of anesthesiology expert consensus on anesthetic management of cardiac surgical patients with suspected or confirmed Coronavirus disease 2019
cord-288580-onzzpkye	2020	This pandemic is accepted as a viral pneumonia pandemic not a simple flu, therefore, intensive care unit (ICU) admission, follow-up, and management of the critically ill patients with COVID-19 is extremely important. HFNO therapy and NIMV support may be applied in selected hypoxemic respiratory failure cases with proper PPE because of high risk of aerosol generation. However, these patients should be followed closely in terms of clinical deterioration, if no positive response is obtained in the first few hours (refractory hypoxemia, tachypnoea, tidal volume (Vt) > 9 mL/kg meaning increased minute ventilation and work of breathing). In the light of the data obtained from COVID-19 pandemic and hospital follow-up of these critically ill patients, the needfulness of intensive care units with well-organized structure and trained HCW, has emerged once again. Expert consensus on preventing nosocomial transmission during respiratory care for critically ill patients infected by 2019 novel coronavirus pneumonia
cord-288606-h8pmqwmk	2020	Among efforts to safely manage warfarin patients during this pandemic, we introduced a hospital drive-up anticoagulation testing service. Among our efforts to enhance patients'' safety and minimize contact time at the healthcare facility while maintaining standard clinical care for warfarin patients, we introduced a hospital drive-up anticoagulation testing service at Al Wakra Hospital (AWH) in Qatar. AWH drive-up anticoagulation testing service was launched in April, 2020 as part of HMC''s strategy to stay ahead of the pandemic and to assure patients who expressed concerns about visiting the anticoagulation clinic at AWH due to COVID-19 spread. This service is one of the efforts of healthcare providers to reduce the risk of exposure of anticoagulation patients to COVID-19 by reducing the contact time with the different personnel at the hospital and by maintaining those patients at a safe distance from others.
cord-288697-9dywuhkc	2020	Here we present two case reports of adult patients with COVID-19 infections who presented with severe psychosis and mania with no prior psychiatric history and in the absence of significant medical or pulmonary symptoms and an unremarkable neurological work-up. Clinical presentation: Patient-A presented with one week of insomnia and two days of altered behavior including confusion, decreased appetite, and grandiosity and making odd statements. Three weeks prior to his ED admission, Patient-A was diagnosed with presumed COVID-19, treated with oral azithromycin, and told to self-quarantine. J o u r n a l P r e -p r o o f These cases illustrate an association of neuropsychiatric symptoms with COVID-19 infection, in the absence of personal or family history of psychiatric illness, as well as the absence of hypoxemia, cerebral infarction or significant pulmonary involvement. Psychiatric and neuropsychiatric presentations associated with severe coronavirus infections: a systematic review and meta-analysis with comparison to the COVID-19 pandemic
cord-288790-5uzgenty	2020	key: cord-288790-5uzgenty title: Rehabilitation of Arthroplasty Patient During Covid-19 cord_uid: 5uzgenty The established protocols were sidelined and patients asked to care on their own with dictum being "stay home and stay safe". The majority may respond well to the rehabilitation protocols adopted in pre-Covid era [4] . The induction of patient into an orthopaedic or arthroplasty programme should be a systematic team approach with the inclusion of established patient-specific home-based rehabilitation protocol. Plans that need consideration [3] are: Physical therapy will be even more crucial in the medium to long-term response to assist the orthopaedic and arthroplasty patient to regain optimal function and to help them return to their previous level of activities [3] . Management of orthopaedic patients during COVID-19 pandemic in India: A guide Orthopaedics in times of COVID 19 Total knee arthroplasty rehabilitation protocol: What makes the difference?
cord-288810-ab7k70c4	2020	title: Development and Validation of a Prognostic Nomogram Based on Clinical and CT Features for Adverse Outcome Prediction in Patients with COVID-19 OBJECTIVE: The purpose of our study was to investigate the predictive abilities of clinical and computed tomography (CT) features for outcome prediction in patients with coronavirus disease (COVID-19). The prognostic nomogram based on the combination of clinical and CT features could be a useful tool for predicting adverse outcomes of patients with COVID-19. Chest CT manifestations of regional involvement, scattering distribution, transverse distribution, the number of involved https://doi.org/10.3348/kjr.2020.0485 kjronline.org pulmonary segments, extent, shape, ground-glass opacity (GGO), consolidation, crazy-paving sign, halo sign, reversed halo sign (RHS), air bronchogram, bronchiectasis, vascular enlargement, pleural thickening, pleural retraction, pleural effusion, and mediastinal lymphadenopathy were assessed. The nomogram developed using a combination of clinical and CT features could aid in https://doi.org/10.3348/kjr.2020.0485 kjronline.org predicting adverse outcomes for patients with COVID-19.
cord-289006-7dv1zsp9	2020	The following topics were discussed: repurposing of surgeons, continuity of spine services, introduction of telemedicine, triaging of spinal surgeries, preoperative testing, new challenges in performing spine surgery, and preparing for the post-pandemic era. The aforementioned challenges in clinical practice brought about by the COVID-19 pandemic raise the question of whether we can use present-day technology to improve patient care. The orthopedic spine service of the National University Hospital has had a long-standing tradition of auditing all upcoming spine surgery cases every week and has reported this to be especially beneficial during the COVID-19 pandemic where resource availability is constantly changing. While the following set of guidelines provide a framework to help spine services triage their patients, the need to continually evaluate the operating lists on a case-by-case and resource-dependent basis remains crucial during this pandemic.
cord-289008-c4cu3vrp	2020	Patients with muscle-invasive bladder cancer are at risk of disease progression, with radical cystectomy delays beyond 12 wk from diagnosis or completion of neoadjuvant chemotherapy. To this end, PubMed was searched from inception until April 2, 2020 to identify studies examining the association between delays in treatment and clinical outcomes, including upstaging, recurrence, and mortality for patients with bladder cancer (BC; both muscle-invasive and non-muscle-invasive disease), prostate cancer (PCa), kidney cancer, upper tract urothelial cancer, germ cell tumors, and penile cancer. Where radiotherapy is planned to be administered, a recent Cochrane Database systematic review and meta-analysis of 10 studies including 8278 patients demonstrated that for those with intermediate-and high-risk PCa, hypofractionation is associated with equivalent oncologic outcomes (MFS, disease-specific survival, and OS), as well as functional outcomes [64] .
cord-289046-frhpt8n9	2020	The Coronavirus Preparedness and Response Supplemental Appropriations Act (H.R. 6074) was signed into law on March 6, 2020, and provides a temporary waiver of many of the CMS restrictions and requirements regarding telemedicine services during the COVID-19 public health emergency. When these barriers to telemedicine were removed, providers, hospitals, and health systems rapidly embraced telemedicine or scaled up existing programs to meet the sudden demand for remote, synchronous patient care. Some patients with new physical symptoms or recent hepatic decompensation are best evaluated in person but may avoid seeking medical care due to social distancing policies or concerns about exposure to COVID-19 in the health care setting. For established patients with decompensated liver disease, review telemedicine can offer rapid evaluation and avoid the need for an in-person appointment when, for example, adjusting diuretics or medications for hepatic encephalopathy. As we look to a future beyond the COVID-19 pandemic, we have an opportunity to consider telemedicine''s place in the routine delivery of patient care.
cord-289054-fh95b5n4	2020	E-mail: angie.au.yong.p.s@singhealth.com.sg Keywords: airway management; COVID-19; extubation; infection control; intubation; operating room; prevention EditordCoronavirus disease 2019 (COVID-19) was declared a pandemic by the World Health Organization 1 on March 11, 2020 because of its rapid worldwide spread. 2 Airway manipulation poses a high risk of viral transmission to humans within close contact because of the proximity of the respiratory secretions that can aerosolise from coughing and gagging. The Singapore General Hospital instituted guidelines for airborne and contact precautions, including (i) environmental, reducing staff during airway manipulation, regular disinfection and sterilisation, sufficient air exchange time; and (ii) personal protective equipment (PPE). The main aim of constructing a tent or screen is that, if the patient coughs/gags during intubation, secretions will land under the sheet. A videolaryngoscope and tracheal tube can be passed under the plastic tent for intubation. Alternatively, Supplementary Fig 4 shows the use of a large plastic screen for intubation.
cord-289064-435bp4rt	2020	Identified risk factors for disease severity and death from SARS-Cov2 infection include older age, male sex, diabetes, obesity and hypertension. We consider roles for the immune system, the observed phenomenon of microangiopathy in severe Covid-19 infection and the potential for direct viral toxicity on metabolically-relevant tissues including pancreatic beta cells and targets of insulin action. (18) , patients with diabetes and hypertension who had been treated with ACE inhibitors or angiotensin receptor blockers (ARB) had a high number of ACE2 receptors in the lung, and could therefore be at higher risk of developing severe symptoms, if infected with Covid-19. With respect to the glycemic deterioration seen in patients with preexisting T2D during Covid-19, a very recent report (63) provides the intriguing observation that ACE2 expression at both the mRNA and protein is increased substantially in human beta cells in response to response to inflammatory cytokines, presumably rendering these cells more susceptible to infection.
cord-289088-7uoia564	2020	title: The clinical characteristics of pneumonia patients coinfected with 2019 novel coronavirus and influenza virus in Wuhan, China In conclusion, those patients with both COVID‐19 and influenza virus infection did not appear to show a more severe condition because based on the laboratory findings, imaging studies, and patient prognosis, they showed similar clinical characteristics as those patients with COVID‐19 infection only. In this study, we describe the clinical characteristics of those patients who got infected with COVID-19 as well as influenza virus. On one hand, this study showed that the clinical characteristics of patients with both COVID-19 and influenza virus infection were similar to those of COVID-19 infection, but the symptoms of nasal tampon and pharyngalgia may be more prone to appear, which would be more convinced when more cases included. Clinical characteristics of 138 hospitalized patients with 2019 novel coronavirus-infected pneumonia in Wuhan, China
cord-289114-ifnk41oq	2020	The SARS-CoV-2 infected patients with the cardiovascular problem have a higher fatality rate as compared to general COVID-19 patients. The ACE-2 has been suggested as a medicine for the treatment of diabetes because it reduces inflammation .Therefore, the diabetes and COVID-19 patients treated with ACE-2 have higher risk of infection (Zachary, 2020) . Although, the specific drug for SARS-CoV-2 is not discovered till date, the medical observers are attempting with different antiviral drugs for the treatment of COVID-19 infection . All rights reserved patients demonstrated that the combination of a new antiviral drug remdesivir and chloroquine slowed down the growth of SARS-CoV-2 (Abdul et al., 2017) . Convalescent plasma therapy has been observed as a better alternative for the treatment of severely infected COVID-19 patients. A research report suggested that plasma treatment is more effective at the initial stage (within 14 days of symptoms) of COVID-19 infection.
cord-289115-bntcn0m6	2020	There are isolated case reports and series that document a milder course of COVID-19 infection in patients who have already been on dupilumab therapy for treatment of conditions such as atopic dermatitis and chronic rhino-sinusitis with nasal polyp. While it has already been in use in dermatology clinics for the treatment of atopic dermatitis (AD), it was most recently approved for the indication of chronic rhinosinusitis with nasal polyp (CRSwNP) by the US Food and Drug Association (FDA) on the 26th of June, 2019 [1] . We included clinical trials, research studies, case reports, and randomized control trials that employed the use of dupilumab at any point in the treatment of patients who were laboratory confirmed cases of COVID19. Details that were extracted included author and journal details, year of publication, sample size, age, sex, indication for rational use of dupilumab, duration for treatment, adverse effects observed, and course of COVID-19 infection. COVID-19 infection in a patient with severe chronic rhinosinusitis with nasal polyps during therapy with dupilumab
cord-289169-3u7qgxud	2020	title: Low-dose corticosteroid therapy does not delay viral clearance in patients with COVID-1 In the present study, all patients were from a single center, and all swab samples were tested using a unified approach at the Chinese Center for Disease Control to avoid measurement bias. In fact, a similar study analyzing data from 72 patients with COVID-19 was conducted at the First Affiliated Hospital of Zhejiang University, and the conclusions were consistent with the results of the present study (7) . In conclusion, low-dose corticosteroid therapy may not delay viral clearance in patients with COVID-19; however, this still needs to be confirmed by well-designed and large-scale Effects of early corticosteroid treatment on plasma SARS-associated Coronavirus RNA concentrations in adult patients Corticosteroid Therapy for Critically Ill Patients with the Middle East Respiratory Syndrome Retrospective study of low-to-moderate dose glucocorticoids on viral clearance in patients with novel coronavirus pneumonia
cord-289179-3zfur0zh	2020	title: How to reorganize the access of children in a radiotherapy department in the era of COVID19, in order to protect themselves and elderly patients How to reorganize the access of children in a radiotherapy department in the era of COVID19, in order to protect themselves and elderly patients According to Liang 1 , as of Jan 31, 2020, based on a cohort of patients in China, 1% of coronavirus disease (COVID-19) cases had a history of cancer. Starting mid-February 2020, we applied these rules for outpatients undergoing radiotherapy: 1) telephonic triage the day before the first admission, and specific clinical triage the day of admission in a dedicated area; 2) daily detailed medical history to detect the possibility of COVID-19 contagion; 3) postponement of non-essential check-ups; 4) medical evaluation or nasopharyngeal swab for patients with rhinitis, conjunctivitis, cough or fever in order to access the hospital; 5) education on hand-washing, no touching mouth, nose, and eyes; 6) couch and mask disinfection after every radiotherapy fraction; 7) compulsory surgical masks for patients, parents and healthcare workers; 8) no volunteers allowed; 9) nasopharyngeal swabs only for people with symptoms or family risk conditions. In most hospitals worldwide, the radiotherapy department is shared by pediatric, adult and elderly patients.
cord-289219-qjxdggz3	2020	Pulmonary rehabilitation is a notoriously known but highly underused intervention aimed to restore or improve functional capacity, symptom management and health-related quality of life among patients with chronic respiratory diseases. Since early 1980s, pulmonary rehabilitation has been acknowledged as a comprehensive intervention with hundreds of studies being performed over the past thirty years demonstrating its benefits on multiple outcomes; nevertheless, there are still multiple unresolved challenges, and new ones are currently emerging, with the COVID-19 outbreak now in the spotlight. PR stems from a comprehensive evaluation of the patient aimed to design an individually-tailored, multi-component intervention to optimise symptom control, pulmonary function, exercise capacity and health-related quality of life [1] . The effectiveness of PR on different outcomes such as exercise capacity, muscle function, dyspnoea and symptom control, is quite robust, so it is currently recommended in the management of different chronic respiratory conditions, especially for patients with chronic obstructive pulmonary disease (COPD).
cord-289311-0wgafqdz	2017	Since the first case of Middle East respiratory syndrome (MERS) was reported in Saudi Arabia in 2012, 1,826 laboratory-confirmed cases have been documented in 27 countries, and 35.5% of these patients have died from this novel virus. A triple antiviral treatment regimen comprising subcutaneous pegylated interferon alpha-2a (180 µg per week for 2 weeks), high-dose oral ribavirin [2,000 mg loading dose, followed by 1,200 mg every 8 h (q8h) for 4 days and then 600 mg q8h for 4-6 days], and oral lopinavir/ritonavir (400 mg/100 mg q12h for 10 days) was administered to all patients regardless of disease severity, which was in accordance with the interim recommendations generated during the early period of the Korean MERS epidemic. 10 GI: gastrointestinal, HFNC: high-flow nasal cannula oxygen therapy, IFN: type 1 interferon, IVIG: intravenous immunoglobulin, LR: lopinavir/ritonavir, MERS: Middle East respiratory syndrome, PSI: Pneumonia Severity Index, Rb: ribavirin, SAPS II: Simplified Acute Physiology Score II.
cord-289322-5ciaonf0	2020	title: Epidemiological and clinical features of 291 cases with coronavirus disease 2019 in areas adjacent to Hubei, China: a double-center observational study Methods: In this double-center, observational study, we recruited all consecutive patients with laboratory confirmed COVID-19 from January 23 to February 14, 2020 in two designated hospitals in Hunan province, China. Epidemiological and clinical data from patients'' electronic medical records were collected and compared between mild, moderate and severe/critical group in detail. Our study also showed the proportion of patients who had been to Wuhan in severe/critical group (48.0%) and moderate group (43.4%) were higher than mild group (17.2%). 77.6% patients with available coagulation function test result had elevated fibrinogen on admission, and the proportion in severe/critical group was even higher, which have not been observed in other studies. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study
cord-289457-06gwrpu0	2020	The term "myositis" is often used interchangeably with "idiopathic inflammatory myopathy" (IIM), referring to primary autoimmune diseases of muscle including dermatomyositis, inclusion body myositis (IBM), antisynthetase syndrome, and necrotizing autoimmune myopathy [1] [2] [3] [4] [5] [6] . Another case series of three patients with dermatomyositis-associated cGVHD showed improvement with immunosuppression via combination treatment of corticosteroids, tacrolimus, rituximab, mycophenolate mofetil, and/or IVIG [43] . Patients with polymyositis or dermatomyositis that underwent intensive aerobic exercise combined with resistance training in a randomized controlled trial have improved muscle function, quality of life, and possible reduced disease activity [89] . A pilot study of 20 patients with refractory dermatomyositis or polymyositis using abatacept found that almost half of their patients showed reduced disease activity and improved muscle performance after treatment for 6 months [98] , and there is now a phase III, randomized, double-blind trial to further evaluate abatacept for myositis treatment (ClinicalTrials.gov identifier: NCT02971683).
cord-289533-hip9qtu5	2020	Since this disease is considered an immunosuppressive status by itself, especially in some types of cancer, the medical community has become increasingly concerned about the potentially deleterious effects that COVID-19 infection may cause in these patients. However, the limited current medical evidence suggests that there is no reason to believe that merely a history of thyroid cancer is enough to have an increased risk of developing COVID-19 infection or to evolve into a poor outcome. The frequency and modality of surveillance for patients with thyroid cancer in the COVID-19 pandemic must be adapted according to the risk of recurrence and the response to treatment. Patients with an excellent, indeterminate, or biochemical incomplete response to treatment do not constitute a risk group for COVID-19 infection, and the frequency of structural disease is less than 4%, 15%, and 20%, respectively [14] .
cord-289542-u86ujtur	2020	Here, we use 3345 retrospective and 474 prospective hospitalizations to develop and validate a parsimonious model to identify patients with favorable outcomes within 96 h of a prediction, based on real-time lab values, vital signs, and oxygen support variables. In this article, we describe how a collaboration among data scientists, electronic health record (EHR) programmers (vendorand health system-based), clinical informaticians, frontline physicians, and clinical leadership led to the development, prospective validation, and implementation of a machine learning model for real-time prediction of favorable outcomes within a 96 h window among hospitalized COVID-19 patients. Our approach differs from prior work in that we: (1) predict favorable outcomes (as opposed to adverse outcomes), (2) use a large COVID-19 patient cohort admitted across our hospitals, (3) design a model that can easily be extended to other institutions, (4) prospectively validate performance, and (5) integrate our model in the EHR to provide a real-time clinical decision support tool.
cord-289553-gygvhzcc	2020	130-132) present an interesting and compelling case of a patient with pulmonary arterial hypertension (PAH) who was treated remotely in an ambulatory setting with inhaled nitric oxide (iNO) (5) . In a randomized and placebo-controlled trial of ambulatory patients with fibrotic lung disease requiring long-term oxygen, INOpulse therapy was associated with greater physical activity than placebo, and in an acute dose escalation study of patients with pulmonary hypertension associated with pulmonary fibrosis, iNO delivered through the INOpulse system lead to a 30% reduction in pulmonary vascular resistance, with improvements in Q _ and pulmonary artery compliance (15) . The Hestia criteria identified a cohort of patients with acute PE who completed outpatient therapy with a low risk of adverse events, including recurrent venous thromboembolism (2%), all-cause mortality (1%), and major bleeding (0.7%).
cord-289574-engwi8h3	2020	Accumulating evidence suggested that the progression of COVID-19 is associated with lymphopenia and excessive inflammation, and a subset of severe cases might exhibit cytokine storm triggered by secondary hemophagocytic lymphohistiocytosis (sHLH). Previously, it has been found that the serum levels of pro-inflammatory cytokines [IFN-γ, IL-1, IL-6, IL-12, and transforming growth factor-β (TGF-β)], and chemokines (CCL2, CXCL9, CXCL10, and IL-8) in SARS-CoV infected patients were higher than those in healthy individuals. Procalcitonin (PCT), released by bacterial infectious tissues under the irritation of pro-inflammatory cytokines, is a more specific marker of serious bacterial infection compared to C-reactive protein (CRP) and IL-6 [111] PCT-based strategy has been applied to guide antibiotic use in ICU or emergency wards, since the serum PCT levels in patients with severe bacterial infections are much higher than those with simple viral infections or non-specific inflammatory diseases [111] [112] [113] . The definition and risks of Cytokine Release Syndrome-Like in 11 COVID-19-Infected Pneumonia critically ill patients: Disease Characteristics and Retrospective Analysis
cord-289581-aozg3o9o	2016	Daher geht eine erhöhte Neutrophile/Lymphozyten Ratio (NLR) mit einem ungünstigen kardiometabolischen Profil einher und konnte bereits als Marker für kardiovaskuläre Erkrankungen im Erwachsenenalter bei Pa-tientInnen ohne Diabetes mellitus herangezogen werden. Ziel: Wir bestimmten den zeitlichen Verlauf der Symptome während und bis zu 9 Stunden nach dem Fruktosetest bei Kindern die sensitiv auf Fruktose reagierten. 60 konsekutive Patienten (Alter: 10-15 Jahre; 28 männlich, 33 weiblich) mit chronisch abdominellen Beschwerden erhielten einen Fruktose H2-Atemtest zur Abklärung des Verdachts auf Kohlenhydratmalabsorption; eine 20 % Fruktoselösung wurde dafür verabreicht, 1 g/kg Körpergewicht bis zu maximal 25 g.Die Diagnose einer Fruktosemalabsorption wurde gestellt, wenn der Anstieg der H2-Atemluftkonzentration über 20 ppm betrug. Nach HDMTX-Gabe zeigten sich in der untersuchten Kohorte breit gestreute und großteils signifikante Blutbildveränderungen, welche jedoch zusätzlich durch die protokollgemäße, gleichzeitige Gabe von Purinethol (6-Mercaptopurin) (mit-)verursacht sein können. Wir berichten von einem 5-jährigen Mädchen bei dem aufgrund erheblicher therapieassoziierter Toxizität im Rahmen der Therapie eines Medulloblastoms die Erstdiagnose einer Ataxia teleangiectasia vor Auftreten charakteristischer Stigmata gestellt wurde.
cord-289612-4x5t4c5u	2020	Laboratory-confirmed SARS-CoV-2 infection requires the detection of viral nucleic acid in respiratory tract samples by the use of real-time reverse-transcription polymerase chain reaction (rRT-PCR) assay. In the course of this phase, upper respiratory specimens were tested by RT-PCR for viral RNA and the majority of the patients showed positive results for SARS-CoV-2. These results contrast with another German smaller study by Wolfel et al., conducted on 9 COVID-19 patients, with no discernible difference in viral loads or detection rates when comparing nasal and throat swabs [38] . found that 66.67% of laboratory-confirmed COVID-19 patients were tested positive for SARS-CoV-2 RNA in stool specimens. enrolled a total of 173 confirmed cases of COVID-19 by the use of rRT-PCR on samples from the respiratory track reported that the seroconversion sequentially appeared for the total antibody (Ab), IgM and then IgG, with a median time of 11, 12 and 14 days, respectively. Correlation of chest CT and RT-PCR testing in coronavirus disease 2019 (COVID-19) in China: a report of 1014 cases
cord-289690-af6lsj1g	2015	BACKGROUND: GATA-2 transcription factor deficiency has recently been described in patients with a propensity towards myeloid malignancy associated with other highly variable phenotypic features: chronic leukocytopenias (dendritic cell-, monocyto-, granulocyto-, lymphocytopenia), increased susceptibility to infections, lymphatic vasculature abnormalities, and sensorineural deafness. CONCLUSION: We conclude that a diagnosis of GATA-2 deficiency should be considered in all patients with diffuse parenchymal lung disease presenting together with leukocytopenia, namely monocyto-, dendritic celland B-lymphopenia, irrespective of severity of the clinical phenotype. Defects of transcription factor GATA-2 have recently been identified in a few overlapping phenotypes associated with myeloid malignancies: dendritic cell, monocyte, B-and NK-cell deficiency; MonoMAC syndrome (monocytopenia with Mycobacterium avium complex infections); Emberger syndrome (early onset primary lymphedema, multiple warts, sensorineural deafness, dysmorphism); and familial MDS/AML with no additional known phenotype. We present an adolescent male with GATA-2 deficiency and early manifestation of diffuse parenchymal lung disease (DPLD) as well as an atypical course of Epstein-Barr virus (EBV) infection.
cord-289719-64ugdvfe	2020	During April 15-May 24, 2020, telephone interviews were conducted with a random sample of adults aged ≥18 years who had positive reverse transcription-polymerase chain reaction (RT-PCR) test results for SARS-CoV-2 in outpatient and inpatient settings at 11 U.S. academic medical centers in nine states. During April 15-May 24, 2020, telephone interviews were conducted with a random sample of adults aged ≥18 years who had positive reverse transcription-polymerase chain reaction (RT-PCR) test results for SARS-CoV-2 in outpatient and inpatient settings at 11 U.S. academic medical centers in nine states. To explore the spectrum of illness across health care settings and potential community SARS-CoV-2 exposures after issuance of national social distancing guidelines on March 16, 2020 (4), 11 academic medical centers in nine states conducted telephone-based surveys of a sample of patients with positive SARS-COV-2 test results during April 15-May 24, 2020 (testing dates = March 31-May 10, 2020).
cord-289775-40bi87iz	2014	The specific criteria for recredentialing are determined by each individual hospital, but should generally parallel the following recommendations: ABIM CCEP board certification and IBHRE certification are limited to 10 years; to stay current for CCEP, the physician must complete a series of CME and/or practice improvement activities 9 ; recertification examination for CCEP and CCDS are each required at 10-year intervals; to ensure that cognitive and technical skills are maintained, the physician''s clinical competence must be evaluated and documented on a regular basis; it is the responsibility of the medical staff credentialing committee to ensure that physicians perform the necessary number of evaluations and procedures needed to maintain their expertise 31 and also that they participate in regular CME activities. The procedure report should include, at minimum, all the following: the primary and secondary operators, the indication for the procedure, names and doses of any medications administered, catheter/pacing/ICD lead model and serial numbers, insertion sites and intracardiac destinations, findings and procedure performed, complications encountered, and fluoroscopic exposure (fluoroscopy time, radiation dose, and the dose-area product) by an Advanced Cardiac Life Support (ACLS)/Pediatric Advanced Life Support (PALS)-certified nurse.
cord-289806-6ihptx6n	2020	The pandemic brought near-complete cessation of nonurgent hospital activities with the rapid expansion of critical care services, with the notable exception of the labor and delivery unit (LDU), which continued to have a full complement of patients presenting for obstetric care. By the time the obstetric ICU (OBICU) was fully operational (end of March), the volume demand was mildly curtailed by some patients electing to leave NYC; however, interinstitutional transfers for maternal or fetal indications provided steady demands for care, with fluctuations occurring week by week. However, a key difference is that the critical care attendings (ICU oversight) are not ultimately responsible for patient care decisions and provide ad hoc consultations if deemed needed by the obstetric anesthesia attending. Daily online lectures by the Internal Medicine or Anesthesia departments review critical care topics that are both general in nature and specific to SARS-CoV-2 infection; these lectures while targeted at residents were available to all members of the OBICU team.
cord-289816-rlwoy8ms	2020	This is a case report of a 60‐year‐old male, without any cardiovascular risk factor and no cardiac history admitted to hospital with a diagnosis of interstitial pneumonia caused by coronavirus disease 2019 (COVID‐19). Due to high levels of proinflammatory mediators, diffuse coronary thrombosis could occur even in patients without cardiac history or comorbidities. This clinical case suggests that coronary thrombosis in COVID‐19 patients may be unresponsive to optimal pharmacological (GP IIb–IIIa infusion) and mechanical treatment (PCI). The chest X-ray revealed evidence of pneumonia with bilateral multiple interstitial ill-defined patchy opacities ( When admitted, the patient was treated with dexamethasone (12 mg iv), hydroxychloroquine (200 mg twice daily), antiviral drugs (lopinavir/ritonavir-2 tablets 200/50 mg twice daily), oxygen support (Venturi mask FiO2 40%), antibiotic prophylaxis with ceftriaxone (2 g iv), and venous thromboembolic (VTE) prophylaxis with enoxaparin (4,000 U.I. sc). Clinical characteristics of 138 hospitalized patients with 2019 novel coronavirus-infected pneumonia in Wuhan, China
cord-289828-3k088z9n	2020	[3] [4] [5] In the last few years, numerous initiatives and dedicated programs were developed worldwide with the aim to help these patients to deal with diagnosis and treatments, and also to allow them to imagine, dream, design, learn, and maintain relationships with their peers in and outside the hospital walls. AYA with cancer are more vulnerable to experience high levels of fear and Play4You gave them a coping strategy based on game sharing. The aim of this report was to share with the community that takes care of AYAs; this model is able to reach and help more patients at home, in hospital or elsewhere, simply by using relatively old tools such as Internet connection, individuals'' smartphones, and selected RPGs. Psychosocial dimensions of cancer in adolescents and young adults The experience of loneliness among young adult cancer patients Health and supportive care needs of young adult cancer patients and survivors
cord-289852-4uxb70rh	2020	Thus, harnessing the immunomodulatory properties of mesenchymal stem cells (MSCs) to ameliorate that cytokine-storm can indeed provide a golden key for the treatment of COVID-19 patients, especially severe cases. In fact, MSCs transplantation can improve the overall outcome of COVID-19 patients via multiple mechanisms; first through their immunomodulatory effects which will help to regulate the infected patient inflammatory response, second via promoting tissue-repair and regeneration, and third through their antifibrotic effects. Similar studies are also warranted to compare the therapeutic benefit of a certain MSCs type, and its derived EVs. Antimicrobial activity of mesenchymal stem cells: current status and new perspectives of antimicrobial peptide-based therapies Expanded umbilical cord mesenchymal stem cells (UC-MSCs) as a therapeutic strategy in managing critically ILL COVID-19 patients: the case for compassionate use Human umbilical cord-derived mesenchymal stem cell therapy in patients with COVID-19: a phase 1 clinical trial
cord-289854-p8okfa4b	2020	In this report, we outline the clinical presentation of a 40-year-old male who developed severe coughing and sneezing before presenting to the emergency department with confusion, somnolence, and respiratory distress. On hospital day four, his neurological examination deteriorated to quadriparesis and only cough and gag reflexes remaining intact after which his family opted for comfort measures only. Since initial reports in December 2019 from Wuhan, China, the coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus two (SARS-CoV-2) has become a global pandemic. Our patient is a 40-year-old male with past medical history of obesity, hypertension, and type two diabetes mellitus who developed severe coughing and sneezing before presenting to the emergency department with confusion, somnolence, and respiratory distress. Severe cough was reported to cause cerebral hemorrhage in patients with whooping cough as early as 1885 [8] . Increased risk of intracerebral hemorrhage adds to the complexity of management of patients with COVID-19.
cord-289859-b1k9uyp6	2020	title: Successful management of COVID‐19 and associated coagulopathy in a patient with durable left ventricular assist device Patients with durable left ventricular assist devices pose special problems for management in the setting of COVID‐19 infection. We describe the successful management of a 44‐year‐old man with severe COVID‐19 infection and HeartMate 3 left ventricular assist device. Patients with durable left ventricular devices (LVADs) pose special problems for management in the setting of COVID-19 infection. [1] [2] [3] We present the case of a patient with ischemic cardiomyopathy supported by durable LVAD who developed severe COVID-19 infection with acute respiratory distress syndrome complicated by coagulopathy. Management of COVID-19 infection in the context of durable LVAD support requires careful institutional planning and a multidisciplinary approach. Successful management of COVID-19 and associated coagulopathy in a patient with durable left ventricular assist device
cord-289930-7xm6q68s	2020	In this study, we test the hypothesis that short-term, low-to-moderate-dose corticosteroids would benefit patients when used in the early phase of excessive inflammation, namely, the therapeutic window. According to the currently known molecular mechanisms and pathophysiology data on severe acute respiratory syndrome (SARS), middle east respiratory syndrome (MERS), and influenza patients, critically ill patients usually undergo the following stages: virus invasion, immune activation, excessive inflammatory response, acute respiratory distress syndrome (ARDS), and, in the end, possible recovery or death [6] [7] [8] [9] [10] [11] . Among COVID-19 patients with marked radiologic progression, short-term, low-to-moderate-dose corticosteroids could benefit patients with LDH levels of less than two times ULN, who may be in the early phase of excessive inflammation. Among COVID-19 patients with marked radiologic progression, short-term, low-to-moderate-dose corticosteroids could benefit patients with LDH levels of less than two times ULN, who may be in the early phase of excessive inflammation.
cord-289973-1mczuxsy	2020	14 Understanding the limitations of observational studies, but with the urgency to assess potential therapeutic approaches, the 13 hospitals within the Hackensack Meridian Health network (NJ, USA) considered offlabel use of tocilizumab in patients with severe SARSCoV2 infection who required intensive care unit (ICU) support. Adjusted Cox proportional hazards regression models were fitted to estimate the associ ation between tocilizumab use and overall survival, using clini cally likely confounders including age, gender, diabetes, chronic obstructive pulmonary disease (COPD) or asthma, hypertension, cancer, renal failure, obesity, oxygena tion less than 94%, quick Sequential Organ Failure Assessment (qSOFA) score, use of steroids, Creactive protein 15 mg/dL or higher, and intubation or mech anical ven tilator support. Propensity score-matched patients (n=630)* First, we calculated a propensity score of receiv ing tocilizumab treatment for each patient using multi variable logistic regression with the confounders age, gender, diabetes, COPD or asthma, hypertension, cancer, renal failure, obesity, oxygenation less than 94%, qSOFA score, use of steroids, Creactive protein 15 mg/dL or higher, and intubation or mechanical ventilator support.
cord-290006-63sa00ju	2018	14 Other lymphoproliferative disorders affecting the lung and pleura also include nodular lymphoid hyperplasia and Castleman''s disease, which lack monoclonal proliferation, in addition to primary effusion lymphoma that affects pleural, pericardial, or peritoneal spaces in immunocompromised individuals such as with acquired immune deficiency syndrome (AIDS). 43 Subsequently, a number of etiologies known to cause a reversed-halo sign and include infection such as zygomycosis, invasive apergillosis, tuberculosis, histoplasmosis, cryptococcosis, Pneumocystis jirovecii pneumonia, paracoccidioidomycosis; infarct from pulmonary embolism; eosinophilic processes; post-lung ablation and stereotactic body radiation therapy changes; lung adenocarcinomas; granulomatosis with polyangiitis; lymphoproliferative disorders; and sarcoidosis. Aspergillus infection affects immunocompromised patients, such as those on steroids, leukemia, and after bone marrow and organ transplantation, often in the form of angioinvasive aspergillosis (ANG), although airway invasive aspergillus (AIA) is another manifestation that is associated with peribronchial opacities. Viral infections affect the lung interstitum and present on CT with centrilobular nodules, ground-glass opacity, consolidation, and bronchial wall thickening (Fig. 7) .
cord-290028-oyd7vzj6	2020	This will be accomplished with a randomized controlled trial (RCT) in which 126 participants treated with HD in community-based dialysis facilities with chronic insomnia will be assigned 1:1:1 to telehealth CBT-I, trazodone, or medication placebo, respectively; short-term effectiveness of each treatment arm will be determined at the end of 6-weeks of treatment and long-term effectiveness at 25-weeks. Study design and overview SLEEP-HD is a parallel-group RCT wherein 126 HD patients treated in community-based dialysis facilities in Seattle and Albuquerque will be randomized 1:1:1 over 31 months to 6-week treatment with telehealth Cognitive Behavioral Therapy for Insomnia (CBT-I), trazodone, or medication placebo (Fig. 1) .
cord-290041-zxlq63n5	2020	MATERIALS AND METHODS: We retrospectively abstracted cT1b-T2bN0M0 RCC patients from the National Cancer Database (NCDB), stratifying them by clinical stage and time from diagnosis to surgery. 1 These delayed surgeries include many potentially curative urologic oncologic surgeries 2, 3 , such as partial and radical nephrectomies for renal cell carcinoma (RCC), which remain the preferred curative treatment for localized kidney cancer. Our retrospective analysis using the NCDB is the largest study to date to examine the risks of surgical delay on up-staging and OS in cT1b-T2b RCC. 16 Additionally, our grouping points of <1 month, 1-3 months, >3 months were selected based on prior literature and our clinical practice during the COVID-19 pandemic where local institutions delayed most kidney cancer cases by 1-3 months. In most patients with clinically localized cT1b tumors, surgery may be safely delayed for up to 6 months without significant sacrifices in overall survival. Impact of Time-To-Surgery and Surgical Delay on Oncologic Outcomes for Renal Cell Carcinoma
cord-290051-22gwwrpw	2020	Therefore, we simulated fiberoptic endotracheal intubation on a mannequin representing the patient, using an ultrathin flexible gastrointestinal endoscope as an alternative to the bronchoscope, in order to maintain distance from the patient during the procedure. Therefore, we simulated fiberoptic endotracheal intubation on a mannequin representing the patient, using an ultrathin flexible gastrointestinal endoscope as an alternative to the bronchoscope, in order to maintain distance from the patient during the procedure. The flexible tip-steerable control and length of the gastrointestinal endoscope contributed to shortening the procedure time and maintaining distance from the patients. The flexible tip-steerable control and length of the gastrointestinal endoscope contributed to shortening the procedure time and maintaining distance from the patients. Endotracheal intubation using an ultrathin flexible gastrointestinal endoscope is a quick and reliable procedure that can be performed while maintaining distance from the patient.
cord-290065-ouua7wnq	2020	title: Severe arterial thrombosis associated with Covid-19 infection • We observed very severe arterial thrombotic complications in COVID-19 patients with cardiovascular history despite the use of antiplatelet or anticoagulant therapy, including five irreversible lower limb ischemia and two thoracic aortic free floating thrombi. • Further studies are needed to evaluate the necessity of therapeutic anticoagulation in COVID-19 patients with peripheral arterial occlusive disease or thrombophilia. reporting the incidence of thrombotic complications in critically ill ICU patients diagnosed with Covid-19 1 . We report seven cases of severe arterial thrombotic events in patients infected with Covid-19. On We describe very severe arterial thrombotic complications occurring in COVID-19 patients despite the use of antiplatelet or anticoagulant therapy, including irreversible lower limb ischemia and free floating thrombi in the thoracic aorta. Incidence of thrombotic complications in critically ill ICU patients with COVID-19 Anticoagulant treatment is associated with decreased mortality in severe coronavirus disease 2019 patients with coagulopathy
cord-290081-pjg00t7g	2020	PURPOSE: The COVID pandemic has decreased orthopaedic fracture operative intervention and follow-up and increased the use of virtual telemedicine clinics. We surveyed 100 virtual fracture clinic follow-up patients for satisfaction, time off work and travel. New virtual follow-up fracture clinics reduced patient face-to-face appointments. All the patients brought into hospital were ''normal'' decisions and all those in the virtual fracture clinic review clinic were ''COVID'' due to lack of normal face-to-face interaction. The PIFU patients were subdivided into 3 groups: ''normal'' decisions, ''COVID'' decisions based on lack of clinical review or follow-up, and ''COVID'' decisions based on potential mal-unions (see Fig. 1 ). Of the 11 patients who were brought back for a face-to-face follow-up, five were due to future appointments to have a cast removed and six were due to the clinician deciding they needed a clinical assessment in hospital (thus a repeat appointment).
cord-290195-8uaai9nv	2020	Furthermore, baricitinib treatment resulted in a significant reduction (p<0.05) from baseline in plasma IL-6 at week 12 in patients with active RA who had an inadequate response to methotrexate from a phase 2b (Tanaka, Emoto et al., 2016) , randomized, placebo-controlled, dose-ranging study (Fig. 1B) . As shown in Figure 3A , all four patients showed improvement with baricitinib treatment in signs and symptoms such as cough, fever, and reduction in plasma IL-6 levels, along with a reduction in the SARS-CoV-2 RNA viral load, as detected by the real-time reverse-transcriptase-polymerase chain reaction (RT-PCR) signal from the nasopharyngeal carriage. Therefore, the impact of baricitinib on the subsequent development of protective humoral and cell-mediated anti-viral immunity in COVID-19 patients must be evaluated in randomized clinical trials (Ottoviani & Stebbing, 2020) . The finding that baricitinib is a potent AAK1/BIKE/GAK inhibitor that may reduce host cell infectivity, along with reaffirmation of its anti-cytokine profile, provide reasons to study this intervention in randomized clinical trials.
cord-290200-csmisulw	2020	Immune checkpoint inhibitors (ICPIs) have revolutionized the management and prognosis of fit patients with advanced non-small cell lung cancer (NSCLC). In the OAK trial, assessing the efficacy of the anti-PD-L1 antibody, atezolizumab, until progression or unacceptable toxicity in previously treated advanced NSCLC, regardless of PD-L1 expression, patients, 28% of those in the experimental arm demonstrated long-term survival, defined as greater or equal to 24 months (10). In the Checkmate 153 trial, continuous nivolumab treatment resulted in grade 3 or higher immune-related adverse events in 8% of patients, compared to 4% in the 1-year fixed duration cohort, but very few new safety events took place after the first year of therapy (8) . CheckMate 153: randomized results of continuous vs 1-year fixed-duration nivolumab in patients with advanced non-small-cell lung cancer Early immune-related adverse events and association with outcome in advanced non-small cell lung cancer patients treated with nivolumab: a prospective cohort study
cord-290267-ke696q8j	2020	In this study, we included patients with COVID-19, divided them into ordinary, severe, and critical types according to the clinical manifestations at admission, and aimed to assess the impact of comorbidities on prognosis in patients with three different types of COVID-19, and to provide reference for the treatment of these patients. According to the Diagnosis and Treatment Program of Novel Coronavirus Pneumonia (Trial Seventh Edition) issued by the National Health Commission, all patients were divided into ordinary, severe, and critical types based on their clinical manifestations at admission. These results indicated that comorbidities can significantly affect the clinical course (length of hospital stay, time from onset to discharge) of ordinary patients, reduce the cure rate, and increase mortality rate of critical patients. In terms of clinical symptoms, ordinary patients without hypertension, diabetes, and coronary heart disease had a significantly higher proportion of fever compared with patients who had those comorbidities (p<0.05).
cord-290295-gl144dh9	2020	Among MM patients, inpatient mortality was 41% in males, 42% in patients aged >65 years, 49% in patients with active/progressive MM at hospitalization, and 59% in patients with comorbid renal disease at hospitalization, which were independent prognostic factors on adjusted multivariate analysis. There are cumulative data indicating that patients with cancer may be at increased risk for more severe COVID-19 and associated complications, including those receiving or not receiving treatment within the month prior to infection 5, 6 , although other recent results suggest mortality may be primarily associated with age, male sex, and comorbidities 7 . To our knowledge, this is the first large case-series study to describe comprehensively the clinical characteristics of COVID-19 in hospitalized MM patients, compare outcomes with a noncancer cohort of COVID-19 patients, and identify preadmission prognostic factors of inpatient mortality.
cord-290326-umv0q4d7	2020	Consequently, due to lack of specific COVID-19 data, the recommendations in our review are based on viral and bacterial pneumonia studies, as well as recommendations made for critically ill patients. Nutritional treatment for critically ill patients diagnosed with COVID-19 (especially in case of respiratory and multiorgan failure) [22] is a key element of comprehensive treatment aimed to reduce the mortality. American Society for Parenteral and Enteral Nutrition (ASPEN) criteria for increased risk for aspiration are: inability to protect the airway, mechanical ventilation, age > 70 years, reduced level of consciousness, poor oral care, inadequate nurse: patient ratio, supine positioning, neurologic deficits, gastroesophageal reflux, transport out of the ICU, and use of bolus intermittent EN. Poor nutritional status is a prognostic factor for mortality in severe pneumonia and critical illness, especially for elderly patients. ESPEN and ASPEN guidelines for nutritional support in critical illness are applicable for COVID-19 patients requiring ICU support.
cord-290341-ei768v4s	2020	Herein we discuss the evolving role of the cardiac intensivist and changes to the CICU in the era of the COVID-19 pandemic and provide recommendations based on our own experiences at NewYork-Presbyterian Columbia University Irving Medical Center. There are several domains across which innovation may occur including the physical layout of the CICU, the timing of laboratory and diagnostic studies, medication administration, clinical monitoring, and the management of cardiac arrests. Timing of Lab Testing and Diagnostic Studies: As typical of critically ill patients, patients in an intensive care setting with COVID-19 will require frequent testing as part of their clinical assessment and management. The cardiac intensivist and staff also serve as a consultative resource throughout the hospital to other clinicians given the clinical expertise of the CICU in the management of critically ill patients with cardiovascular complications of COVID-19.
cord-290401-t87i3exo	2017	Source control performed after 12 h was not associated with higher mortality, implying that in high-risk patients even beyond the 12-h timeframe from admission, it may contribute to improved outcomes [5] . In another Spanish retrospective cohort of intraabdominal candidiasis (IAC), source control along with early antifungal treatment was associated with improved survival in both ICU and surgical wards, standing out as the main goal for decreasing mortality of IAC episodes inside and outside the ICU [13] . Numerous studies have demonstrated that the delay of initiation of antifungal therapy was associated with significant increases in both in-hospital mortality and the cost of care for patients with IC [16] . Association between source control and mortality in 258 patients with intra-abdominal candidiasis: a retrospective multi-centric analysis comparing intensive care versus surgical wards in Spain
cord-290551-a02tueuu	2020	title: Impact of Obesity on Outcomes of Patients with COVID-19 in United States: A Multicenter Electronic Health Records Network Study. We performed a retrospective cohort study using TriNetX (Cambridge, MA, USA), a global federated health research network that provided access to electronic medical records of patients from multiple large member healthcare organizations (HCOs) in United States. Our study using a large nationally representative database showed that COVID-19 patients with any degree of obesity had a significantly higher risk of hospitalization and intubation or death compared to patients without obesity. An analysis of a larger group of selected patients using diagnostic criteria of obesity as any time before the index event (after PSM n=9769) showed a higher risk for composite outcomes in the obesity group ( J o u r n a l P r e -p r o o f
cord-290611-fhaguv3f	2020	Since the onset of coronavirus disease 2019 (COVID19) pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), a growing body of evidence has shown that patients with confirmed COVID-19 may present elevated blood levels of high-sensitivity TnI (hs-TnI) during hospital stay, which might reflect ischemic cardiovascular complications or acute myocarditis [1] [2] [3] . The main finding is that, in this cohort, in-hospital mortality was associated with older age, respiratory failure and elevated plasma levels of hs-TnI whereas cardiovascular comorbidities were not an independent risk factor at multivariable analysis. However, when age and respiratory failure at hospital admission were analyzed together with cardiac involvement in a multivariable analysis, only older age, a P/F ratio < 200 and elevated hs-TnI plasma levels were significant predictor of death and of the combined outcome.
cord-290658-r2bqqovo	2020	OBJECTIVE: The aim of this study was to investigate the incidence, clinical presentation, cardiovascular (CV) complications and mortality risk of myocardial injury on admission in critically ill ICU inpatients with COVID-19. We conducted a retrospective study of data from 77 patients admitted to a newly constructed ICU in Wuhan, compared patients with and without myocardial injury, detailed the relationship of myocardial injury with the survival rate and CV outcomes, and presented the following conclusions: 1) Myocardial injury is a common complication in critically ill COVID-19 patients; 2) Additionally, we further compared the mortality and time from ICU admission to death between the myocardial injury and non-myocardial injury patients, which suggested the predictive value of co-existing myocardial injury on admission as a high-risk factor in critically ill patients with COVID-19 in this study.
cord-290712-flj352ql	2020	title: Does Chemotherapy Reactivate SARS-CoV-2 in Cancer Patients Recovered from Prior COVID-19 Infection? Those studies mainly addressed whether chemotherapy could predict for hospitalization, severe disease, and mortality in cancer patients with COVID-19 infection. To address this knowledge gap, this study''s findings suggest that administering chemotherapy to this population is associated with a very low short-term risk of SARS-CoV-2 reactivation. Third, the duration of follow-up in this study was relatively short and it may take a longer period of time to determine immune-related alterations caused by chemotherapy in cancer patients who have recovered from COVID-19 infection. Nevertheless, when conservatively interpreted, our study indicates no overt short-term increase in the risk for SARS-CoV-2 reactivation following immunosuppressive chemotherapy in this uniquely vulnerable population. To our knowledge, this is the first study reporting that recovered COVID-19 cancer patients remain negative in the short-term for SARS-CoV-2 after delivery of chemotherapy.
cord-290750-85731og8	2020	Because of the very high transmission capacity, the WHO declared the outbreak of coronavirus disease (COVID-19) caused by SARS-CoV-2 infection a public health emergency of international concern. Additional recommendations for patients with IBD from the IOIBD: • Medicines such as mesalamine are safe • If possible, withdraw from steroid use • Biologic agents used to treat IBD (e.g. anti-TNF agents, ustekinumab and vedolizumab) are generally safe; there are no recommendations to stop taking these medications and the effects of these drugs are present for many months • Thiopurines and tofacitinib tend to inhibit the immune response to viral infections, but stopping these agents in the short-term will not help • Get the influenza vaccination • Stay at home and minimize social contact c | Strategies to enable maintenance of our biologic agent clinic during the COVID-19 outbreak in Italy include checkpoints at hospital entrances for symptom screening and use of surgical masks for clinical staff and patients.
cord-290771-18dj37dj	2020	CONCLUSIONS: Cancer surgeons should continue to use their oncologic knowledge to determine the window of opportunity for each surgical procedure, based on tumor biology, preoperative treatment sequencing, and response to systemic therapy, to safely guide patients through this cautious recovery phase. Total surgical case volume by week during early COVID-19 response, in which MD Anderson Cancer Center implemented goals to create a ''''moat'''' around hospitalized patients, to reduce workforce and visitor traffic, and to limit ''''elective'''' cases. Because the Department of Surgical Oncology and MD Anderson Cancer Center have traditionally favored neoadjuvant therapy for many solid tumors, we strategically initiated or continued this treatment sequencing when possible to postpone surgery to beyond the late April peak of COVID-19 incidence in the Houston area.
cord-290832-zmj59rc3	2020	AIMS: To assess the role of nutritional status as an independent prognostic factor for in-hospital death in elderly patients. At univariate analysis, age (HR 1.045 [CI 1.008–1.082]), cognitive impairment (HR 1.949 [CI 1.045–3.364]), C-reactive protein (HR 1.004 [CI 1.011–1.078]), lactate dehydrogenases (HR 1.003 [CI 1.001–1.004]) and GNRI moderate–severe risk category (HR 8.571 [CI 1.096–67.031]) were risk factors for in-hospital death, while albumin (HR 0.809 [CI 0.822–0.964]), PaO(2)/FiO(2) ratio (HR 0.996 [CI 0.993–0.999]) and body mass index (HR 0.875 [CI 0.782–0.979]) were protective factors. The main result of our study is that impaired nutritional status, assessed by the GNRI, together with the PaO 2 /FiO 2 ratio, is an independent predictor of in-hospital mortality in elderly patients with symptomatic SARS-CoV-2 infection. Future larger and multicentric studies are needed to validate our results on the prognostic value of GNRI in predicting in-hospital death and to further explore the role of other nutritional parameters in elderly patients hospitalized for COVID-19.
cord-290836-jldfrec9	2020	Objective To evaluate the role of functional status along with other used clinical factors on the occurrence of death in patients hospitalized with COVID-19. Estimated model coefficients served to calculate the expected probability of death for a selected combination of five variables: Barthel, sex, age, comorbidities and severity index (qSOFA). Evidence is even smaller regarding the joint 47 Therefore, the aim of this study was to evaluate, in patients hospitalized with COVID50 19, the role of limitations in activities of daily living along with other habitual clinical 51 factors on death during hospitalization, building a predictive model. Risk factors for mortality in patients with Coronavirus disease 2019 (COVID-19) infection: a systematic review and meta-analysis of observational studies Clinical characteristics, outcomes, and risk factors for mortality in patients with cancer and COVID-19 in Hubei, China: a multicentre, retrospective, cohort study
cord-290856-6de0mwg0	2020	A second key component of this challenge was the overwhelming surge in patient burden and the relative lack of trained staff and medical equipment which required rapid re-organization of large systems and augmenting health care efficiencies to unprecedented levels. This review article describes the early research and development response in Israel under the scope of in-hospital patient care, such as non-contact sensing of patients'' vital signs, and how it could potentially be weaved into a practical big picture at the hospital or national level using a strategic management system. This review article describes the early research and development response in Israel under the scope of in-hospital patient care, and how it could potentially be weaved into a practical strategic big picture that could help confront the next wave or any upcoming health crisis. The C 4 I™ system is a command and control tactical system integrating computing, communication, and intelligence information (for health care applications this applies for patient sensors), developed for military use by Elbit Systems.
cord-290947-5ewpvo4j	2020	The Chinese Center for Disease Control recently published data on 44,672 patients infected with SARS-CoV-2 (1) , showing that 88% of patients were < 70 years old, with an overall mortality rate of 2%, but 19% of cases needed hospitalization in an intensive care unit (ICU). The proportion of patients with COVID-19-related disability will be rapidly growing, and a prompt response from physical medicine and rehabilitation (PMR) specialists is crucial to reduce disability and help re-establish and optimize the function of the acute hospital setting. The most common forms are 1) mild: no dyspnea, no low blood oxygen saturation (SatO2); 2) moderate: dyspnea, SatO2 94% to 98%, radiological signs of pneumonia; 3) severe: dyspnea, SatO2 ≤ 93%, respiratory rate (RR) >30/min, radiological progression of lesions, with O2 supplementation required, eventually with non-invasive ventilation; and 4) critical: patients need mechanical ventilation.
cord-290975-2kmvyovm	2020	In this paper, we aim at evaluating the impact that the COVID-19 pandemic, and the relative containment measures, have had on a real-life sample of patients suffering from substance use disorders (SUDs) and/or behavioral addictions. Within the general population, problems such as feelings of frustration, aggressive behavior (2) , post-traumatic stress symptoms (PTSS), depression, anxiety, insomnia, perceived stress, and adjustment disorder symptoms (ADS) have increased (3) , with the consequent risk of self-medication through the abuse of alcohol and/or psychoactive substances and with a greater tendency to engage in pathological behaviors (gambling and internet addiction). The aim of this study was to evaluate the impact that the COVID-19 pandemic, and the relative containment measures adopted by the Italian Government, had on patients with SUDs and/or behavioral addictions; to assess the psychopathological burden in terms of depression, anxiety, post-traumatic load; and to evaluate the relevance of craving symptoms and their correlation with psychiatric symptoms and quality of life.
cord-291016-c83fs5ih	2020	Furthermore, the new, emergency-driven changes to hospital logistics conflict with important principles of treatment of patients with acute coronary syndromes: patients with an undefined contact history or ambiguous symptoms are often approached as potential Sars-Cov-2 positive at the time of their medical contact. It is now of paramount importance that communication media inform the population that most large centers have restructured their admission protocols to provide a rapid and Covid-secure care of patients with acute coronary syndromes while still addressing the diagnosis of Sars-CoV-2 infection. International experts and the European Society of Cardiology "strongly recommend that physicians and patients should continue treatment with their usual anti-hypertensive therapy", given the lack of clinical or scientific evidence to suggest that treatment with angiotensin-converting enzyme inhibitors or angiotensinreceptor blockers might favor the spread or the severity of Sars-CoV-2 infection [9] .
cord-291024-9g4om4sf	2004	To better assess the risk for transmission of the severe acute respiratory syndrome–associated coronavirus (SARS-CoV), we obtained serial specimens and clinical and exposure data from seven confirmed U.S. SARS patients and their 10 household contacts. To that end, we obtained serial biologic specimens and clinical and exposure data for 5 to 10 weeks after onset of illness from seven laboratory-confirmed U.S. SARS patients and their household contacts. We detected SARS-CoV in fecal and respiratory specimens and found that SARS case-patients may have high concentrations of virus in stools during the 2nd week of illness and continue to shed the virus in feces until at least 26 days after onset of symptoms. All upper respiratory specimens in the first 2 weeks after onset were negative for SARS-CoV by RT-PCR; this finding differs from a report in Hong Kong, where viral RNA was detected in nasopharyngeal aspirates of 68% of case-patients at day 14 (21) .
cord-291025-u5z8zji3	2020	title: Mortality of a pregnant patient diagnosed with COVID-19: A case report with clinical, radiological, and histopathological findings According to the data, several clinical outcomes such as sepsis, respiratory failure, acute respiratory distress syndrome (ARDS), septic shock, coagulopathy, acute cardiac injury, and acute kidney injury are significantly (all P-values < 0.0001) higher in non-survivor patients compared to survivors. To our knowledge, this case is the first maternal death reported for pregnant patients diagnosed with COVID-19 so far. An early study has evaluated the outcome of nine pregnant patients with COVID-19 without any specific underlying diagnosed diseases (all gestational ages ≥36 weeks). Another study evaluated 13 pregnant patients (two cases < and 11 cases≥ 28 week of gestation) diagnosed with COVID-19. This case with the mentioned clinical, imaging, and laboratory data was the first report of COVID-19 pregnancy mortality.
cord-291052-nstfe15a	2020	This manuscript aims to present a treatment algorithm we applied to manage COVID-19 patients admitted to our hospital. We administered hydroxychloroquine plus doxycycline to mild cases (isolated at home) for 3 days and lopinavir plus doxycycline to moderate and severe cases (hospitalized) for 5 days. Second, moderate to severe cases were hospitalized and prescribed with a regimen of lopinavir plus doxycycline plus ceftriaxone for 5 days. We hospitalized moderate to severe cases and administered lopinavir combined with doxycycline and ceftriaxone to 343 patients, among whom 161 had positive PCR test results (161/343, 46.9%). We administered hydroxychloroquine to mild cases isolated at home, lopinavir plus doxycycline to hospitalized moderate to severe cases, and favipiravir in the salvage treatment. We concluded that home isolation of mild cases is an effective means to manage the burden of disease, while lopinavir plus doxycycline is an alternative to current treatment regimens for COVID-19.
cord-291168-4u4cssky	2020	METHODS: A multicentric prospective observational study of 1890 COVID-19 patients undergoing tracheostomy across 120 hospitals was conducted over 7 weeks in Spain (March 28 to May 15, 2020). The group has performed a national multicentric prospective observational study on 1890 COVID-19 critical patients undergoing tracheostomy in a total of 120 hospitals in Spain. On early March, 2020, at a very critical moment of the pandemic in Spain and without published data yet from initial experiences in China or Italy, Spanish otolaryngologists began their first tracheostomies in Madrid (March, 11) and Barcelona (March, 16) , with the onrush of more than a thousand patients in their respective overcrowded ICUs, which doubled its current capacity. Between March 28 and May 15, the Spanish COVID Group, encompassing 120 hospitals, performed 1890 tracheostomies, the equivalent of 16.4% of all registered ICU patients with mechanical ventilation in Spain.
cord-291176-evb6yt0r	2020	In this report, based on the cohort of all residents in the province of Reggio Emilia who were SARS-CoV-2-positive at nasal and pharyngeal swab and with symptoms (COVID-19 cases) since the inception of the epidemic, we describe patient characteristics and explore their role as putative prognostic factors in predicting the occurrence of hospital admission or death. We considered the following patient characteristics: age, sex, place of birth (Italy or abroad), time span (in days) from symptom onset to diagnosis/ hospitalization, and comorbidities, whose prognostic role was explored both singly (chronic obstructive pulmonary disease, arrhythmia, diabetes, coronary heart disease, heart failure, vascular diseases, obesity) and by computing the Charlson Comorbidity Index, which provides an overall measure of an individual patient''s complexity [12] . While in this study we focused on the risk of hospitalization and death in a cohort of COVID-19 patients diagnosed during the epidemic in Northern Italy, it also provided us with the opportunity to describe the pattern of distribution of the disease in the whole population.
cord-291244-o4isx15k	2020	Herein, we report a case of critical COVID-19 pneumonia treated with extracorporeal membrane oxygenation from symptom onset day 19 (SOD#19) to SOD#30. Here, we report the clinical course of a patient with a severe case of COVID-19 complicated with acute respiratory distress syndrome (ARDS). We report the patient''s response to intensive care, including invasive ventilation in the early stage of the illness and extracorporeal membrane oxygenation (ECMO) with antiviral, immunomodulatory, and glucocorticoid therapies as the illness progressed. In this case, ECMO showed great effectiveness 13 in treating the patient''s rapidly deteriorating respiratory status due to pneumonia. Clinical course and outcomes of critically ill patients with SARS-CoV-2 pneumonia in Wuhan, China: a single-centered, retrospective, observational study • A critical case of 76-year-old female with COVID-19 pneumonia.• No significant clinical benefits of lopinavir-ritonavir and peramivir treatment.• The pneumonia rapidly progressed to acute respiratory distress syndrome.• Extracorporeal membrane oxygenation from illness day 21 to 31 lead to recovery.
cord-291265-qmylxndp	2020	title: COVID-19 pandemic: Ophthalmic practice and precautions in a tertiary eye hospital in Iran 7 Here, we address the prevention strategies employed against COVID-19 according to assessments of infection control experts and ophthalmologists, in Amiralmomenin Hospital a tertiary referral eye hospital in Guilan, Iran. To avoid redundant visits to the hospital, patients who were managed in an outpatient setting were contacted via phone by eye-care professionals at appropriate intervals. Environmental surfaces frequently touched by staff and patients, such as light switches, door knobs, and nursing stations were cleaned according to Centers for Disease Control and Prevention (CDC) recommendations. The personal protective equipment for the eye-care nursing staff, ophthalmology residents, and attending eye surgeons included Latex gloves, eye protection (goggles or face shields), a surgical-style face mask, a long-sleeved fluid-resistant gown, and disposable shoe covers. Evaluation of coronavirus in tears and conjunctival secretions of patients with SARS-CoV-2 infection Interim infection prevention and control recommendations for patients with suspected or confirmed coronavirus disease 2019 (COVID-19) in healthcare settings
cord-291340-8gj0ofmp	2020	In a Cochrane review [26] , and other studies [27] probiotics were shown to decrease upper respiratory infections through their effect on the gut lung axis [28] Role of several other nutrients and food constituents like Vitamins(E, B) Carotenoids, minerals (Fe, Zn, Mg, Cu, Se), and polyphenols in immunity have been suggested because of their effects on inflammatory cascade, antioxidant activities and effects on nitrous oxide signalling pathways [25] (Table 1) . Controlled trials also show reduced complications when serum albumin level is adequate [44] .In a recent scoping review(four studies in patients with ventilator-related pneumonia and acute respiratory distress syndrome, and the other 4 in patients with ventilator-associated pneumonia), intravenous ascorbic acid, intramuscular cholecalciferol, enteral and intramuscular vitamin E, enteral zinc sulphate, and oral and parenteral glutamine were given as interventions.
cord-291388-tt9eq7e0	2004	Previous reports have described some major clinical findings of SARS, including the temporal progression of clinical symptoms and chest radiography, the outcomes, suggested treatment protocol, and risk factors for death (4, 5) . We report on the clinical features of our SARS patients with pneumonia, with emphasis on temporal progression of laboratory findings, treatment outcome, and risk factors for poor prognosis. Methylprednisolone was usually administered in the second week of the disease if any of the following occurred: a flare of fever, progression of clinical symptoms (such as dyspnea or diarrhea), a surge or resurge of CRP level, or rapid deterioration of chest radiographic findings (development of new infiltration). A previous study reported the temporal progression of clinical and radiologic findings in SARS patients and indicated that several parameters would become more severe in the second and third week of disease (5).
cord-291397-look6ddt	2020	Given the lack of specific therapy about the ongoing SARS-CoV-2 infection, we conducted a brief review to summarize the mechanism of action and the potentially side effects of the treatment currently available, focusing on the effects of the drugs on renal disease at different stages in terms of therapeutic management and survival. A randomized clinical trial, handled by a Chinese group, suggested that in hospitalized adult patients with severe infection, no benefit was observed with lopinavir/ritonavir beyond standard care in terms of time to clinical improvement, reduction of mortality and safety (side effects and discontinuation of treatment) [29, 30] . Effect of high vs low doses of chloroquine diphosphate as adjunctive therapy for patients hospitalized with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection: a randomized clinical trial
cord-291413-cgec7150	2020	There are several challenges facing endovascular therapy for stroke, including shortages of medical staff who may be deployed for COVID-19 coverage or who may have contracted the infection and are thus quarantined, patients avoiding early medical care, a lack of personal protective equipment, delays in door-to-puncture time, anesthesia challenges, and a lack of high-intensity intensive care unit and stroke ward beds. As a leading regional neurovascular organization, the Middle East North Africa Stroke and Interventional Neurotherapies Organization (MENA-SINO) has established a task force composed of medical staff and physicians from different disciplines to establish guiding recommendations for the implementation of acute care pathways for various neurovascular emergencies during the current COVID-19 pandemic. As a leading regional neurovascular organization, the Middle East North Africa Stroke and Interventional Neurotherapies Organization (MENA-SINO) has established a task force composed of medical staff and physicians from different disciplines to establish guiding recommendations for the implementation of acute care pathways for various neurovascular emergencies during the current COVID-19 pandemic.
cord-291417-p49ukyhx	2020	METHODS: This observational single-center study included patients with COVID-19 pneumonia who were not intubated and received either standard of care (SOC, controls) or SOC plus early (within 3 days from hospital admission) anti-inflammatory treatment. This observational single-center study included patients with COVID-19 pneumonia who were not intubated and received either standard of care (SOC, controls) or SOC plus early (within 3 days from hospital admission) anti-inflammatory treatment. We hypothesized that outcomes such as no need for intubation and survival of patients with severe COVID-19 pneumonia in whom tocilizumab and/or methylprednisolone were administered in addition to standard of care (SOC) could be better than in those who received only SOC. In this observational study in non-intubated patients with mainly severe COVID-19 pneumonia, the early addition of tocilizumab and/or methylprednisolone to SOC resulted in adjusted failure-free survival of 86.5% and 80.8% at day 14 and 30, which was, respectively, 10.7% and 16.7% higher than in SOC patients.
cord-291430-rsu6xviv	2020	He was subsequently found to have parathyroid carcinoma as the cause of the acute encephalopathy with impressive serum calcium and parathyroid hormone levels. According to a systemic review conducted from 1995-2003 by Ruda et al., parathyroid carcinoma accounted for 0.74% of cases out of the total study population of 22,225 patients [3] . On days 4-10 of hospitalization, the patient became more lucid as serum calcium level had normalized to 9.1 mg/dL with treatment. The patient remained to have normal serum calcium levels with elevated PTH levels for the next few days. The primary treatment for parathyroid carcinoma is surgical resection, as it offers the greatest chance for potential cure [11] . However, it is advised that the serum calcium levels should be controlled prior to surgery as our patient''s hypercalcemia was normalized after being treated with intravenous fluids, calcitonin, cinacalcet, and pamidronate. Surgical treatment of parathyroid carcinoma (review)
cord-291469-cohrewj5	2020	His father had died of sudden death after 3 days of remittent chest pain and dyspnea, but did not come to our emergency room for the Luckily, we expect that the vast majority of patients with cardiovascular disease in the Covid-era will survive, and will ultimately develop heart failure in the next few months. Since the beginning of the pandemic, we have heard of protocols, distance, masks, lock-down, but not a single word has been spent regarding how will we be able to manage the new cardiovascular pandemic in the next few months, when everything will be open again and patients will not refuse to come to our emergency rooms and office visits. However, since the median stay of a Covid-19 patient in Lombardy is 23 days if he had a transit through the ICU, and 14 days if not, 3-5 it is expected that in the next 2-3 months all hospitals in the region will have dedicated resources and wards for this disease.
cord-291566-jwlvustd	2020	This paper summarizes clinician reports on these changed processes, including overall nutrition care, nutrition assessment, enteral nutrition and parenteral nutrition care steps, and food and oral supplement delivery. Experience and research on nutrition support therapy in patients with COVID-19 has brought about new healthcare practice processes that include telemedicine, personal protective equipment (PPE), and exposure limitations. Inpatient nutrition support clinicians working from home have found it challenging to be involved in patient care rounds. Nutrition clinicians are also using telephone or video conferencing to round with the primary medical teams to see patients together and limit going into patients'' rooms to minimize COVID-19 exposure. Some dietitians are reporting that patients with COVID-19 infections are in negative-pressure rooms, and therefore they do not need to wear entire PPE on the patient care unit, which allows them greater access to other healthcare professionals.
cord-291588-tp89j1kk	2020	During the current pandemic, 370 patients with SARS-CoV-2 infection out of 37 studies (Table 3) were reported to suffer from AIS or transient ischemic attack (TIA). (145) Acute Necrotizing Encephalopathy(ANE) which was reported in 8 patients (Table 3) with COVID-19 is a distinct entity defined as rapid onset of neurological symptoms often secondary to a viral infection such as herpes viruses and influenza. Clinical findings in a group of patients infected with the 2019 novel coronavirus (SARS-Cov-2) outside of Wuhan, China: Retrospective case series Evolution and resolution of brain involvement associated with SARS-CoV2 infection: A close Clinical -Paraclinical follow up study of a case EEG Findings in Acutely Ill Patients Investigated for SARS-CoV-2/COVID-19: A Small Case Series Preliminary Report. Guillain-Barré syndrome in a patient infected with SARS-CoV-2, a case report Guillain-Barré Syndrome as a Neurological Complication of Novel COVID-19 Infection: A Case Report and Review of the Literature
cord-291624-fod0eyuj	2020	We propose that the principal famotidine mechanism of action for COVID-19 involves on-target histamine receptor H (2) activity, and that development of clinical COVID-19 involves dysfunctional mast cell activation and histamine release. Patients with COVID-19 disease can present with a range of mild to severe non-speci c clinical signs and symptoms which develop two to fourteen days after exposure to SARS-CoV-2. The most likely mechanisms of actions include: via antiviral activity, via novel human targets, or via the on-target mechanism described in the current FDA market authorization-famotidine is a histamine receptor H 2 antagonist (and inverse agonist). To assess the possibility that famotidine may inhibit SARS-CoV-2 infection by other routes, a Vero E6 cell-based assay was performed to compare median tissue culture infectious doses (TCID50/mL) of famotidine, remdesivir, and hydroxychloroquine ( Figure 2 ). In both of these studies, the observed non-in ammatory edema in early-stage COVID-19 pulmonary disease is consistent with histamine release by mast cells.
cord-291670-mqj071gp	2020	-Pressure-control ventilation mode is optimal and assumed for this design -Pressure readouts on the ventilator screen reflect unmodified pressures delivered by the ventilator, and are not representative of what each patient is seeing -PIP and PEEP for each patient are obtained by adding/subtracting each patient''s valve settings from displayed ventilator settings -see below -Tidal volume readout on the ventilator is total tidal volume for both patients -Additional monitors may be deployed in-line for each patient, to measure tidal volumes and airway pressures individually and in real time -FIO2 and respiratory rate are the same for both patients -Tidal volumes will differ for each patient, depending on PIP, PEEP and lung compliance -A short circuit from the ventilator outflow to ventilator inflow is necessary to avoid triggering of circuit occlusion alarm and to allow ventilator bias flow -Because of changes to the expected circuit, ventilator alarms will not always work as expected, and an alternate alarm strategy must be employed (see discussion below)
cord-291686-kgewmqg5	2020	Moreover there is lack of sufficient data regarding impact of COVID-19 on post operative outcomes in patients who were infected with novel coronavirus and underwent cardiac and thoracic procedures. Peng et al 3 reported that patient who underwent thoracic surgery at the time of pandemic and later found to be affected with the novel coronavirus had greater than anticipated incidence of severe illness as well as case fatality rate, thus emphasizing the importance of correct triage and prioritizing cases to be considered for cardiac and thoracic surgery. 14 American college of surgeons has defined triage guidelines for vascular surgery patients, 8 and have provided guidelines regarding whether to postpone or not, vascular surgical procedures including, ascending aortic aneurysm, peripheral aneurysms, aortic dissection, mesenteric ischemia, peripheral vascular disease, trauma, venous thromboembolism, and amputation of limbs (Table 2) .
cord-291687-kwu0otpi	2020	A review of 44,672 confirmed COVID-19 cases from Wuhan, China, demonstrated increased mortality in patients with cardiovascular disease (10.5%), diabetes (7.3%), and hypertension (6%), which was significantly higher than the overall case-fatality rate of 2.3% [22] . These initial cases series have shown a similar relationship between underlying cardiac comorbidities with a higher prevalence of hypertension, diabetes, coronary artery disease, and obesity in patients requiring mechanical ventilation [24] . Early studies reported a prevalence of acute cardiac injury of 12% in the entire cohort as defined by either high sensitivity troponin (Hs Tn) or the MB fraction of creatinine kinase (CK-MB) [ 99 th percentile or new echocardiographic or electrocardiographic abnormalities with greater elevations in cardiac biomarkers among patients requiring ICU care [1, 20] . Case cohort studies included data in patients for whom the outcome and illness course helped further elucidate the role of cardiac injury in COVID-19 disease.
cord-291697-wpnq9wc0	2020	RESULTS: Overall and tumour-specific recommendations were made by stage (including surgical, locoregional, radiotherapy, systemic treatments and follow-up strategies) for the most common gastrointestinal malignancies: esophagus, gastric, pancreas, bile duct, hepatocellular, colorectal, anal cancer and neuroendocrine tumours. All the recommendations proposed in this manuscript, besides being evidencebased, aimed at the following objectives: (1) to prioritise curative-intent cancer treatments during the pandemic; (2) to support the treatment of aggressive tumours when effective therapies are available; (3) to decrease the number of or delay oncological non-priority surgeries; (4) to decrease hospital visits (e.g., substitute intravenous for similarly effective oral drugs; propose when and to whom treatments delays/ interruption/watchful waiting can be offered); (5) to minimise anticancer therapy-related immunosuppression in specific high-risk groups (here defined as: elderly, comorbid illnesses [especially diabetes, cardiovascular and/or pulmonary concurrent diseases], fragility, ECOG 2 or higher).
cord-291855-wtwz94sy	2020	title: Ethical Criteria for the Admission and Management of Patients in the ICU Under Conditions of Limited Medical Resources: A Shared International Proposal in View of the COVID-19 Pandemic According to the above, we propose the following five ethical criteria for the triage of patients in conditions of limited resources, such as the COVID pandemic. It is rooted in the idea of human dignity, which gives birth to the humanitarian imperative conveyed in the first core principle of "disaster medicine"; the common good also means that, in a Global Health framework, patients are not just isolated individuals but persons with strong ties to their communities, and therefore both patient and community need to be taken into account (5); (b) no one must be abandoned or discriminated against for any reason (6); (c) before denying a necessary referral of a patient to an ICU, due to lack of resources, it is required to consider alternatives both for the immediate case and, based on the experience gained, for similar future cases.
cord-291873-inzzywps	2020	To diminish the risk of contamination, some healthcare facilities, included our hospital, were assigned as referral regional care centre for COVID-19 patients. According to our recent experience, we share a series of measures to prevent the nosocomial transmission of the disease and to reduce the risk of contamination for patients, caregivers and administrative staff. The triaging system screens patients through temperature measurements, and a questionnaire about upper respiratory symptoms, fever, myalgia and anosmia, domicile or travelling in hot areas, and contact history with confirmed or suspected COVID-19 patients within the past 14 days. Patients who meet one of these criteria are addressed to a separate controlled circuit to test for COVID-19 positivity. In our practice, patients with an urgent surgical condition (such as retinal detachment, endophthalmitis, open globe trauma and sight-threatening uncontrolled ocular pressure) are first screened for COVID-19. Precautionary measures needed for ophthalmologists during pandemic of the coronavirus disease 2019 (COVID-19)
cord-292054-x0saq938	2020	Given physiological roles of IL-6 in inflammatory conditions and the data from real world, IL-6 signal inhibitors, along with standard of care (SOC) treatment, might provide efficacy, offering the potential to treat COVID-19 in hospitalized populations more effectively than current SOC alone. Therefore, on-going and planned randomized placebo-controlled studies in combination with SOC and other therapeutics to assess safety and efficacy of IL-6 signal inhibitors in hospitalized patients with severe COVID-19 pneumonia will be warranted to address the high unmet need and burden of disease in this severely ill population. Elevated tissue and serum levels of IL-6 have been implicated in the disease pathology of several inflammatory and autoimmune disorders including multiple myeloma, Crohn''s disease, rheumatoid arthritis (RA), Castleman disease, systemic juvenile idiopathic arthritis (sJIA), polyarticular juvenile idiopathic arthritis (pJIA), adult-onset Still''s disease (AOSD), ankylosing spondylitis, psoriatic arthritis, systemic lupus erythematosus, giant cell arteritis (GCA), Takayasu arteritis (TAK), systemic sclerosis, and cytokine-release syndrome (CRS), and targeting of the IL-6 pathway has led to innovative therapeutic approaches for various rheumatic conditions such as RA, JIA, AOSD, GCA, TAK, and others such as Castleman disease or chimeric antigen receptor (CAR) T cell-induced CRS [2] .
cord-292056-dtdyxhq4	2020	Second, the neurosurgery workflow was changed dramatically by the cancellation of elective surgery cases in order to increase hospital capacity for future COVID-19 patients. In most hospitals, all interventional spine procedures have been postponed to decrease patient exposure to COVID-19 and allow surgeons to focus their efforts on the treatment of patients who require urgent care. As more patients are admitted to hospitals with active COVID-19 infections, the risk of exposure for spinal surgeons increases. While caring for COVID-19-positive patients who might need emergency spine surgery, all personnel are required to wear N95 masks and no personnel other than the anesthesiologist are allowed in the OR for 30 minutes following intubation. As elective surgery has been reduced in hospitals, many spinal surgeons have been asked to participate in the care of medical patients. Having models to compensate physicians and hospitals for the effective use of telehealth will be one positive aspect of this crisis, which has provided many opportunities for new learning.
cord-292094-vmsdhccp	2007	Severity-of-illness scores, such as the CURB-65 criteria (confusion, uremia, respiratory rate, low blood pressure, age 65 years or greater), or prognostic models, such as the Pneumonia Severity Index (PSI), can be used to identify patients with CAP who may be candidates for outpatient treatment. A respiratory fluoroquinolone should be used for penicillin-allergic patients.) Increasing resistance rates have suggested that empirical therapy with a macrolide alone can be used only for the treat-ment of carefully selected hospitalized patients with nonsevere disease and without risk factors for infection with drug-resistant pathogens. Advantages include the high specificity, the ability of some assays to distinguish between influenza A and B, the rapidity with which the results can be obtained, the possibly reduced use of antibacterial agents, and the utility of establishing this diagnosis for epidemiologic purposes, especially in hospitalized patients who may require infection control precautions.
cord-292315-7vwybku8	2020	Then, an ordinal scale of relative privacy risk levels was introduced for evaluation, and the assessment was performed on the personal information included in the contact trace data, such as demographics, significant places, sensitive information, social relationships, and routine behaviors. As shown in Table 2 , the released contact trace data included (1) the patient''s demographics (i.e., nationality, gender, age, and residence), (2) infection information (i.e., infection route and confirmation date), and (3) travel log in time series (e.g., transport modes and visited places). The codebook has an ordinal scale of privacy risk levels and the scale quantifies relative risks from five major categories: demographics (nationality, gender, age), significant places (residence, workplace), sensitive information (hobby, religion, accommodation), social relationships, and routine behavior. In particular, the data from Sejong revealed the most detailed information on significant places (the average privacy risk levels for residence and workplace in Sejong were over level 3), whereas Ulsan showed a relatively high percentage of data disclosure on social relationships (i.e., 72.4% of the confirmed patients in Ulsan).
cord-292335-al6v3b9x	2015	METHOD: This was a single-center retrospective cohort study to evaluate the impact of antibacterials in viral pneumonia on clinical outcomes and subsequent multidrug-resistant organism (MDRO) infections/colonization. CONCLUSION: This study found that long-course antibacterial use in the setting of viral pneumonia had no impact on clinical outcomes but increased the incidence of subsequent MDRO infection/colonization. The relationship between viral and bacterial respiratory infections creates a difficult situation for clinicians determining the appropriate use of antimicrobials as they treat hospitalized patients with pneumonia while also trying to minimize the development and selection of resistant organisms. This study aimed to describe the use of continued empiric antibacterials in patients with known viral pneumonia and to determine the impact of such therapies on subsequent bacterial infections/colonization and clinical outcomes. This study compared a cohort of 174 patients with viral pneumonia and mixed viral-bacterial infection based on exposure to continued empiric antibacterials after respiratory virus identification.
cord-292345-zc209dfx	2020	Although it has been noted that COVID-19 may increase risk for acute cerebrovascular events, including both ischemic and hemorrhagic stroke [2] , to our knowledge, this is the first report of patients with COVID-19 who had catastrophic intracranial hemorrhages. To address this, Thachil noted that use of anticoagulation in patients with elevated D-dimers may decrease mortality by both preventing thrombi and dampening the inflammatory response triggered by COVID-19 [7] . Thus, at our center, it was decided that therapeutic anticoagulation should be initiated empirically for patients with COVID-19 who have a D-dimer > 10,000 ng/ mL and considered for patients who have a D-dimer between 2000 and < 10,000 ng/mL using treatment dose enoxaparin or heparin titrated to a low therapeutic anti-Xa goal of 0.3-0.5 U/mL.
cord-292350-cmrtg91a	2020	Table 1 & 2 summarize the various thrombotic complications noted in COVID-19 patients as published as of June 6 th , 2020 obtained by a literature search on PubMed and EMBASE using combinations of the following MeSH terms: COVID-19, SARS-COV2, novel corona virus, thrombosis, thromboembolic complications, pulmonary embolism. Clinical signs and symptoms of thrombosis such as cutaneous manifestations ("COVID toe") [84] , overt line thrombosis, arterial or venous clots, unexplained increase in oxygen requirement, or organ dysfunction should raise suspicion and prompt further investigation and/or discussion about therapeutic intervention [7] As new information becomes available, it appears increasingly important to routinely monitor platelet count, PT/aPTT, d-dimer, and fibrinogen to assist in anticipating and managing thrombotic complications. ICU patients positive for COVID-19 with elevated d-dimer levels and/or clinico-radiological suspicion for thrombosis as noted above should be considered for therapeutic anticoagulation only after careful assessment of their bleeding risk.
cord-292387-2xv3wgaq	2020	Approximately 2 months after the COVID-19 outbreak in Lombardy and 50 days into national lockdown, we began to hospitalize patients with brief psychotic episodes at a remarkable rate. We report a case series of all consecutive patients admitted to the 2 psychiatric inpatient units of the San Paolo University Hospital who were discharged with a diagnosis of BPD during the COVID-19 pandemic lockdown in Milan, Italy (March 9 to May 18). In order to standardize the evaluation criteria, the following set of instruments was employed: the Brief Psychiatric Rating Scale (BPRS) 20 was performed as a global measure of psychopathology upon admission and at discharge; the presence of stressful life events in the 12 months before the lockdown was assessed using Paykel''s interview for recent life events 21 ; the Structured Clinical Interview for DSM (SCID-II) 22 was performed to evaluate the presence of a personality disorder; and the Temperament and Character Inventory-240 items (TCI-240) 23 was administered to investigate personality dimensions.
cord-292394-91b3mm6c	2020	The use of Continuous Positive Airway Pressure (CPAP) in patients with COVID-19 has now become established as a common clinical practice based on recent experience. Using routinely collected data, the use of CPAP as a supportive non-invasive ventilatory treatment is described in 35 patients with COVID infection. Although the analysis is affected by a small sample size, the results have shown good evidence that supports the early use of CPAP in patients with COVID-19 infection. . https://doi.org/10.1101/2020.05.28.20116152 doi: medRxiv preprint indicates a preference for early CPAP clinical strategy when treating patients with COVID-19. At this early stage in the treatment of COVID-19 respiratory infections the evidence presented supports the early use of CPAP in such patients. Continuous positive airway pressure and noninvasive ventilation in prehospital treatment of patients with acute respiratory failure: a systematic review of controlled studies
cord-292474-dmgd99d6	2020	As the Italian National Institute for the Infectious Diseases, we have hospitalized the first Italian COVID-19 patients and since then, our general surgery department had to face this reality [16] . Pancreatic resections, total gastrectomies, major hepatectomies, and multivisceral resections as well as liver and kidney transplantations were considered as the high-risk surgical procedures because of the increased likelihood of postoperative ICU admission. On January 31, 2020 (Day 0), the first two COVID-19-positive patients in Italy were admitted to the department of infectious diseases of our hospital with mild fever and atypical pneumonia requiring no invasive treatment. Considering only the transplantations and the operations performed for cancer, patients in the second period had fewer comorbidities, lower ASA score, CCI, and RCRI, being overall at lower risk of postoperative ICU admission (Table 3) . As an institutional policy, our transplant center remained opened and we decided to continue with our standard surgical oncology activity, improving selection of patients to limit the need for postoperative intensive care management.
cord-292485-vk5xy3zn	2020	We aimed to analyze the effect of lockdown imposed due to COVID-19 pandemic on the care of patients with kidney diseases in India. METHODS: We surveyed 19 major hospitals (8 in public and 11 in private sector) to determine the effect of lockdown on the care of patients with kidney disease, including those on dialysis after the first 3 weeks of lockdown. CONCLUSION: Lack of preparedness before lockdown resulted in an interruption in health care services and posed an immediate adverse effect on the outcome of dialysis and kidney disease patients in India. This survey clearly demonstrates the impact of the COVID-19 pandemic and lockdown on the care of patients with kidney diseases in India, a low-middle income country. In many private hospitals, services were affected due to lockdown restrictions, lack of internal protocols to handle the pandemic, fear of infection to medical staff, and an unwillingness to risk the business from non-COVID patients (22).
cord-292493-lx7zfgoi	2020	Few specific guidelines are available to outline the steps necessary to adequately maintain appropriate isolation precautions in patients who require emergent surgical interventions and who are either confirmed SARS-CoV2 or who are awaiting the results of testing. The purpose of this discussion is to outline the steps our U.S. institution undertook in managing a patient who required emergent cardiac surgery for an acute aortic syndrome who was presumptively infected, and did test positive on post-operative day two. Given the findings of pulmonary infiltrates, upon admission, he was placed in strict droplet and contact precautions in a negative air-flow Intensive Care Unit (ICU) room as a potential COVID-2019 case. Written surgical and anesthesia consent was obtained by the operating surgeon and anesthesiologist wearing appropriate personal protective equipment (PPE) that included N-95 mask, face shield, gown, and gloves).
cord-292561-iy06b9h9	2020	The novel coronavirus infection (COVID-19) is caused by the new coronavirus SARS-CoV-2 and is characterized by an exaggerated inflammatory response that can lead to severe manifestations such as adult respiratory syndrome, sepsis, coagulopathy, and death in a proportion of patients. 5 While most patients show only mild symptoms, 6 a characteristic feature of COVID-19 is that a proportion of patients develop severe complications within a short time after infection, such as adult respiratory syndrome (ARDS) or disseminated intravascular coagulation (DIC), sepsis followed by organ failure, and death. 15 These laboratory changes are consistent with previous studies which showed that hypoalbuminemia, lymphopenia, and C-reactive protein 4 mg/dL were the predictive factors for the progression of pneumonia to respiratory failure in MERS-CoV-infected patients and that elevated lactate dehydrogenase (LDH) levels were associated with hospital-acquired infection with SARS-CoV.
cord-292620-t8ocqm6g	2020	Methods and Findings: Retrospective cohort study of patients with confirmed SARS-CoV-2 discharged alive from five hospitals in New York City with index hospitalization between February 27th-April 12th, 2020, with follow-up of [≥]14 days. Of 2,864 discharged patients, 103 (3.6%) returned for emergency care after a median of 4.5 days, with 56 requiring inpatient readmission. Patients who returned had higher proportion of COPD and hypertension with shorter LOS on index hospitalization, and a trend towards lower rates of in-hospital treatment-dose anticoagulation. . https://doi.org/10.1101/2020.05.17.20104604 doi: medRxiv preprint Certain index hospitalization laboratory values on discharge differed among patients who returned vs. Finally, returning patients had shorter LOS on index hospitalization with notably a lower frequency of ICU care and inpatient anticoagulation. Among patients discharged following admission for COVID-19, the rate of return to hospital was relatively low, with only half requiring readmission.
cord-292826-lus0tqmi	2020	Injury 51 (2020) [1245] [1246] Contents lists available at ScienceDirect Injury journal homepage: www.elsevier.com/locate/injury Editorial Trauma care in a low-COVID pandemic environment: A new normal A pandemic is defined as an outbreak of a disease that spreads quickly over a wide geographical area and infects a high proportion of a population. As we have seen with the current COVID-19 pandemic, some countries have managed to control spread early (eg Taiwan, Singapore, New Zealand and Australia) by immediate action involving physical distancing, widespread testing, contact tracing, isolation of positive cases and supportive treatment. Current recommendations [5] for the management of injured patients in a COVID-19 environment include bypassing the Emergency Department for uncomplicated injuries, minimising invasive procedures, in particular those that are AGPs, and providing surgical treatment that is only absolutely essential. Editorial / Injury 51 (2020) [1245] [1246] The COVID 19 pandemic presents challenges for trauma clinicians with the ongoing risk of virus transmission for both patients and clinical staff which will need to be managed over the coming months or longer.
cord-292856-7hjzzxtm	2012	The main complications reported in hospitalized adults with influenza A(H1N1)pdm09 were pneumonia (primary influenza pneumonia and concomitant/secondary bacterial pneumonia), exacerbations of chronic pulmonary diseases (mainly chronic obstructive pulmonary disease and asthma), the need for intensive unit care admission (including mechanical ventilation, acute respiratory distress syndrome and septic shock), nosocomial infections and acute cardiac events. The main complications reported in hospitalized adults with influenza A(H1N1)pdm09 were pneumonia (primary influenza pneumonia and concomitant/secondary bacterial pneumonia), exacerbations of chronic pulmonary diseases (mainly chronic obstructive pulmonary disease and asthma), the need for intensive unit care admission (including mechanical ventilation, acute respiratory distress syndrome and septic shock), nosocomial infections and acute cardiac events. 6, 34, 35 Chronic pulmonary diseases, mainly COPD and asthma, are frequent comorbidities reported in hospitalized patients with influenza A(H1N1)pdm09 virus infection.
cord-292952-z7ajsf2r	2020	One of the repercussions of promotion of medications/treatments prior to the results of large robust clinical trials being available is that people may start to self-medicate and potentially overdose. As emergency doctors, we need to be able to tease out the disease process of COVID-19 from potential side effects of trial medications or overdose of these. A small (n = 42), non-randomised open label trial showed decreased viral load in patients receiving hydroxychloroquine (600 mg daily for 10 days) and azithromycin. Hydroxychloroquine and azithromycin as a treatment of COVID-19: results of an open-label non-randomized clinical trial No evidence of clinical efficacy of hydroxychloroquine in patients hospitalised for COVID-19 infection and requiring oxygen: results of a study using routinely collected data to emulate a target trial Effect of high vs low doses of chloroquine diphosphate as adjunctive therapy for patients hospitalized with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection: a randomized clinical trial
cord-293086-6282sb6b	2020	2 As a result, at present, the only central guidance comes from the ''COVID-19 Rapid Guideline'' issued by the National Institute for Health and Care Excellence (NICE), which recommends triaging admission to the ICU based on frailty assessments, but provides little concrete guidance on how to allocate or re-allocate ventilators once a patient is in the ICU. At present, the prognostic tools required to produce an effective decision support system (triage protocol) are lacking along with most of the infrastructure, processes, legal protections, and training for critical care triage.'' 13 It is difficult to attribute relative probabilities of survival to patients, or to anticipate length of bed stay, with a novel disease like COVID-19. Thus, if ventilation is clinically indicated, it is doubtful that doctors can Current controversy unilaterally decide to withhold care on the grounds that a scarce resource would be more effectively used on future (anticipated) patients.
cord-293143-1k170shh	2016	A clinical case of fatal HBoV infection in an adult cystic-fibrosis patient awaiting lung transplantation is reported. A clinical case of fatal HBoV infection in an adult cystic-fibrosis patient awaiting lung transplantation is reported. The human bocavirus (HBoV) is a parvovirus that is associated with acute and chronic infections of the upper and lower respiratory tract, persists in some tissues and solid cancers and putatively may play an aetiologic role in the development of idiopathic lung fibrosis [1] [2] [3] [4] [5] [6] [7] [8] . To date, no animal model exists, thus studies on the pathology of HBoV infections are limited to clinical studies, case descriptions, and air-liquid interface cell culture models that have been shown to mimic some important steps of the infection cycle [1, 7, [10] [11] [12] .
cord-293167-3bd3adip	2020	Most patients infected by SARS-CoV-2 have presented with a mild clinical course: beginning with fever and dry cough, progressing to a form of mild or moderate respiratory disease, and resolving without specific treatment [2] . A retrospective observational study from Wuhan, China, reported that six (2.8%) patients, out of the 214 reviewed COVID-19 cases, developed ischemic stroke. A retrospective observational study from a different center in Wuhan, China, found eleven (5.0%) patients, out of 221 reviewed COVID-19 cases, developed acute ischemic stroke. Those who had COVID-19 infection with new onset of ischemic stroke were more likely to have a severe SARS-CoV-2 presentation, an advanced age (71.6 ± 15.7 years versus 52.1 ± 15.3 years), and preexisting cardiovascular risk factors including hypertension, diabetes, and previous cerebrovascular disease. A retrospective observational study from Wuhan, China, reported one (0.45%) patient, out of 221 reviewed COVID-19 cases, who developed intracerebral hemorrhage.
cord-293180-f1ulk9ce	2004	Special management protocols and modified measures that regulate droplet and aerosol contamination in a dental setting have to be introduced and may include the reduction or avoidance of droplet/aerosol generation, the disinfection of the treatment field, application of rubber dam, pre-procedural antiseptic mouthrinse and the dilution and efficient removal of contaminated ambient air. In the first part of this two-part article an account of the epidemiology, virology, pathology and management of Severe Acute Respiratory Syndrome (SARS) was provided together with public health issues and general aspects of infection control. On the other hand smaller droplets (or aerosols, generally under 10 µm in size) or small-particle residue of evaporated droplets are usually airborne and are entrained in the air for a lengthy period • SARS is a highly infectious disease and dental personnel are likely to be at risk because of the nature of their profession, working in close proximity to the patient.
cord-293285-w8c3ma8l	2020	title: Reflection on passive immunotherapy in those who need most: some novel strategic arguments for obtaining safer therapeutic plasma or autologous antibodies from recovered COVID ‐19 infected patients In this mini-report we propose three potential additional options as the source of such autologous Ab and provide some operational arguments, on evidence based to support implementation such strategic approaches urgently for those in need to save lives: a] the use of hyperimmune immunoglobulin concentrates, which derives from plasma of physiologically immunized donors. However, in western countries the use of convalescent plasma and related strategies may become a reality provided that our hospitals will recommend obtaining an informed consent from recovered COVID-infected patients in order to collect and store their FFP and their derived bioproducts. Use of convalescent whole blood or plasma collected from patients recovered from Ebola virus disease for transfusion, as an empirical treatment during outbreaks
cord-293333-mqoml9o5	2020	The second local model refers to a single node of the health system network, i.e. it models the flows of patients with a smaller granularity at the level of a regional hospital care center for COVID-19 infected patients. In particular apart the high transmission rate, other two aspects were immediately pointed out by the physicians which did strongly influence the diffusion of the disease and the medical resources: first it was estimated that a large delay of time (10 to 14 days) is present between the moment in which a person becomes infected and can infect, and the instant in which symptoms become evident and the person is isolated and sent to quarantine. The subsystem (2) consisting by I q , R and D q is then further discussed in Section 4: a group of people who are aware of their infection define the flow of admissions in a local hospital and are split into two populations, the patients admitted in conventional hospitalization and the patients admitted in intensive care.
cord-293472-d3iwlpsr	2012	During influenza season (testing should be done in the following persons if the result will influence clinical management) Outpatient immunocompetent persons of any age at high risk of developing influenza complications (eg, hospitalization or death) presenting with acute febrile respiratory symptoms 5 days or less after illness onset (when virus is usually being shed) Outpatient immunocompromised persons of any age presenting with febrile respiratory symptoms, irrespective of time since illness onset (because immunocompromised persons can shed influenza viruses for weeks to months) Hospitalized persons of any age (immunocompetent or immunocompromised) with fever and respiratory symptoms, including those with a diagnosis of community-acquired pneumonia, irrespective of time since illness onset Elderly persons and infants presenting with suspected sepsis or fever of unknown origin, irrespective of time since illness onset Children with fever and respiratory symptoms presenting for medical evaluation, irrespective of time since illness onset Persons of any age who develop fever and respiratory symptoms after hospital admission, irrespective of time since illness onset Immunocompetent persons with acute febrile respiratory symptoms who are not at high risk of developing complications secondary to influenza infection may be tested for purposes of obtaining local surveillance data
cord-293522-gg706q8s	2020	title: Commentary on "Hydroxychloroquine and azithromycin as a treatment of COVID-19: results of an open label non-randomized clinical trial" by Gautret et al The results of a clinical trial comparing hydroxychloroquine with or without azithromycin to the standard of care for the treatment of COVID-19 were recently published by Philippe Gautret et al. This study provides outstanding results for the combination of hydroxychloroquine and azithromycin over the standard of care, but the evidence was deemed insufficiently robust to warrant a public health decision to widen the use of hydroxychloroquine for the treatment of COVID-19. The results of a clinical trial comparing hydroxychloroquine with or without azithromycin to the standard of care for the treatment of COVID-19 were published in the International Journal of Antimicrobial Agents by Philippe Gautret et al. The US Centers for Disease Control and Prevention provides information on the use of hydroxychloroquine and chloroquine in the USA to treat coronavirus 2infected patients.
cord-293547-29i3u83s	2020	RESULTS: Based on diagnostic and treatment standards developed by EAACI, on international information regarding COVID‐19, on guidelines of the World Health Organization (WHO) and other international organizations as well as on previous experience, a panel of experts including clinicians, psychologists, IT experts and basic scientists along with EAACI and the "Allergic Rhinitis and its Impact on Asthma (ARIA)" inititiative have developed recommendations for the optimal management of allergy clinics during the current COVID‐19 pandemic. CONCLUSIONS: This international Position Paper provides recommendations on operational plans and procedures to maintain high standards in the daily clinical care of allergic patients whilst ensuring necessary safety in the current COVID‐19 pandemic. In the current SARS-CoV-2 pandemic, the European Task Force on Atopic Dermatitis (ETFAD) recommends to continue all immune-modulating treatment since exacerbations of underlying diseases can have a large negative impact on the patient''s immunity [30] .
cord-293570-gh6ykmea	2020	Renal biopsy findings in hospitalized COVID-19 patients presenting solely with acute kidney injury (AKI) have recently been described in published literature in few case reports. We herein describe two cases where the patients presented primarily with nephrotic syndrome with a temporal association with COVID-19; the two renal biopsies showed two different histologic lesions on light microscopy (at least on initial biopsy) with diffuse podocytopathy as the sole ultrastructural lesion for both cases. BP was controlled to 128/84 mmHg. Follow-up: Two subsequent COVID-19 RT-PCR tests came back negative on the 4th and the 5th of May. He was commenced on oral prednisone 60 mg a day on the 8th of May. Unfortunately, there was no response to high-dose steroids and the patient continued to have nephrotic-range proteinuria and worsening renal function.
cord-293575-h3wc7j4v	2020	Univariate Cox model for survival analysis by smoking status showed that among smokers only current smokers had higher risk of death compared with never smokers (HR 1.61, 95% CI 1.22 to 2.12, p<0.001). CONCLUSION: In our large single-centre retrospective database of patients hospitalised with COVID-19, smoking was associated with development of critical illness and higher likelihood of death. Our hospital is located in New York City where 13.1% of the Key Messages ► Does the smoking status affect outcomes of hospitalised patients with COVID-19. We included adult patients (aged 18 and above) with known smoking status who were hospitalised with COVID-19 for whom severity of illness could be established and had final disposition status at the time of the study. Use of tocilizumab was suggested in patients with evidence of disease progression (defined as worsening respiratory status or radiographic findings) and increasing inflammatory markers early in their acute COVID-19 illness.
cord-293634-4rryqbnu	2020	Based on the algorithm, COVID-19 inpatients were selected to receive telerehabilitation if they could ambulate independently, could use technology, had stable vital signs, required minimal supplemental oxygen, and were cognitively intact. The purpose of the inpatient telerehabilitation PT program for COVID-19 patients was to safely assess barriers to discharge, deliver patient education, and provide a home exercise program (HEP) all while minimizing staff exposure. Success of the inpatient telerehabilitation program was determined based on the ability to create an algorithm, train staff, deliver education efficiently, maintain patient and staff safety during interventions, and ensure patients discharged home safely. Despite these limitations, we believe that this retrospective review provides preliminary data on how to implement an inpatient telerehabilitation program and suggests that selected COVID-19 patients can be discharged successfully after this method of treatment.
cord-293704-tnik6sd3	2020	There is a higher risk of mortality of COVID-19 in cancer patients and hence unique considerations for a radiation oncology department operating in an infectious disease outbreak. There is a higher risk of mortality of COVID-19 in cancer patients and hence unique considerations for a radiation oncology department operating in an infectious disease outbreak. This includes interventions, business continuity plans and workflow in managing a COVID-19 positive patient on radiotherapy. With the evolving COVID-19 outbreak, there needs to be provisions and policies to ensure continuity of radiation oncology services. There should be provisions within the department such that continuity of radiation oncology services will not be impacted as there is possibility of staff managing confirmed cases and therefore needs to be self-quarantined at home. Nonetheless, radiation oncology departments can act to better position themselves to continue radiotherapy services in the face of resource limitations brought on by the outbreak, as well as to protect staff and patients.
cord-293730-dlqo6fep	2020	Information on age, sex, education, clinical characteristics including dementia diagnosis, dementia severity by Clinical Dementia Rating scale (CDR) [6] , Mini Mental State Examination (MMSE) [7] , and Basic Activity of Daily Life (BADL) [8] , walking, total number of chronic diseases and type of diseases among a pre-defined list (hypertension, COPD, renal disease, heart disease, cancer, gastrointestinal diseases, hepatic disease, diabetes, thyroid disorders, arthritis), number of drugs, and flu vaccination were obtained from previous medical records based on the last recorded visit at CDCD. Findings from our study showed that COVID-19 affected over 10% of home-dwelling older patients with dementia who showed high risk of adverse outcomes, such as unplanned hospitalization and mortality. Findings of this study are in line with previous reports [10] [11] [12] and add new insight by showing that COVID-19 exerted a relevant impact on health status of home-dwelling elderly patients with dementia determining a high rate of hospitalization and mortality.
cord-293740-4c3yemi3	2020	METHODS: This is a multicenter, prospective, observational study in consecutive, mechanically ventilated patients with ARDS (as defined by the Berlin criteria) affected with with COVID-19 (confirmed SARS-CoV-2 infection in nasal or pharyngeal swab specimens), admitted to a network of 36 Spanish and Andorran intensive care units (ICUs) between March 12 and June 1, 2020. [temperature, mean arterial pressure (MAP), heart rate], laboratory parameters (blood test, coagulation, biochemical), ventilatory parameters [tidal volume (VT), inspiratory oxygen fraction (FiO 2 ), respiratory rate (RR), PEEP, plateau pressure (Pplat), driving pressure (DP), respiratory system compliance (Crs)], the use of adjunctive therapies [recruitment maneuvers (RM), prone position, neuromuscular blocking agents (NMBA), extracorporeal membrane oxygenation (ECMO)], pharmacological treatments, disease chronology [time from onset of symptoms and from hospital admission to initiation of mechanical ventilation (MV), ventilator-free days (VFDs) during the first 30 days, ICU length of stay (LOS)].
cord-293852-r72c6584	2020	Different studies found that the values of cardiac Troponins were increased in COVID-19 patients with more severe disease [4, 5, [68] [69] [70] , indicating an association of SARS-CoV-2 with myocardial damage. Moreover, the single-cell RNA-sequencing (scRNAseq) approach has been used to profile the SARS-CoV-2 host-response in the PBMCs of COVID-19 patients, and to comprehensively characterize the immunological changes [124] [125] [126] [127] [128] [129] [130] . However, SARS-CoV-2 infection of human induced pluripotent stem cell-derived cardiomyocytes (iPSC-CMs) induced cytotoxic effects and RNA-seq findings highlighted significant transcriptional changes in gene pathways related to cellular metabolism and immune response [131] [132] [133] . This analysis also revealed several host-derived lncRNAs differentially expressed in COVID-19 patient-derived lung tissue, and in SARS-CoV-2 infected epithelial cells, including MALAT1 (metastasis-associated lung adenocarcinoma transcript 1) and NEAT1 (nuclear-enriched autosomal transcript 1) [151] (Fig. 5) .
cord-293922-knzv4jvj	2020	Results: We found markedly elevated levels of tPA and PAI-1 among patients hospitalized with COVID-19. Conclusion: While both tPA and PAI-1 are elevated among COVID-19 patients, extremely high levels of tPA enhance spontaneous fibrinolysis and are significantly associated with mortality in some patients. These data indicate that fibrinolytic homeostasis in COVID-19 is complex with a subset of patients expressing a balance of factors that may favor fibrinolysis and suggests that further study of tPA as a potential biomarker is warranted. Utilizing established Luminex platforms, we measured total PAI-1 and tPA levels in the plasma of 118 patients hospitalized with COVID-19 and 30 healthy controls. Elevated PAI-1 and its associated hypofibrinolytic state were observed in the 2002 SARS-CoV epidemic [22] , while recent characterizations of COVID-19 patients have suggested impaired global fibrinolysis [16, 23] . Interestingly, in our large cohort of hospitalized COVID-19 patients, we observed elevated levels of not only PAI-1, but also tPA.
cord-293964-hz5uow2b	2020	Infection with the Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV2), hereafter referred as COVID-19, often affects patients with chronic health conditions and takes a more severe course in patients with comorbidities such as cardiovascular disease, diabetes mellitus, and obesity. Within two days after admission for rehabilitation all patients were assessed with questionnaires, such as Chronic Respiratory Questionnaire (CRQ), Hospital Anxiety and Depression Scale (HADS), and Cumulative Illness Rating scale (CIRS) and Functional Independence Measure (FIM). To measure changes during rehabilitation, functional assessments with 6-minute walk test (6-MWT) and Feeling Thermometer (FT) were performed on admission and before discharge. Exercise capacity was measured at hospital admission and discharge using the 6-min walk test (6-MWT), performed once at the beginning and once at the end of the CR program after 20 days, according to the guidelines of the American Thoracic Society (ATS) and carried out by experienced, well-instructed examiners.
cord-294057-fbox3a5q	2020	It was divided into seven parts: (a) Sociodemographic and other information such as age, sex, current self-reported height and weight, occupational situation during the COVID-19 pandemic, and contact history with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), that is, current or previous own confirmed infection or infection of others (yes/no answers); (b) Overall impact of the COVID-19 pandemic on ED symptoms and general well-being, that is, deterioration of symptomatology and quality of life, adverse effects on therapy, incidence of new symptoms (5-point scale with 1 = strongly agree to 5 = strongly disagree); (c) Worries, for example, regarding infections, relapses, food insecurity, finances, and job (5-point scale with 1 = extremely worried to 5 = not at all worried); (d) General psychopathology and interpersonal conflicts (5-point scale with 1 = significantly worsened to 5 = significantly improved); (e) Specific ED symptoms and behaviours (5-point scale from 1 = significantly worsened/much more to 5 = significantly improved/much less); (f) Health care utilisation before and during the COVID-19 pandemic (yes/no answers); (g) Use and helpfulness of strategies as suggested by Fernandez-Aranda et al.
cord-294064-vdpak3fm	2020	title: Single centre concept of ''cold site'' elective surgery during the peak of COVID-19 pandemic: A cohort study Our hospital utilised local private hospital as a dedicated cold site (CS) for urgent elective surgery during the peak of the COVID-19 pandemic. CONCLUSION: Urgent elective surgery is safe and feasible during the COVID-19 pandemic if a dedicated cold site is available. A mortality of 19% has been reported in a recent study on 278 patients undergoing elective surgery who were diagnosed with COVID-19 peri-operatively (6) . This was a retrospective review of a prospectively maintained database of consecutive patients undergoing urgent elective surgery at the dedicated CS during the COVID-19 pandemic. J o u r n a l P r e -p r o o f J o u r n a l P r e -p r o o f ¨ This study reports findings of a dedicated cold site elective surgery during the peak of COVID-19 pandemic.
cord-294073-65h2mkdy	2020	We also recommend that each hospital should establish a group of diagnostic experts with responsibilities for risk stratification, especially for patients under investigation who need urgent surgery. • It is known that fever is one of the most common symptoms of COVID-19 and that patients with certain GI diseases (e.g. acute appendicitis, gastric perforation, intestinal obstruction) who required urgent care with emergency GI surgery often present with high fever as well. COVID-19-positive patients with GI bleeding with hemodynamic stability should undergo conservative treatments first, including angioembolization, before endoscopic treatment due to the high risk of endoscopy being an aerosol-generating procedure. For confirmed/high-risk COVID-19 patients and PUIs, diagnostic and therapeutic GI endoscopies should be performed in a negative-pressure room with Level Three precautions. For all surgical personnel involved in GI surgery for confirmed/ high-risk COVID-19 patients or for PUIs for COVID-19, we recommend the following protective measures (Figure 1 ).
cord-294079-px9c20il	2020	Consumption of CKRT resources can be made more efficient by optimizing circuit anticoagulation to preserve filters, extending use of each vascular access, lowering blood flows to reduce citrate consumption, moderating the CKRT intensity to conserve fluids, or running accelerated KRT at higher clearance to treat more patients per machine. Specifically, we aimed to: (i) develop projections regarding the demand for CKRT that are revised weekly in accordance with prevailing rates; (ii) improve efficiency of existing care practices to avoid future rationing; (iii) optimize stocks of consumables by trimming current consumption and diversifying sources, while preventing hoarding; (iv) ramp up clinical and nursing training but maintain realistic workforce awareness; and most importantly, (v) collaborate widely at a national and regional level, and stay in close communication despite the social disconnect forced by COVID-19 (Fig.1) .
cord-294108-uvnh0s9r	2020	[2, [8] [9] [10] This article discusses SARS-CoV-2 nanostructure, the virus biology in connection to its epidemiology, clinical manifestations, and potential and future therapeutic options including repurposed drugs, vaccine/protein therapies, immune therapies, and nanotherapeutics. Mechanisms such as inhibition of viral enzymes (DNA and RNA polymerases, 3CL pro, TMPRSS2, reverse transcriptase, neuraminidase, endonucleases, and other proteases) or processes such as ACE2 cellular receptor inhibitors and endosomal acidification mediators prohibiting viral fusion; molecules interfering with glycosylation of the viral protein, viral assembly, new viral particle transport, and release, and immunomodulation of cytokine release can be potential targets in developing various antiviral drugs for the SARS-CoV-2. [85] A randomized, placebo-controlled, Phase IV clinical trial assessing the safety and efficacy of umifenovir as an adjuvant therapy to the combined therapeutic regimen of IFN 1a, lopinavir/ritonavir and hydroxychloroquine in moderate to severe COVID-19 patients (NCT04350684) is underway.
cord-294139-78c5h7la	2020	The frequency of common comorbidities (hypertension, dyslipidemia, diabetes mellitus, acute coronary syndrome /coronary artery disease), atrial fibrillation, stroke/transient ischemic attack, and malignancy), etiology of stroke if specified in the articles, and treatment (tissue plasminogen activator (tPA), mechanical thrombectomy, and anticoagulation were calculated by summation of events divided by the number of total patients from all studies whose information is available for each value. The salient findings of the study can be summarized as the followings; (1) the frequency of stroke in hospitalized COVID-19 patients was 1.1%, with mean days from COVID-19 symptom onset to stroke at 8 days, most commonly cryptogenic; (2) even with early case series with younger patients without a pre-existing medical condition, the mean age was 66.6, with slight male preponderance (65.6%); (3) stroke risk factors such as hypertension, dyslipidemia, and prior strokes were common as comorbidities; altered mental status was as frequent as 51.4 % as presenting symptom of stroke; (4) elevation of d-dimer and CRP were reproduced after synthesis of results; (5) case fatality rate was as high as 44.2% in patients with COVID-19 and stroke.
cord-294184-jte9xx5e	2020	Careful consideration of ethical principles must guide production of local guidance ensuring consistent patient selection thus preserving equality as well as quality of clinical services. As a surgical department operating under COVID-19 (severe acute respiratory syndrome coronavirus 2) crisis conditions, a multitude of ethical, practical and medical dilemmas are encountered. Coupling the unclear risk profile of COVID-19 with a lack of alternatives to provide the gold standard surgery, what is the ethical justification for performing a substitute procedure on this cohort of patients? hoW CAn We eThICAlly proVIde The TrAdITIonAl gold sTAndArd, or AlTernATIVe, operATIon To pATIenTs durIng The CoVId-19 CrIsIs? One such framework has formed the basis of healthcare ethics: initially proposed by Beauchamp and Childress in 1979, the four principles of patient care are beneficence, non-maleficence, respect for autonomy and justice. For those patients requiring acute treatment, an alternative to the conventional gold standard can be performed if its known inferiority is outweighed by the reduced risk of COVID-19-related complications.
cord-294270-do6i6ymq	2019	A population-based cohort study with 46,237 elderly patients found that immunosuppression, COPD, smoking, congestive heart failure, diabetes, malignancy, and previous hospitalizations for pneumonia are independent risk factors for developing the disease in this age group (Barlow et al., 2007) . Presence of comorbidities such as chronic heart, lung, liver or renal disease; diabetes mellitus; alcoholism; malignancies; asplenia; immunosuppressing conditions or use of immunosuppressing drugs; or use of antimicrobials within the previous 3 months A respiratory fluoroquinolone (moxifloxacin, gemifloxacin, or levofloxacin [750 mg]) (strong recommendation) (1 point) ATS, American Thoracic Society; CAP, community-acquired pneumonia; ICU, ıntensive care unit; IDST, Infectious Diseases Society of America; PIRO, predisposition, infection, response and organ dysfunction score; PS CURXO80, pH, systolic blood pressure, confusion, urea nitrogen, respiratory rate, x-ray finding, oxygen arterial pressure and age of 80 years or more; SMART-COP, systolic blood pressure, multilobar chest radiography, albumin level, respiratory rate, tachycardia, confusion, oxygenation and pH; BUN, blood urea nitrogen; WBC, white blood cell.
cord-294294-66udu5y4	2020	CONCLUSION: Strategic outpatient management of acute closed ankle fractures is associated with acceptable rates of unplanned emergency department visits, hospital readmissions, and SSIs. In the context of the recent SARS-CoV-2 outbreak, outpatient management of these injuries may aide in the mitigation of nosocomial infections and the preservation of finite healthcare resources. Our study data shows that outpatient surgical fixation represents a reasonable approach to these injuries, as we demonstrated acceptable rates of unplanned ED visits, hospital readmissions, and SSIs. Based on these findings, we suggest that a safe and properly implemented outpatient protocol may be beneficial in mitigating the risk of inpatient viral transmission, safeguarding frontline healthcare workers, and conserving finite resources. In this context, we would also like to emphasise the potential benefit of outpatient surgery for controlling nosocomial infections as it has been suggested that longer pre-operative admissions for surgical fixation of ankle fractures may increase rates, thereby increasing downstream resource utilisation and hospital staffing demands [5, 27] .
cord-294336-fqobpo47	2020	This paper aims to review the pathogenesis and the clinical picture of HLH, and its severe complication, the cytokine storm, with a special emphasis on the developed classification criteria sets for rheumatologists, since COVID-19 infection has clinical symptoms resembling those of the common rheumatologic conditions and possibly triggers HLH. Hemophagocytic lymphohistiocytosis (HLH) comprises two different conditions that may be difficult to distinguish from one another: A primary form that occurs due to genetic disorders and a secondary form that is triggered by various infections, autoimmune/autoinflammatory diseases, or chemicals [1, 2] . In this review, we aim to contribute to the rheumatologists'' awareness of the life-threatening rare complication of HLH, the cytokine storm, to prevent a possible misdiagnosis in the presence of the clinical and laboratory features of COVID-19 resembling or mimicking to that of an underlying or a new-onset rheumatological condition.
cord-294349-ps3qlho2	2020	PURPOSE: Several studies have reported conflicting results on ocular manifestations and transmission of coronavirus disease 2019 (COVID-19) whose causative virus, SARS-CoV-2, belongs to the coronavirus family, the seventh recognized as a human pathogen and the third causing a severe clinical syndrome. Coronavirus disease 2019, known as COVID-19, is an emerging infection which is caused by the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) that was first reported in Wuhan city, China, late in December 2019 [4] . Clinical ocular manifestations were absent in all SARS-CoV-1 patients, and viral RNA was detected in the conjunctival secretions and tears in three cases out of 120 (2.5%) with a range of 0-8% [6] [7] [8] [9] . Similarly, a small study testing the conjunctival secretions and tears (collected twice over 2-3 days) of 30 confirmed COVID-19 patients demonstrated the presence of viral RNA (in both samples) in one patient only who also showed clinical signs of conjunctivitis [12] .
cord-294371-xot2oj2t	2020	In this review, we tried to explain how to prevent the negative effects of the COVID-19 pandemic on the diagnosis and treatment of breast cancer patients. In this process, as in many other types of cancer, there are also challenges in the management of breast cancer treatment due to the limited use of resources and the working discipline of the healthcare staff according to the pandemic conditions. High-priority: Recommendations are applied to patients whose condition is either clinically unstable or who have life-threatening cancer burden and requires immediate hospital treatment. [7] Diagnostic imaging for an abnormal mammogram or for suspicious symptoms of breast cancer, biopsies for BI-RADS 4 or 5 lesions, and breast MRI for the extent of disease evaluation or pre-chemotherapy assessment are still being performed in hospitals having sufficient resources because pandemic may be long-lasting and this may threaten patients'' lives in the long run. ER+ early breast cancer patients should have neoadjuvant endocrine therapy before surgery during the COVID-19 pandemic.
cord-294443-w6p3f5qc	2020	Concern was therefore raised at the start of the pandemic that ACE inhibitors and angiotensin receptor blockers (ARBs), medications that are commonly used for hypertension and heart failure, could have a potential deleterious effect [11] , as ACE2 is widely expressed in the cardiovascular system and is up regulated by these drugs in some tissues in a subset of animal models [12, 13] . Subsequent data have raised the possibility that patients treated with ACE inhibitors or ARBs do indeed have a better outcome, with the crucial caveat that the possibility of unmeasured confounding and bias precludes drawing cause-effect conclusions from the clinical studies available thus far. A recent retrospective study from China comparing outcomes on hospitalised patients with COVID-19 with and without ACE inhibitors or ARBs for hypertension has suggested that in the former all-cause mortality was lower (adjusted HR, 0.42; 95% CI, 0.19-0.92; P = 0.03) [18] . Retrospective study of risk factors for severe SARS-Cov-2 infections in hospitalized adult patients.
cord-294487-hcuzxhb3	2020	The current COVID 19 global pandemic has forced a paradigm shift with many centers rapidly adopting virtual visits to conduct care resulting in rapid expansion of use of telemedicine amongst practices. BODY: This commentary discusses practical tips for physicians including guidance around administrative and governance issues, preparation for telemedicine, involving the multidisciplinary care team, and teaching considerations. CONCLUSION: This commentary provides a starting framework for telemedicine use in pediatric rheumatology and further work on validation and acceptability is needed. Virtual care models with remote clinics and video visits (e-visits or telemedicine) have become widespread practice overnight. This commentary describes practical creative approaches based on our experiences and discusses the potential for telemedicine to address unmet needs in the wider context of pediatric rheumatology. Young patients (< 3 years) are more challenging to keep on task with a virtual joint exam, but a care-giver only visit to discuss symptoms or medication side effects is often feasible. Decreasing patient cost and travel time through pediatric rheumatology telemedicine visits
cord-294527-fct2y5vn	2020	The human infection of the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a public health emergency of international concern that has caused more than 16.8 million new cases and 662,000 deaths as of July 30, 2020. Although coronavirus disease 2019 (COVID-19), which is associated with this virus, mainly affects the lungs, recent evidence from clinical and pathological studies indicates that this pathogen has a broad infective ability to spread to extrapulmonary tissues, causing multiorgan failure in severely ill patients. In this context, SARS-CoV-2 can also cause viral meningitis and encephalitis, as demonstrated by a recent report of a 64-yearold patient with laboratory-confirmed COVID-19 who presented neurologic manifestations during the infection, including lethargy, clonus, and pyramidal signs in the lower limbs as well as stiff neck and Brudzinski sign (76) . Future studies are required to evaluate the serologic features of anti-glycolipid antibodies in patients with COVID-19 to elucidate possible mechanisms underlying the association between SARS-CoV-2 infection and Guillain-Barré syndrome.
cord-294557-4h0sybiy	2020	Objectives include to: i) outline pathophysiology and basic epidemiology useful for radiographers, ii) discuss the role of medical imaging in the diagnosis of Covid-19, iii) summarise national and international guidelines of imaging Covid-19, iv) present main clinical and imaging findings and v) summarise current safety recommendations for medical imaging practice. CXR imaging of suspected or confirmed Covid-19 cases should be performed with portable equipment within specifically designated isolated rooms for eliminating the risks of cross-infection within the Radiology department. After the outbreak of the Covid-19 pandemic, many professional bodies and learned societies have been quick to issue official guidelines on how medical imaging should optimally be performed for early diagnosis and related management of these patients, but also how staff should be protected from cross-infection. Chest radiographic and CT findings of the 2019 novel Coronavirus disease (COVID-19): analysis of nine patients treated in Korea Imaging and clinical features of patients with 2019 novel coronavirus SARS-CoV-2: a systematic review and meta-analysis
cord-294593-mh1uh1b3	2020	Some of these issues include the inefficacy of conventional payment mechanisms in providing incentives for providers, practice guidelines in pain management that are not easily implementable across different medical specialties, barriers in adopting multi-modal pain management strategies, low capacity of providers/treatments to address opioid/substance use disorders, the complexity of addressing the co-occurrence of chronic pain and opioid use disorders, and patients'' non-adherence to opioid substitution treatments. These include the implementation of prescription drug monitoring programs [54, 55] , statewide Medicaid program initiatives such as coordinated care organizations [56] [57] [58] , educational outreach and academic detailing for providers [59] [60] [61] , advances in medicine/surgery that lower post-surgical dependence on narcotics [62, 63] , the fentanyl patch-for-patch program [64] , pharmacy consult intervention [65] , quality measure development and/or quality improvement [66] , using data analytics to predict the risk of overdose [67] , and schedule change of opioid analgesics [68] .
cord-294617-i8j36bol	2020	Initially the surgical specialties had a marginal role in the patient care, but as the timeline has expanded, the surgeon is being increasingly called upon to participate in this prolonged tussle [1] . Questions about the pandemic enforced surgical prioritization and the potential problems that the patient might face due to the delay, down the line, continue to challenge our ethical principles. The dominant view in ethics literature is that no individual health professional has a specific positive obligation to treat a patient when doing so places the professional at risk. As the authorities develop and change their policies especially regarding the management of COVID positive pregnant patients, our obstetric surgeons feel as if they are riding an emotional roller coaster. Ethics for surgeons during the COVID-19 pandemic; review article Your country needs you?'' the ethics of allocating staff to high risk clinical roles in the management of patients with COVID-19
cord-294628-ecg13s7a	2020	During the coronavirus disease 2019 (COVID-19) pandemic, Singapore implemented large-scale institutional isolation units called Community Care Facilities (CCFs) to combat the outbreak in the community by housing low-risk COVID-19 patients from April to August 2020. During the coronavirus disease 2019 (COVID-19) pandemic, Singapore implemented large-scale institutional isolation units called Community Care Facilities (CCFs) to combat the outbreak in the community by housing low-risk COVID-19 patients from April to August 2020. In the first month, a total of 3758 patients were admitted to 4 halls, 4929 in-house medical consults occurred, 136 patients were transferred to a hospital, 1 patient died 2 weeks after discharge, and no health care workers became infected. As such, isolation centers called Community Care Facilities (CCFs) were set up throughout the country to house patients with COVID-19 who were at low risk for dying of the disease.
cord-294636-xes8g0x4	2020	The harm caused by failure to modify the surgery schedule has been clearly demonstrated in countries like China where ongoing elective operations and nonessential clinic visits contributed to early rates of in-hospital COVID-19 transmission 2 ; and from Italy where resources consumed through elective surgery including personal protective equipment left health care workers vulnerable when the pandemic crested. Although nonoperative care of appendicitis may have a failure rate between 14 and 30%, the majority of patients will get out of hospital without surgery and will not consume the human and material resources that are most needed in COVID-19 management. 9. COVID-19 surgical care pathways and a COVID-19 Operating room will need to be maintained after the peak of the pandemic has passed as patients with COVID-19 will continue to present with conditions requiring surgery.
cord-294700-pb5k21da	2020	Although the majority of SARS-CoV-2 infections in pediatric populations result in minimal or mild COVID-19 in the acute phase of infection, a small subset of children develop severe and even critical disease in this phase with concomitant inflammation that may benefit from immunomodulation. The framework presented herein offers an approach to decision-making regarding immunomodulatory therapy for severe or critical pediatric COVID-19 and is informed by currently available data, while awaiting results of placebo-controlled randomized clinical trials. Given the lack of available results from randomized-controlled trials of immunomodulatory therapy in children with COVID-19, the risk-benefit ratio for most pediatric patients points toward supportive care as the key management strategy. In the absence of such opportunity, and recognizing that definitive evidence is lacking, consideration for use of immunomodulatory agents in cases of SARS-CoV-2 infection with clinical and biochemical evidence of cytokine storm physiology (e.g., features of secondary HLH) should be limited to patients with clear evidence of critical COVID-19 disease and risk for multi-organ failure.
cord-294768-bs6thjw2	2020	title: Prevalence of pulmonary embolism in patients with COVID-19 pneumonia and high D-dimer values: A prospective study CONCLUSIONS: Patients with COVID-19 pneumonia and D-dimer values higher than 1 μg/mL presented a high prevalence of PE, regardless of clinical suspicion. [12] found, in a retrospective study in 184 intensive care unit (ICU) patients with severe COVID-19 pneumonia, a high prevalence of thrombotic complications and, by far, pulmonary embolism (PE) was the most frequent. Pulmonary embolism in COVID-19 pneumonia with high D-dimer values: A prospective study procoagulant (D-dimer) markers that correlated with the extend of the thromboembolic episode compared to those patients without PE. We included patients with D-dimer values higher than 1 μg/mL, which have been associated with disease severity and in-hospital mortality in patients with COVID-19 infection. Pulmonary embolism in COVID-19 pneumonia with high D-dimer values: A prospective study of our patients, allocated in the non-PE group, was not on enoxaparin prophylaxis during hospitalization.
cord-294788-9usyb1nn	2020	Severe acute respiratory syndrome-coronavirus 2 (SARS-CoV-2), the virus strain that causes coronavirus disease 2019 (COVID-19), was first identified in Wuhan, China in December 2019. It is suspected that the acute respiratory distress syndrome (ARDS)-like picture in SARS-CoV-2-infected patients is precipitated and worsened by the excess monocytes in response to GM-CSF, which is released by rapidly activated CD4+T-cell lineage [17] . have reported that the cytokine profile and the trend of the inflammatory markers of SARS-CoV-2-infected patients present similarly to the secondary hemophagocytic lymphohistiocytosis (sHLH), whose severe clinical presentation is related to the cytokine storm [23] . There is no consensus yet on how to treat SARS-CoV-2-infected patients who present with a wide spectrum of clinical symptoms and severity. In vitro antiviral activity and projection of optimized dosing design of hydroxychloroquine for the treatment of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Epub ahead of print)
cord-294810-mq9vjnro	2020	title: Clinical characteristics and drug therapies in patients with the common-type coronavirus disease 2019 in Hunan, China Background Clinical characteristics of patients with the coronavirus disease 2019 (COVID-19) may present differently within and outside the epicenter of Wuhan, China. According to the clinical manifestations, the confirmed COVID-19 patients can be divided into mild, common, severe, and critical type groups based on the China National Health Commission Diagnosis and Treatment Plan of Novel Coronavirus Pneumonia (trial version 6) [7] . The blood test also showed that in general, patients with severe COVID-19 had worse results such as electrolyte and inflammatory biomarker abnormalities than those in patients with the common-type infection. In this study, we reported the clinical characteristics of patients with COVID-19 as well as therapies they received during hospitalization in Hunan province, China. Clinical findings in a group of patients infected with the 2019 novel coronavirus (SARS-Cov-2) outside of Wuhan, China: retrospective case series
cord-294907-i836d6im	2020	Early in 2013, KAMC-R launched the Infection Disease Epidemic Plan (IDEP), in response to the MERS-CoV outbreak, which consists of three phases that activate based on the number of confirmed cases reported to/within the hospital. 7 Following thatthe hospital medical director initiated major actions such as isolation rooms for suspected or confirmed case, implementing a screening process for all health care workers and new patients, education and training on identifying symptoms of the disease, and means of protection. Therefore, the first steps were prevention; this included early identification of any symptoms that might encounter patients or health care workers, screening the EMS providers at the beginning of each shift and after each transport through temperature checks, followed by tacking employees sick leave records. In this experience, it was clear that paramedics needed training, and once provided, they were confident and competent in transporting critically ill positive MERS-CoV patients.
cord-294933-oc2glu4a	2020	The document provides clinical recommendations for the noninvasive respiratory support (noninvasive ventilation, high flow oxygen therapy with nasal cannula) in any patient with suspected or confirmed presentation of COVID-19 with acute respiratory failure. The document provides clinical recommendations for the noninvasive respiratory support (noninvasive ventilation, high flow oxygen therapy with nasal cannula) in any patient with suspected or confirmed presentation of COVID-19 with acute respiratory failure. The present document has been developed by consensus among the scientific societies involved in acute respiratory failure in adult patients, and seeks to provide a more detailed description of the recommendations on the use of non-invasive respiratory support (NIRS) in the management of acute respiratory failure (ARF) secondary to infection by the newly emergent SARS-CoV-2 coronavirus, which causes so-called COVID-19 disease, as a complement to the information emitted by the Spanish Ministry of Health, Consumer Affairs and Social Wellbeing (Ministerio de Sanidad, Consumo y Bienestar Social [MSC]), 1,2 which is frequently updated and establishes a series of general recommendations.
cord-294959-xy8976jz	2020	title: Allium fistulosum congee as a home remedy to ward off the corona virus at an early stage Elisabeth Hsu a,* , Buxian Zhu b , Zewan Ding b , a Institute of Social and Cultural Anthropology, School of Anthropology and Museum Ethnography, University of Oxford, Oxford, UK b Chinese Medicine, Oxford, UK At the early stage of COVID-19, patients experience flu-like symptoms such as fever, chills, headaches, sore throat and etc. 3 Based on prior experience, several COVID-19 patients were successfully treated with Allium fistulosum congee. Two to three hours after the first taking of Allium fistulosum congee, the patient started to sweat with lots of phlegm coming out and the body temperature dropped from 38.5°C to 37.3°C. Other patients who were in the early or mild stage recovered much sooner, usually within three to four days taking Allium fistulosum congee.
cord-294969-57xgqf2g	2020	Therefore, the purpose of this paper is to describe the rapid deployment of remote musculoskeletal care through telehealth, particularly using real time video conferencing, for chiropractic services integrated in 2 health centers located on 2 campuses of a large company in California. There were 3 distinct challenges to operationalizing remote RTVCs: (1) the chiropractors had to conduct their part of the visits from their homes; (2) the patients had to access visits from home; and (3) there was no direct contact with the interprofessional provider team, health center management, or technical support. The setting and context of the WSHC environment is a key part of how we have operationalized the use of chiropractic RTVCs. The interprofessional collaborative team that staffs the health center greatly facilitates the ability to transition rapidly from in-clinic care to RTVCs. The providers have a regular practice of working as a team.
cord-295086-tc3re52f	2020	METHODS: We closely tracked the epidemiological history, diagnosis and treatment process, as well as dynamic changes in routine blood indicators, of a severe COVID-19 patient who was hospitalized for 26 days. RESULTS: Our study found that the patient''s condition worsened in the first week after admission; white blood cells (WBCs), neutrophils, lymphocytes, monocytes, eosinophils, erythrocytes, hemoglobin, neutrophil lymphocyte ratio (NLR), platelets (PLT) and platelet lymphocyte ratio (PLR) decreased. The number of WBCs, neutrophils, monocytes, eosinophils and lymphocytes increased gradually, and the erythrocyte parameters stopped declining and stabilized in a certain range; CRP decreased rapidly. On the 20th day of admission, the nucleic acid test was negative, WBC, neutrophil, CRP, NLR and PLR decreased gradually, and monocyte, lymphocyte, and eosinophil counts increased. In addition, it should be noted that monocytes and eosinophils were extremely low within 10 days after admission, which might indicate that the patient''s condition was serious, and then gradually recovered to normal.
cord-295123-x2gxgave	2020	However, according to the Chinese government''s daily report, 13.2-21.3% of patients with 2019-nCoV infection developed into severe or fatal illness (Fig. S1a ), which is characterized by the rapid development to acute respiratory distress syndrome (ARDS) or septic shock. On February 7, 2020, the China''s National Health Commission released the fifth trial version of Diagnosis and Treatment Scheme for Pneumonitis with 2019-nCoV Infection, and provided a systematic treatment strategy for severe cases. Some scholars may not support the corticosteroids treatment for novel coronavirus pneumonia (NCP), because observational studies and systematic reviews have indicated inconclusive clinical evidence on the effect of corticosteroids therapy for viral pneumonias (such as SARS, MERS and H1N1). Evidently, all these results strongly suggest that proper use of low-dose corticosteroids may bring survival advantages for critically ill patients with 2019-nCoV, but this treatment should be strictly performed on NCP patients with definite clinical indications (such as refractory ARDS, sepsis or septic shock) according to the recommended guidelines.
cord-295144-tyyc81uc	2020	In this review, we summarize the published cases of COVID-19 infections in RMD patients, including patients with inflammatory arthritis and connective tissue diseases as well as anti-phospholipid syndrome and Kawasaki syndrome. It also reviews the general risk of viral infections in patients with RMD, the impact of disease modifying anti-rheumatic drugs (DMARDs) on the outcome of infections, and gives a comparison between present and previous coronavirus pandemics. This argues against a protective role of HCQ (in the usually administered dose for RMD patients) in SARS-CoV-2 infection, which is also supported by pharmacological in vitro data describing a much higher level needed for effective viral inhibition (61) . In conclusion, data published in the first 6 months do not consistently describe a higher risk for infection with SARS-CoV-2 or a more severe course of COVID-19 in patients with either inflammatory arthritis or connective tissue diseases.
cord-295216-eff02z0i	2020	While some recommendations apply to neurosurgery, particularly endoscopic sinonasal and skull base recommendations [2] , no manuscripts exist to systematically stratify risk associated with delay in common pediatric neurosurgical procedures. Urgent cases that present an immediate threat to the patient''s life or neurologic well-being (e.g., shunt malfunction, acute hematoma evacuation, tumor with hydrocephalus, empyema, spinal cord compression) are straightforward and undergo prompt surgical intervention. [27] of the membership of the American Society of Pediatric Neurosurgery (ASPN) demonstrated a strong preference for using presence of a syrinx regardless of symptoms in the setting of Chiari I malformation as a threshold for surgery [27] . In a cohort of 35 patients with total obstetric brachial palsy injury, younger age at the time of surgery correlated with better functional recovery (r = − 0.356, p = 0.049), particularly with finger and thumb flexion [59] . Patients with Chiari malformation type I presenting with acute neurological deficits: case series
cord-295323-snrt9odv	2020	Although the prevention and treatment of COVID 19 has become the priority for the majority of the population, most medical professionals are facing the challenge of balancing the management of this pandemic and treating patients with other diseases. Although the prevention and treatment of COVID 19 has become the priority for the majority of population, most medical professionals are facing the dilemma of balancing out essential healthcare for patients suffering from other diseases. Medical care personnel from all specialties are facing this situation and have established guidelines and recommendations that have contributed to the literature and are providing guidance for managing the pandemic. Thus, minimizing unnecessary patient visits, issuing preventive instructions to predisposed patients, ensuring the safety of the operative team, are maximizing the use of digital media for postoperative care surveillance are vital in the ongoing scenario.
cord-295332-wlnss6bg	2020	This work reviews effective methods of using filtration devices in treatment to reduce the level of various inflammatory mediators and discharge patients from the ICU faster. Another study involved 38 patients with septic shock associated with AKI who were treated with CVVHD with HCO membrane for 72 h. A crossover randomized double-blinded study was conducted to investigate the effect of the oXiris membrane on 16 septic shock patients with AKI. This membrane with continuous hemodiafiltration (CHDF) was used to treat 34 septic shock patients in addition to the conventional treatment according to the Surviving Sepsis Campaign guidelines. Severe acute pancreatitis patients (the study group) were treated with a combination of CPFA and CVVH, while the control group received CVVH. The authors recommend using blood filtration devices in addition to current treatment to reduce the number of patients admitted to ICUs. Correction to: clinical predictors of mortality due to COVID-19 based on an analysis of data of 150 patients from Wuhan, China.
cord-295371-ccqne6nu	2020	title: Dermatology residents and the care of patients with coronavirus disease 2019 (COVID-19) Additionally, there is an American Academy of Dermatology Code of Medical Ethics that states, ''''It is .unethical for a dermatologist .to refuse the management of a patient because of medical risk, real or imagined (page 18, section 1C).'''' 4 Subsequently, in the current pandemic, it is a dermatologist''s duty to treat patients in the clinic, in the hospital, in the emergency room, and in the intensive care unit if called upon. The current COVID-19 pandemic is a public health crisis that requires physicians, of all specialties, to step up and help. The bottom line is that to fulfill your obligation as a professional in the house of medicine, ensure medical care is delivered to those in need (distributive justice), help patients, and do no harm (beneficence and nonmaleficence,) and for your own dignity, do not call a lawyer!
cord-295414-v10454ns	2020	1 Furthermore, research by Alipio and colleagues 2 , in a retrospective study, provides evidence of an association between vitamin D deficiency and adverse outcome in patients with COVID-19. Among patients with vitamin D deficiency in the COVID-19-positive group, there was a higher average peak in D-dimer level (1914.00 μgFEU/L vs 1268.00 μgFEU/L) (p=0.034) and a higher incidence of NIV support and HDU admission (30.77% vs 9.68%) (p=0.042). The main findings of our study suggest that older patients with lower serum concentrations of 25(OH)D, when compared with aged-matched vitamin D-replete patients, may demonstrate worse outcomes from COVID-19. In non-communicable diseases, both viral and bacterial, vitamin D deficiency has been associated with increased morbidity and mortality as well as a higher incidence of acute respiratory distress syndrome in critically unwell patients. • Older patients with COVID-19 infection and vitamin D deficiency (≤30 nmol/L) have higher peak D-dimer level and higher incidence of NIV support and HDU admission.
cord-295514-vhymj0rw	2004	Severe acute respiratory syndrome (SARS) is a new respiratory viral epidemic that originated in China but has affected many parts of the world, with devastating impact on economies and the practice of medicine and rehabilitation. Rehabilitation was significantly affected by SARS, because strict infection control measures run counter to principles such as multidisciplinary interactions, patients encouraging and learning from each other, and close physical contact during therapy. Rehabilitation medicine was increasingly affected by everstricter infection control measures regarding close contacts and interactions between health care workers. Rehabilitation medicine was directly affected when the entire neurology ward, including patients and health care staff, were transferred out to TTSH for isolation and observation because of suspicious clusters of fevers that involved both patients and staff. Severe acute respiratory syndrome (SARS) in Singapore: clinical features of index patient and initial contacts
cord-295523-5pv7kw6i	2020	However, in about 20% of patients, the infection progresses to severe interstitial pneumonia and can induce an uncontrolled host-immune response, leading to a life-threatening condition called cytokine release syndrome (CRS). We critically review the rationale for the adoption of immunosuppressive agents, commonly used in autoimmune diseases, in the treatment of SARS-CoV-2 infection and report current knowledge of ongoing studies. The exacerbated reaction to infections or to biological therapy is caused by the rapid recruitment of macrophages and neutrophils, which produce pro-inflammatory cytokines and alter the fragile balance between a controlled immune response and a host-damaging reaction. As of now, four clinical trials are recruiting patients with COVID-19, severe acute respiratory failure, and CRS, aiming at evaluating the safety and effectiveness of anakinra alone or in combination with anti-IL-6 agents (NCT04330638, NCT0432402, NCT04357366, NCT04339712). High disease activity is associated with an increased risk of infection in patients with rheumatoid arthritis
cord-295700-lzaxzuwe	2020	CONCLUSION: The risk of in-hospital death among patients with severe COVID-19 can be predicted by markers of myocardial injury, and was significantly associated with senior age, inflammatory response, and cardiovascular comorbidities. The major findings of the present study are as follows: (i) myocardial injury is not uncommon among patients with severe COVID-19, especially among those who die; (ii) elevated levels of myocardial markers predict risk for in-hospital death; and (iii) senior age, inflammatory response, and underlying cardiovascular-related comorbidities are associated with myocardial injury in patients with COVID-19. To further analyse related factors of myocardial injury by multivariable regression, senior age, comorbidities (e.g. hypertension, coronary heart disease, chronic renal failure, and chronic obstructive pulmonary disease), and inflammatory markers (e.g. PCT and C-reactive protein) were predictors of in-hospital myocardial injury in patients with severe COVID19 . cTnI and CK-MB levels predict risk for in-hospital death, and myocardial injury is associated with senior age, inflammatory response, and cardiovascular-related comorbidities.
cord-295703-no45mgyd	2020	Combined metabolic cofactors supplementation (CMCS) consisting of L-serine, N-acetyl-L-cysteine (NAC), nicotinamide riboside (NR), and L-carnitine tartrate is being studied for the treatment of patients with COVID-19. CONCLUSIONS In patients with mild-to-moderate COVID-19, CMCS resulted in a significant reduction in recovery time and liver enzymes associated with hepatic function compared to placebo. Recently, we performed integrative analysis of multi-omics data on different metabolic conditions and found that combined metabolic cofactors supplementation (CMCS) consisting of L-serine, N-acetyl-L-cysteine (NAC), nicotinamide riboside (NR), and Lcarnitine tartrate may be used for treatment of the patients with non-alcoholic fatty liver diseases (11, 12) . In this randomized, open-label, placebo-controlled, phase 2 trial involving ambulatory COVID-19 patients, we found that the combination of CMCS and hydroxychloroquine significantly reduced the average recovery time compared with hydroxychloroquine and placebo (6.6 days vs 9.3 days, respectively).
cord-295794-glcg36si	2020	Social distancing, stay home/work safe orders, protective measures for vulnerable individuals (e.g., immunocompromised patients), masking protocols, visitation policies, testing and many more measures resulted in an accelerated but necessary ramping down of elective hospital services [4] [5] [6] [7] [8] [9] . While the radiologist-in-chief also participates in daily meetings with other clinical service chiefs and executive leadership for the hospital, the radiologist-in-chief is an integral member of the systemwide "Phased Recovery and Redesign Team" as well, which includes team captains for infection control, surgery, anesthesia, emergency and urgent care centers, radiology, pathology, ambulatory medicine, specialty care centers, e-health, revenue cycle and billing, and marketing and public relations. This can include patient-directed online scheduling and expanded access to imaging, offering same-day service with hours and locations adapted to the patient and family lifestyle; improved use of virtual dashboards to more easily track various metrics including MR efficiency, sedation utilization, and length of patient stay in the imaging department; and investment in Table 2 Radiology: the opportunity to re-design operations post COVID-19
cord-295798-x7or932x	2020	title: A Case of Novel Coronavirus Disease 19 in a Chronic Hemodialysis Patient Presenting with Gastroenteritis and Developing Severe Pulmonary Disease During this interval, he reported nausea, vomiting, diarrhea, and low-grade fevers but was not suspected of COVID-19 infection until he developed respiratory symptoms and was admitted to the hospital. We present a case of COVID-19 in the United States in a long-term dialysis-dependent ESRD patient reported thus far in the 2020 COVID-19 pandemic. The following day the patient traveled by commercial airline from Southern California to Utah where he presented to an emergency department for continued intermittent vomiting and fevers but was now reporting mild congestion and cough. This case report highlights the importance of considering COVID-19 infection in a variety of clinical presentation that may not initially include typical respiratory symptom to prevent ongoing exposure of potentially affected individuals to the general population.
cord-295800-w0dup04b	2003	Add combination treatment with ribavirin and methylprednisolone when: q Extensive or bilateral chest radiographic involvement q Or persistent chest radiographic involvement and persistent high fever for 2 days q Or clinical, chest radiographic, or laboratory findings suggestive of worsening q Or oxygen saturation <95% in room air Standard corticosteroid regimen for 21 days q Methylprednisolone 1 mg/kg every 8 h (3 mg/kg daily) intravenously for 5 days q Then methylprednisolone 1 mg/kg every 12 h (2 mg/kg daily) intravenously for 5 days q Then prednisolone 0·5 mg/kg twice daily (1 mg/kg daily) orally for 5 days q Then prednisolone 0·5 mg/kg daily orally for 3 days q Then prednisolone 0·25 mg/kg daily orally for 3 days q Then off Ribavirin regimen for 10-14 days q Ribavirin 400 mg every 8 h (1200 mg daily) intravenously for at least 3 days (or until condition becomes stable) q Then ribavirin 1200 mg twice daily (2400 mg daily) orally Pulsed methylprednisolone q Give pulsed methylprednisolone if clinical condition, chest radiograph, or oxygen saturation worsens (at least two of these), and lymphopenia persists q Give as methylprednisolone 500 mg twice daily intravenously for 2 days, then back to standard corticosteroid regimen Ventilation q Consider non-invasive ventilation or mechanical ventilation if oxygen saturation <96% while on >6 L per min oxygen or if patient complains of increasing shortness of breath conditioning) was increased to 10-12 changes per h.
cord-295971-jtv1jj2z	2016	BACKGROUND: In 2015, a large outbreak of Middle East respiratory syndrome coronavirus (MERS-CoV) infection occurred following a single patient exposure in an emergency room at the Samsung Medical Center, a tertiary-care hospital in Seoul, South Korea. INTERPRETATION: Our results showed increased transmission potential of MERS-CoV from a single patient in an overcrowded emergency room and provide compelling evidence that health-care facilities worldwide need to be prepared for emerging infectious diseases. Excluding three patients with confi rmed MERS-CoV infection who were not identifi ed in the initial patient contact investigation (appendix p 5), the overall attack rate for patients in the emergency room was 4% (30 of 675). No MERS-CoV infection was reported in patients and visitors who had been in the emergency room on May 29 during the time period when they were exposed only to zones II (n=81) or III (n=15), while Patient 14 was confi ned to zone IV.
cord-296013-6ej3pd0u	2020	key: cord-296013-6ej3pd0u title: Telemedicine for Inpatient Dermatology Consultations in Response to the COVID-19 Pandemic cord_uid: 6ej3pd0u 3 Inpatient 46 dermatology services will continue to provide impactful care throughout the COVID-19 crisis 47 with a particular need to help allocate scarce resources. Outpatient 55 teledermatology services have the potential to increase access to dermatology care, and to 56 address health care disparities for urban-underserved and rural populations. 5 Dermatologists are poised to 58 utilize teledermatology to increase access to dermatologic care for hospitalized patients, reduce 59 the risk of infection of patients, trainees and staff, and reduce the use of precious resources such 60 as personal protective equipment (PPE) and medical supplies. Characterisation and diagnosis of ulcers in 108 inpatient dermatology consultation services: A multi-centre study Improved patient access and outcomes with the 111 integration of an eConsult program (teledermatology) within a large academic medical 112 center
cord-296018-lgx5k2kp	2019	title: Evaluation of prognosis related to compliance with supportive periodontal treatment in patients with chronic periodontitis: a clinical retrospective study Additionally, the number of newly decayed and extracted teeth and changes in alveolar bone levels around the teeth and implants were significant prognostic factors related to PC-SPT. In addition, the majority of studies mainly focused on classifying patients based on previous dental treatments and on conducting comparisons based on clinical indices in periodontal tissues without considering the SPT period [13] [14] [15] . Using patients'' clinical and radiographic records, the number of newly decayed teeth, alveolar bone level changes around the teeth and implants, the number of newly extracted teeth, https://doi.org/10.5051/jpis.2019.49.2.76 Importance of supportive periodontal treatment https://jpis.org and implant removal during SPT were examined. The effect of PC-SPT on treatment prognosis was evaluated by studying its relationship with the number of newly decayed and extracted teeth and the direction of alveolar bone change around teeth and implants.
cord-296113-syi2fwuo	2020	BACKGROUND: Patients with critical coronavirus disease 2019 (COVID-19), characterized by respiratory failure requiring mechanical ventilation (MV), are at high risk of mortality. When their condition did not improve after 2 h of NIV, each patient was advanced to MV [tidal volume (Vt), 6 mL/kg ideal body weight (IBW); 8-10 cmH(2)O of positive end-expiratory pressure; respiratory rate, 20 breaths/min; and 40%-80% FiO(2)] with prone positioning for 12 h/day for the first 5 d of MV. CONCLUSION: A MV protocol attentive to intubation/extubation timing, prone positioning early in MV, infection control, and sequential withdrawal of respiratory support, may be an effective regimen for patients with critical COVID-19. In accordance with this recommendation, we summarize our weaning procedure and associated experience with two critical COVID-19 patients, including intubation timing, use of the prone position, infection control, and sedation titration.
cord-296182-hhswage4	2020	Healthcare providers, who are tasked with taking care of critically ill patients, need to perform the best practices of intubation and ventilation tailored explicitly to the victims of this sweeping COVID-19 outbreak and, at the same time, adhere to strict self-protection precautions. The Chinese Society of Anesthesiology Task Force on Airway Management released a fast-track publication with the recommendation to proceed with endotracheal intubation for patients showing no improvement in respiratory distress, tachypnea (respiratory rate greater than 30 per minute), and poor oxygenation (Pao 2 to Fio 2 ratio less than 150 mmHg) after 2-h highflow oxygen therapy or noninvasive ventilation. Although the aerosol-generating potential of noninvasive ventilation is a potential concern to some providers, 19 the bilevel positive airway pressure machine is widely used amid this outbreak for patients with acute hypoxemic respiratory failure in Wuhan and the rest of China.
cord-296219-zzg9hds0	2020	Within this Abbreviations: ACE2, angiotensin-converting enzyme-2; ANE, acute necrotizing encephalopathy; ARDS, acute respiratory distress syndrome; BALF, bronchoalveolar lavage fluid; BBB, blood brain-barrier; CA, Ammon''s horn; CD, cluster of differentiation; CI, confidence interval; CNS, central nervous system; CoV, coronavirus; COVID-19, coronavirus disease 2019; CT, computed tomography; CXCR, chemokine receptor; DIC, disseminated intravascular coagulation; DO 2 , oxygen delivery; DPP4, dipeptidyl dipeptidase-4; ECMO, extracorporeal membrane oxygenation; FiO 2 fraction of inspired oxygen; FOX, forkhead box; HLH, hemophagocytic lymphohistiocytosis; ICAM, intracellular adhesion molecule; ICH, intracerebral hemorrhage; ICP, intracranial pressure; IFN, interferon; MERS, Middle East respiratory syndrome; MHV, mouse hepatitis virus; MRI, magnetic resonance images; nCoV, novel coronavirus; OR, odds ratio; PaCO 2 , partial pressure of carbon dioxide; PaO 2 partial pressure of oxygen; PbtO 2 brain tissue oxygenation tension; PCR, polymerase chain reaction; PEEP, positive end-expiratory pressure; PRES posterior reversible encephalopathy syndrome; RM, recruitment maneuvers; RNA, ribonucleic acid; SARS, severe acute respiratory syndrome; TLRs, toll-like receptor; TMPRSS2 transmembrane serine protease 2; TNF, tumor necrosis factor; WHO, World Health Organization.
cord-296331-i4hyzqcv	2020	COVID-19 infection causes acute kidney injury (AKI) and is an independent risk factor for mortality. The impact of COVID-19 infection on chronic kidney disease (CKD) and renal transplant patients is also discussed in the manuscript. Acute kidney injury (AKI) was seen in 5-15% of the cases infected with SARS-CoV and MERS-CoV, and had a higher mortality rate of 60-90% as per the literature [12] . We summarized the finding from multiple studies including patient characteristics, co-morbidities, incidence of AKI in general as well as ICU/severely ill patients, number of patients requiring continuous renal replacement therapy (CRRT), extracorporeal membrane oxygenation (ECMO) and mortality in Table 2 [9-11, 13, 19, 22-24, 26-32] . Human kidney is a target for novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) Infection. Clinical characteristics of 138 hospitalized patients with 2019 novel coronavirus-infected pneumonia in Wuhan
cord-296440-18vpg419	2020	The objective of this study was to investigate the characteristics and outcomes of asthmatic patients with COVID-19 pneumonia who required hospitalisation during the spring 2020 outbreak in Paris, France. As the world faces the coronavirus disease 2019 (COVID-19) pandemic due to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, concerns have arisen about a possible increased risk of asthma exacerbations. In Wuhan, authors pointed out a rate of 0.9% [3] , markedly lower than that in the local population; in another study investigating the clinical characteristics and allergy status of 140 patients infected by SARS-CoV-2 in Wuhan, no patient were reported as being asthmatic [3] . All adult patients hospitalized from March 15, 2020 to April 15, 2020 with a diagnosis of SARS-CoV-2 infection and reporting a history of asthma were included. Moreover, obesity, hypertension and diabetes were the most common comorbidities observed in our cohort of hospitalized asthmatics with COVID-19, which is consistent with earlier research in other patient groups [4] [23] .
cord-296494-6kn4mr04	2020	Bearing this in mind, it is quite likely, that if we have fewer complications, particularly severe ones (cardiac arrest, ventricular tachyarrhythmia, acute heart failure, acute coronary syndrome, haemorrhagic or massive ischaemic stroke), this integrated approach could cut down the elevated mortality in the highest risk group (cancer, COPD and oldest subjects with comorbidities), usually preceded by a multi-organ failure. In aged COVID-19 patients or with history of coronary artery disease (CAD) an acute coronary syndrome (ACS) can also be seen for plaque vulnerability in the presence of a pro-inflammatory state with cytokine release (71) but from the experience in animals, could it be plausible that any of them could be due to arteritis? The third aspect would be the combination of T2DM and Heart failure (HF) (the most frequent cardiac complication in any of the phases of the disease), which is present in a high percentage of patients, especially those at higher risk.
cord-296562-3h2oqb9k	2020	In contrast to other respiratory viral infections like influenza, a major pathogenic mechanism implicated in severe clinical manifestations of COVID-19 is an aberrant host immune response resulting in an excessive cytokine and chemokine release known as "cytokine storm" or "cytokine release syndrome" 2,3 . In a sensitivity analysis including only the 55 patients with confirmed SARS-CoV-2 infection by RT-PCR, the significant variables in the adjusted multivariate model were a NLR > 2.55 (OR 5.26; 95% CI 1.02-25), higher Charlson comorbidity index (OR 1.56; 95% CI 1.04-2.34) per unit, and higher SOFA score (OR 5.05; 95% CI 1.10-23.24) (Supplementary Table 2 ). This biomarker reflects excessive inflammation and dysregulation of immune cells that play a central role in severity of disease in viral infections 23 , and has been associated with mortality in patients hospitalized with COVID-19 24 . www.nature.com/scientificreports/ four comorbidities are included in the Charlson index, and have been associated with higher disease severity in patients with COVID-19 31 .
cord-296588-q2716lda	2020	OBJECTIVE: The IDSA''s goal was to develop an evidence-based diagnostic guideline to assists clinicians, clinical laboratorians, patients and policymakers in decisions related to the optimal use of SARS-CoV-2 nucleic acid amplification tests. It is important to note as well, that not all specimens were collected from the same patient at the same time, the time of collection from symptom onset was not provided in all studies and various approaches for establishing SARS-CoV-2 positivity were used to define positive results (i.e., clinical evaluation, detection different gene targets versus nucleic acid sequencing). While NP swab collection is widely used and the primary specimen type for commercial direct SARS-CoV-2 test platforms, based on current available evidence, clinical practice, and availability of testing resources, the panel believes there are comparable alternative methods for sampling the nasal passages.
cord-296605-p67twx7a	2004	title: Management of Critically Ill Patients with Severe Acute Respiratory Syndrome (SARS) Most SARS patients would require high flow oxygen supplementation, 20–30% required intensive care unit (ICU) or high dependency care, and 13–26% developed acute respiratory distress syndrome (ARDS). The management of critically ill SARS patients requires timely institution of pharmacotherapy where applicable and supportive treatment (oxygen therapy, noninvasive and invasive ventilation). More than onethird of all the SARS patients required high flow oxygen therapy [4] , 20-30% required intensive care unit (ICU) admission or high dependency care, and 13-26% developed acute respiratory distress syndrome (ARDS) [5, 6] . Description and clinical treatment of an early outbreak of severe acute respiratory syndrome (SARS) in Guangzhou, PR China Evaluation of non-invasive positive pressure ventilation in treatment for patients with severe acute respiratory syndrome Clinical observation of non-invasive positive pressure ventilation (NIPPV) in the treatment of severe acute respiratory syndrome (SARS)
cord-296607-h2zwlyz7	2020	What is clear is that patients appear to be at higher risk for thrombotic disease states including acute coronary syndrome (ACS), venous thromboembolism (VTE) such as deep vein thrombosis (DVT) or pulmonary embolism (PE), or stroke. In most scenarios, direct oral anticoagulants (dabigatran, rivaroxaban, apixaban, and edoxaban) are recommended over warfarin due to large randomized controlled trials showing noninferiority or superiority for stroke reduction and superiority for bleeding risk in patients with non-valvular atrial fibrillation [29] [30] [31] [32] . The use of UFH or LMWH may be considered in patients with high potential stroke risk and new onset atrial fibrillation; however, heparin drips require constant monitoring and titration of dosing during hospitalization leading to increased nursing exposure to potential COVID-19 patients. A French cohort of ICU patients on pharmacologic prophylaxis found a high prevalence of thrombotic complications including PE, stroke, circuit clotting of continuous renal replacement therapy or extracorporeal membrane oxygenation (ECMO) with minimal bleeding risk suggesting the need for higher doses of prophylactic anticoagulation in this patient population [70] .
cord-296676-2anl2agl	2020	Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), is a global pandemic with a wide spectrum of clinical signs and symptoms. These neurologic manifestations were more common in severely affected patients, tended to occur early in the disease course, and could be the initial, presenting clinical evidence of COVID-19 [4] . Lastly, the authors note that ECMO alone (in the absence of SARS-CoV-2 infection) is a risk factor for intracranial hemorrhage, further limiting the generalizability of this small case series. Regardless, prior studies that evaluated neuroimaging findings of patients infected with other members of the Betacoronavirus genus have also demonstrated significant abnormalities, including intracranial hemorrhage and evidence of acute disseminated encephalomyelitis (ADEM), which could represent sequelae of inflammatory response and/or direct CNS infection [50, 51] . On behalf of the CoCo Neurosciences study group (2020) Retrospective observational study of brain magnetic resonance imaging findings in patients with acute SARS-CoV-2 infection and neurological manifestations
cord-296694-2js639bk	2020	The true prevalence of thrombosis associated with COVID-19 infection is unknown, as most studies to date do not include systematic and comprehensive investigation protocols. Two recent Dutch studies have reported cumulative incidences of thrombotic events between 48 and 49% respectively in their ICUs in patients with COVID-19 pneumonia [10, 11] . refine this further by describing a 50% cumulative incidence of pulmonary embolism (PE), diagnosed by CT-pulmonary angiogram (PA), in COVID-19 patients admitted to ICU in two hospitals of the University of Paris (ERJ ref Bompard). In addition to ACE2 mediated SARS-CoV-2 viral entry, recent reports of affinity of the SARS-CoV-2 spike protein and CD147, a membrane glycoprotein and extracellular matrix metalloproteinase inducer expressed on a variety of haematopoietic cell lines, suggest another potentially novel mechanism of thrombosis and inflammation in the arterial and venous circulations [27] . High incidence of venous thromboembolic events in anticoagulated severe COVID-19 patients
cord-296773-5o4hr6ir	2020	In the early phase of the pandemic, the search of emerging literature was aimed at finding peer-reviewed information needed to keep nursing teams and other healthcare professionals upto-date in the following areas: disease physiopathology and symptoms, ways of person-to-person transmission; evidence or recommendations on infection prevention and control precaution measures; epidemiology, reusable equipment and environmental cleaning procedures, diagnostic tests, efficacy of personal protective equipment (PPE) and communication strategies in healthcare organizations during health emergency events. Patient, caregiver and employee safety, patient health outcomes, use of resources Adopted strategies and instruments for achieving goals Risk assessment to screen those with flu-like symptoms and refer them to their general practitioner for early communication, isolation and treatment for COVID-19 to prevent severe disease; telephone triage of patients before planning their visit to hospital; triaging patients and their caregivers before their access to cancer services; Continuity of essential services, appropriate case management Communication instruments
cord-296881-2g81sjnl	2020	On May 7, 2020, Gilead Sciences, announced that the Japanese Ministry of Health, Labour and Welfare (MHLW) has granted regulatory approval of Veklury® (Remdesivir) as a treatment for SARS-CoV-2 infection, the virus that causes COVID-19 acute respiratory syndrome, under an exceptional approval pathway. In COVID-19 infection, a massive number of T-lymphocytes and mononuclear macrophages are activated, emitting different cytokines such as interleukin-6 (IL-6), which binds to the IL-6 receptor on its target cells, causing the cytokine storm and severe inflammatory responses in most organs including lungs, liver, kidney and other tissues and organs. Moreover, in July 2020 the WHO discontinued clinical trials with hydroxychloroquine and lopinavir/ritonavir treatment arms for COVID-19 (WHO, 2020b), where both therapies produced little and no reduction in the mortality of hospitalized SARS-CoV-2 cases when compared to standard of care. COVID-19 infection and treatment with hydroxychloroquine cause severe haemolysis crisis in a patient with glucose-6-phosphate dehydrogenase deficiency
cord-296936-5gkx4jxa	2020	Results: Kaplan-Meier curves drawn using propensity score-matched data revealed no differences between the length of time to viral clearance and duration of hospital stay between the two treatment arms (p=0.18, p=0.088). Conclusions: HQ with antibiotics was not associated with better clinical outcomes in terms of time to viral clearance, length of hospital stay, and duration of symptoms compared to conservative treatment alone. There were significant differences between two groups before propensity score matching in all endpoints: time to viral clearance, hospital stay, and symptom duration ( Table 2) . This retrospective cohort study compared treatment response to two different treatment protocols in mild to moderate COVID-19 patients using several clinical outcome measures. HQ with antibiotics was not associated with better clinical outcomes and did not reduce time to viral clearance, length of hospital stays, and duration of symptoms compared to conservative treatment in mild to moderate COVID-19 patients.
cord-297001-4g3wb8qi	2020	Understanding the true impact of VTE on patients with COVID-19 will potentially improve our ability to reach a timely diagnosis and initiate proper treatment, mitigating the risk for this susceptible population during a complicated disease. However, many of the COVID-19 patients may present with high levels of D-dimer due to other causes -inflammation, disseminated intravascular coagulation, advanced age, or infection [23] suggesting the need for CTPA as an initial rule-out test as well. Finally, based on the correlation between high levels of D-dimer and severe COVID-19 disease [7, 37] as well as higher mortality rate [5, 38] , the International Society on Thrombosis and Haemosthasis (ISTH) and American Society of Hematology (ASH) guidelines [39] advises prophylactic LMWH in all hospitalized COVID-19 patients in the absence of any contraindications (active bleeding and platelet count less than 25 × 10 9 /L) [34, 40] .
cord-297093-ld89vmct	2020	CONCLUSION: Intravenous anakinra is safe to use in patients with COVID-19 and evidence of supra-added bacterial infection. These patients all showed evidence of hyperinflammation with raised inflammatory markers, and CRP, and were given intravenous anakinra, with safe and successful use, suggesting the potential benefit from IL-1 blockade in this subgroup of patients with confirmed COVID-19. We present four cases of immunosuppressed patients, receiving beneficial effects from the use of intravenous anakinra to treat severe COVID-19 with hyperinflammation and concomitant bacterial infections. Our case series supports the hypothesis of IL-1 blockade as an important disease modifying treatment in those patients with severe late stage COVID-19, with evidence of cytokine storm. We believe that administering intravenous anakinra at the height of the cytokine storm has profound beneficial effects, both clinically and biochemically on patients with severe COVID-19 infection.
cord-297127-nhgm09db	2020	OBJECTIVES: Patients with inflammatory rheumatic diseases (IRD) infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) may be at risk to develop a severe course of COVID-19. 2 In this situation, patients with inflammatory rheumatic diseases (IRD) may face a particular risk as their disease, especially when clinically active, and their immunomodulatory treatment may impact the course of COVID-19 infection. However, firm knowledge of the course of SARS-CoV-2 infection in patients with IRD is missing, and therefore, evidence-based recommendations for the management of COVID-19 in patients with rheumatic disorders and antirheumatic treatments are lacking. As necessary data cannot be extracted from clinical charts or health insurance records, the DGRh and the Justus-Liebig University Giessen decided to establish a web-based registry, which allows a rapid and timely collection of IRD cases with confirmed SARS-CoV-2 infections in Germany to analyse the clinical course of SARS-CoV-2 infections in patients with IRD and to develop guidance for the management of patients with IRD during the COVID-19 pandemic.
cord-297132-lhfa9fl5	2020	In this review, we synthesize a range of clinical observations and initial case series describing potential neurologic manifestations of COVID-19 and place these observations in the context of coronavirus neuro-pathophysiology as it may relate to SARS-CoV-2 infection. The novel 2019 coronavirus disease (COVID-19) caused by Severe Acute Respiratory Syndrome coronavirus 2 (SARS-CoV-2) results in a variety of symptoms including fever, cough, and fatigue [1] . The Kawasaki-like syndrome that is now described in young patients following COVID-19 infection and associated with a hyper-inflammatory state is further suggestive of a vascular inflammatory potential of SARS-CoV-2 [48, 49] . Once established in the CNS, SARS-CoV, the virus responsible for Severe Acute Respiratory Syndrome (SARS), has been shown to be capable of inducing rapid transneuronal spread and death of infected neurons in transgenic mice models expressing human ACE2 receptors [63] .
cord-297138-t8b3914h	2015	Conclusions Compared with placebo the essential-oil extract of three Cretan aromatic plants provided no detectable statistically significant benefit or harm in the patients with upper respiratory illness, although descriptive differences were identified in favorable direction mainly in the virus-positive population. As stated above, this study reports the results of the effectiveness of an extract based on three Cretan aromatic plants in the reduction of duration and severity of symptoms of patients with upper respiratory tract infections, utilizing a standardized questionnaire, physical examination measurements and the decrease of inflammation assayed by C-reactive protein [CRP] levels. Severity of symptoms over the study period was compared between intervention and control groups, using the 19-item WURSS-21 scores, with both univariate techniques and multiple linear regression models, adjusting for age, sex, initial CRP level, body mass index (BMI) and the presence of chronic diseases.
cord-297208-f4ob3ox6	2020	1 Evidently, countries which faced the severe acute respiratory syndrome (SARS) outbreak, the first coronavirus pandemic of the current century which affected more than 8000 people (mainly in China, Vietnam, Singapore and Canada) in 2003 7 , were much more prepared, both culturally and in terms of facilities and equipment, as compared with western countries (many of which had to face, in the initial stages of the emergency, the shortage of even simple and cheap devices such as surgical masks).
cord-297327-19dfgfz6	2020	Many patients with SARS-CoV-2 infection will suffer from severe pain and require reliable pain assessment to provide adequate analgesia, often with multiple drugs, including opioids, nonPutative mechanisms of myalgia and headache during viral infection. Many patients with SARS-CoV-2 infection will suffer from severe pain and require reliable pain assessment to provide adequate analgesia, often with multiple drugs, including opioids, non-steroidal inflammatory drugs or analgosedation [52] . Recently, concerns about the possible higher frequency of adverse effects and exacerbation of symptoms of viral respiratory tract infections, such as COVID-19, in patients treated with NSAIDs have been raised [67] . There are reports of a significantly higher use of opioids because of sedation requirements during respiratory failure caused by SARS-CoV-2, which highlights the importance of undertaking a study aiming to determine efficacious and safe procedures of pain management in patients with COVID-19.
cord-297414-zq16s9ud	2020	This was integrated with the NHI PharmaCloud System, which allowed thorough checks on the travel and medical history of preregistered patients for all outpatient clinic visits, day This article is part of a topical collection on Perspectives on COVID-19 surgery, scheduled examinations, or hospital admissions in advance [8] . Measures in the clinic include plastic barrier shields mounted to slit lamps and machines; all staff are asked to wear cap, eye goggles, protective clothing, surgical mask, and glove during clinic; video calls to check the patients with fever and red eye but not yet diagnosed with COVID at the emergency department. The fact is, telemedicine has been proposed and discussed for several decades before the COVID pandemic, but the current situation where many countries have imposed lockdowns and restrictions to travel to clinics and hospitals has greatly accelerated its use and implementation [10] . Virtual visits in ophthalmology: timely advice for implementation during the COVID-19 public health crisis
cord-297425-vcqqssm8	2020	However, the prognosis varies widely between groups, with age over 60 years and underlying conditions including hypertension, diabetes, cardiovascular disease and cancer identified as risk factors for severe disease and death.(3) The initial reports from China show that patients with cancer are over‐represented among individuals who develop severe Covid‐19 after contracting the virus.(4) Patients with haematological malignancies are expected to be at increased risk of adverse outcomes from this viral infection, due being immunosuppressed as a consequence of the underlying cancer, and from the effects of therapy. (3) The initial reports from China show that patients with cancer are over-represented among individuals who develop severe Covid-19 after contracting the virus.(4) Patients with haematological malignancies are expected to be at increased risk of adverse outcomes from this viral infection, due being immunosuppressed as a consequence of the underlying cancer, and from the effects of therapy.
cord-297494-6yxmaihl	2017	However, influenza virus A and B were associated with three-fold higher mortality in patients with chronic respiratory disease but not with other comorbidities (ARR 3.38, 95% CI 1.54–7.42). We conducted this prospective multicentre study to determine the distribution of viruses associated with pneumonia in adults and to establish their virus-specific effects on pneumonia mortality stratified by age group and comorbidity status. To the best of our knowledge, this study is the first to systematically investigate virus-specific effects on pneumonia mortality by age group and comorbidity status among adults. In our study, multiple viruses were identified in 5.1% of virus-associated pneumonia and were associated with higher mortality than single viral infection in patients with chronic respiratory disease and other comorbidities. Systematic reviews have shown that multiple viral infections in patients with respiratory disease are not associated with disease severity [27, 28] ; however, the majority of previous studies included young children but not adults.
cord-297506-1xjgsz4y	2020	COVID-19 is a novel coronavirus first detected in Wuhan, China in late 2019. A 76 year old male patient presented with his wife for altered mental status and lethargy. She reported the patient had not had fevers at home or dry cough, however she had recently experienced a dry cough. The patient had no known history of pulmonary disease. When vital signs were obtained the patient was found to have an oxygen saturation of 70% on room air. The patient was then weaned and able to maintain oxygen saturation of 93% on 5 L via nasal cannula. The patient was admitted to the progressive care unit for respiratory support and COVID-19 rule out. On follow-up, patient tested positive for COVID-19 with declining respiratory status over the next 24 h. Features, evaluation and treatment coronavirus (COVID-19) Update: public health response to the coronavirus disease 2019 outbreak -United States
cord-297518-6y2uzcde	2020	Results: The result of the multivariable binary logistic regression shows that age group (AOR= 1.818, 95% CI= 1.210, 2.731, p-value=0.004 for 30-39 years; AOR= 1.611, 95% CI= 1.016, 2.554, p-value=0.043 for 40-49 years and AOR= 4.076, 95% CI= 2.582, 6.435, p-value=0.0001 for years and above), sex (AOR= 1.672, 95% CI= 1.216, 2.299, p-value=0.002) and history of diabetes mellitus (AOR= 2.406, 95% CI= 1.384, 4.181, p-value=0.002) were found to be significant factors that determine the development of symptomatic disease in COVID-19 patients. . https://doi.org/10.1101/2020.10.09.20209734 doi: medRxiv preprint Therefore, the objective of this study was to assess the determinants of having symptomatic disease among COVID-19 patients admitted to Millennium COVID-19 Care Center in Ethiopia. Based on the chi-square/ Fischer''s exact test result, a significant difference in the presence of symptom was found among the different age groups, sex, different COVID-19 severity, those with a history of pre-existing co-morbid illness, cardiac disease, hypertension, diabetes mellitus, asthma and the need of oxygen supplement.
cord-297532-ktiwfcop	2020	SARS-CoV2 infection has now spread all over the world and higher mortality rates have been reported among elderly and comorbid (diabetes, cardiovascular disease, immunosuppression) patients. We want to share our experience about the management of patients with bullous disorders, in particular pemphigoid disease in our outpatient clinic during COVID-19 pandemic. 10 patients (6 women and 4 men) with a median age of 68.5 years, affected by bullous pemphigoid, all histologically confirmed, were already followed in our Day-Hospital service before the COVID-19 pandemic spread. Weekly telephonic consultations were performed in order to control patients adherence to treatment and to avoid the risk of COVID-19 infection. In literature, several articles suggesting the use of teledermatology services, such as video-call visits, e-mail and mobile applications as useful tool to take care of patients during this pandemic period have already been
cord-297638-ab70s980	2020	31 Additionally, this trial also demonstrated increased maternal morbidity, such as hemorrhage and infection, associated with expectant management of PPROM after 34 weeks that would further increase exposure to different medical personnel, movement between different hospital settings (i.e., labor, operating room, and intensive care unit), and overall length of stay. Although there has been a recent trend to allow a longer second stage of labor in hope of reducing the cesarean delivery rate due to failure to progress in the second stage, a prolonged second stage may be ill advised during the COVID-19 pandemic due to an increased risk of respiratory secretion exposures to visitors and medical personnel. An Analysis of 38 pregnant women with COVID-19, their newborn infants, and maternal-fetal transmission of SARS-CoV-2: maternal coronavirus infections and pregnancy outcomes Intentional early delivery versus expectant management for preterm premature rupture of membranes at 28-32 weeks'' gestation: a multicentre randomized controlled trial (MICADO STUDY)
cord-297759-arg71du6	2020	The primary aim of this review is to summarize the salient evidence for recommendations and optimal treatment strategies for patients with esophageal cancer amidst the COVID-19 pandemic. In a viral pandemic, clinicians should balance the need to perform life-prolonging surgery and offer perioperative therapies with a patient''s risk of contracting severe pneumonia if infected with SARS-CoV-2. The active surveillance strategy could be an alternative approach for clinically complete responders after neoadjuvant therapy in an effort to avoid possible exposure to COVID-19, which may be particularly beneficial considering the patients'' immunosuppressed status [23] . Similarly to the organ-preserving approach in rectal cancer patients who present a complete response after neoadjuvant or definite therapies, the "active surveillance" pathways have been designed as a rationale for clinical complete responders after neoadjuvant chemoradiotherapy in the treatment of EC. Active surveillance versus immediate surgery in clinically complete responders after neoadjuvant chemoradiotherapy for esophageal cancer: a multicenter propensity matched study
cord-297832-picpuzvo	2020	The number of patients with acute episodes of severe bronchospasm needing intubation and ventilatory support has increased rapidly during the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) coronavirus disease 2019 (COVID-19) pandemic. Anteroposterior chest X-ray at the time of acute bronchospasm with Radiographic Assessment of Lung Edema (RALE) score 2 The initial management comprised placing the patient in the prone position and administering oxygen at high flow through a non-rebreather mask with flow between 10 and 15 liters per minute until reaching 100% FiO 2 . To improve ventilatory mechanics and ultimately postpone the need for IMV due to acute bronchospasm in patients diagnosed with COVID-19, we put in place a therapeutic approach consisting of early respiratory therapy and pharmacological bronchospasm rescue approach. The therapeutic bundle of early respiratory therapy, consisting of deep inspiration with inspiratory hold, and pharmacological bronchospasm rescue decreased the need for invasive mechanical ventilation in patients with bronchospasm associated with SARS-CoV-2 and reduced the mortality rate.
cord-297836-y9vt6wvu	2020	https://doi.org/10.1016/j.eururo.2020.03.027: The Forgotten Urological Patient During the COVID-19 Pandemic: Patient Safety Safeguards As described by Stensland et al [1] , urology services have been reduced significantly, with manpower and resources redeployed and reallocated to frontline departments, focusing attention to urgent-only cases during the COVID-19 pandemic [2] . In this letter, we add to the considerations provided by Stensland et al by highlighting important patient safety strategies and safeguards used at a tertiary urological centre amid the climate of resource scarcity during this pandemic. Our national university centre for organ transplantation maintained our cadaveric-donor and living-donor kidney transplantation programmes during this period, with rigorous protocols to screen donors and recipients for COVID-19 to prevent transmission to these immunocompromised patients. With the global focus on patients affected by COVID-19, appropriate levels of urological care must be maintained as patient safety safeguards, especially for certain vulnerable populations.
cord-297840-z5l6vdsr	2007	57 In any case, to establish a medical opinion on risk in air travel, the type, reversibility, and degree of functional impairment caused by the disease must be assessed along with the tolerance of the patient for the predicted flight altitude and the length of exposure. Supplementary oxygen is recommended during air travel for patients who have an estimated in-flight PaO 2 of less then 50 mm Hg obtained with prediction equations or, preferably, a hypoxic challenge test ( Figure 6 ). It also seems wise to extend that treatment option to those cases and in which the in-flight cabin pressure corresponds to an altitude of greater than 2438 m (8000 feet) and the patient has very severe COPD (FEV 1 ≤30%), where limitations may be present in the mechanisms of compensation for hypoxemia, or diseases that alter oxygen transport.
cord-297870-m7n43k4p	2020	Moreover, as in other respiratory infections, preexisting CV diseases and risk factors can increase the severity of COVID-19, leading to the aggravation and decompensation of chronic underlying cardiac pathologies as well as acute-onset of new cardiac complications [3] , highlighting that myocardial injury can be present in approximately 12% of hospitalized patients with SARS-CoV-2 infection [1] . Within the CV manifestations of COVID-19, we can highlight four different aspects: (a) CV risk factors and established CV disease is associated with a worse prognosis, (b) appearance of acute CV complications in previously healthy individuals, (c) promising therapies with antimalarials and antivirals present important CV side effects, and (d) questioning the safety of the use of renin-angiotensin-aldosterone system (RAAS) inhibitors regarding an increased risk of COVID-19 [1] .
cord-298034-0ntxm28a	2020	Medicine in the United States has generally followed ethical principles espoused by Immanuel Kant where the individual patient takes priority in decision-making. With the advent of coronavirus disease 2019 as a major health event, radiation oncologists in some situations need to alter the manner in which they act with individual patients. The longstanding general ethical principles followed in the United States are based largely on concepts elucidated by Immanuel Kant and emphasize individual autonomy. Our US radiation oncology community fortunately rarely faces such emergency situations, but the present COVID-19 pandemic is forcing us to address serious ethical issues. We need to consider not just the impact of radiation therapy on that patient, but also the impact on other patients, health care workers, and society at large. Much cancer treatment is multi-modality, combining radiation therapy with surgery, chemotherapy, and/or immunotherapy, but it may be appropriate to alter standard sequencing in some situations.
cord-298056-svwtfshi	2020	Multivariable analysis showed older age, coronary artery disease, cancer, low lymphocyte count and high RALE score as factors independently associated with an increased risk of mortality. CONCLUSION: In a large cohort of COVID-19 patients of European origin, main risk factors for mortality were older age, comorbidities, low lymphocyte count and high RALE. 14 In this report we describe the demographical, clinical, radiological and laboratory characteristics, as well as the clinical outcomes and the risk factors for mortality, of the first 500 patients with COVID-19 admitted to San Raffaele Scientific Institute, a tertiary care academic hospital in Milan, Italy. With a clinical observation longer than one months from the last patient admitted, w e were able to identify early predictors of mortality related to patient characteristics, radiological and laboratory findings at hospital admission for COVID-19.
cord-298067-awo3smgp	2020	Through associating infection symptoms with the transmission routes of virus and the patient course of the disease, we expect to provide guidelines for clinical diagnosis and the basis for suppressing the spread of the virus and antiviral treatment. On February 1, 2020, respiratory samples of four patients were confirmed SARS-CoV-2 infections by real-time PCR in Jinan Central Hospital, Shandong province, China. Summarizing the published articles, including SARS-CoV and SARS-CoV-2, we combined with epidemiological and clinical data to analyze the possible routes of asymptomatic patients with virus infection in order to provide the basis for suppressing the spread of the virus, and antiviral treatment and advice for the protection of medical staff. The study found that the detection of SARS-CoV-2 nucleic acid positive in a few feces of patients with confirmed COVID-19 cases indicated the presence of a live virus.
cord-298094-ctikhqvr	2020	The principal findings of this study include: (1) rapid clinical deterioration is common in admitted patients, with 53% of intubations occurring within 48 hours, (2) 33% of admitted patients either died or required mechanical ventilation within fourteen days of COVID-19 diagnosis, and (3) combining abnormal ECG and abnormal respiratory vital signs quickly identifies a group of patients at high risk for mechanical ventilation or death. In this study, we sought to determine if data available early in a patient''s emergency department presentation (demographics, comorbidities, vital signs, and ECG) could prognosticate the composite outcome of mechanical ventilation or death by 48 hours after COVID-19 diagnosis. In this study, we sought to determine if data available early in a patient''s emergency department presentation (demographics, comorbidities, vital signs, and ECG) could prognosticate the composite outcome of mechanical ventilation or death by 48 hours after COVID-19 diagnosis.
cord-298325-2gm4fnqi	2020	title: Novel use of home pulse oximetry monitoring in COVID‐19 patients discharged from the emergency department identifies need for hospitalization OBJECTIVES: Our objective was to evaluate patient‐reported oxygen saturation (SpO(2)) using pulse oximetry as a home monitoring tool for patients with initially non‐severe COVID‐19 to identify need for hospitalization. CONCLUSIONS: This study found that home pulse oximetry monitoring identifies need for hospitalization in initially non‐severe COVID‐19 patients when a cut off of SpO(2) 92% is used. Our objective was to evaluate patient-reported oxygen saturation using pulse oximetry as a home monitoring tool for patients with initially non-severe COVID-19 to identify need for hospitalization. Our results found that pulse oximetry as a home monitoring tool identifies need for hospitalization in initially non-severe COVID-19 patients when a cut off of SpO 2 92% is used. This study found that home pulse oximetry monitoring identifies need for hospitalization in initially non-severe COVID-19 patients when resting home oxygen saturation drops below 92%.
cord-298403-ilpzj2sv	2020	title: Minimally Invasive Surgery is the Key to Patient and Operating room team Safety During the COVID19 Pandemic as well as in the "new normal" or chronic Pandemic State to come In cases of emergency or oncological surgery the decision whether to perform abdominal surgery by laparotomy or laparoscopy is dependent on the COVID-19 status, the complexity of the operation, and the respiratory status. Patients with moderately compromised respiratory function requiring mask oxygen therapy or non-invasive ventilation (i.e. Continuous Positive Airway Pressure) can also be operated safely by laparoscopy. Patients with moderately to severely compromised respiratory function with interstitial pneumonia and ARDS, who are ventilated but have good respiratory system compliance (> 50 ml/cm H 2 O) can be safely operated via laparoscopy. At the present time, aside from the potential pulmonary repercussions, there is no evidence that laparoscopy is more dangerous than laparotomy for patients with COVID-19 disease 5 .
cord-298516-0eda4mzs	2020	This prospective study was performed in May 2020 following Dubai Health Care City Authority HSE protocol. 3 The preoperative phase started by taking the temperature of the patients, looking for symptoms such as cough or dyspnea, before they entered the center and by doing an intensive medical interview concerning any suspicious exposures or travels. Perioperatively, the procedure was performed in a sterilized environment; staff wore an N95 mask, sterile gloves, and a disposable gown, and patients wore a surgical mask. As for the staff of 7, no one tested COVID polymerase chain reaction positive before or after this study, and no one developed any of the aforementioned symptoms. In conclusions, after following an HSE plan adapted to the American Academy of Ophthalmology, the American College of Surgeons, and U.S. Centers for Disease Control and Prevention recommendations and guidelines, it might be safe to do short outpatient elective procedures requiring topical anesthesia if all personal protective equipment are available.
cord-298679-w0yp4u19	2020	Logistic regression analyses showed that fever, pneumonia, acute respiratory distress syndrome, diabetes mellitus and cancer were the variables that showed independent and statistically significant associations with mortality. This is one of the first studies to describe the factors associated with mortality in patients infected with SARS-CoV-2 in Spain, and one of the few in the Mediterranean area. The objective of the present study has been to characterize our patients'' epidemiology and to identify the risk factors associated with mortality for this disease in our geographical area. Logistic regression analyses showed that the presence of fever, pneumonia, acute respiratory distress syndrome, type 2 diabetes mellitus and cancer were the only variables that showed an independent and statistically significant association with mortality when they were adjusted for differences in age, gender, smoking status and alcohol intake (Tables 2 and 3) . Clinical characteristics of COVID-19-infected cancer patients: a retrospective case study in three hospitals within Wuhan, China
cord-298787-4vo9gpiu	2013	A retrospective chart review and comparison of patients positive for HPIV types 1–4 by multiplex polymerase chain reaction between 2009 and 2012 at Children''s Hospital Colorado was performed. Human parainfluenza viruses (HPIVs) are among the most common causes of acute respiratory tract infections in children [1] [2] [3] [4] [5] [6] . However, these studies have primarily been conducted outside North America and are limited by small sample sizes and often included patients with concurrent respiratory viral infections, making it difficult to assess the true clinical significance or epidemiology of HPIV-4 in pediatric patients. Previous studies have implicated HPIV-4 as a cause of upper and lower respiratory tract infections in children, but have not definitively demonstrated its epidemiology secondary to limited sample sizes [12, 18] . The study was performed at a large tertiary care children''s hospital, most likely selecting the more seriously ill patients with HPIV infections.
cord-298894-t5hyfum3	2020	Neurological manifestations were classified as: (a) cerebrovascular disease [53 pts (38.7%)] including 37 ischemic and 11 haemorrhagic strokes, 4 transient ischemic attacks, 1 cerebral venous thrombosis; (b) peripheral nervous system diseases [31 (22.6%)] including 17 Guillain–Barrè syndromes; (c) altered mental status [49 (35.8%)] including one necrotizing encephalitis and 2 cases with RT-PCR detection of SARS-Cov-2 RNA in CSF; (d) miscellaneous disorders, among whom 2 patients with myelopathy associated with Ab anti-SARS-CoV-2 in CSF. COVID-19 diagnosis was confirmed: (1) by real-time reverse-transcriptase polymerase-chain-reaction (RT-PCR) on nasopharyngeal specimens [13] ; or (2) by RT-PCR on bronchoalveolar lavage (BAL) obtained by bronchoscopy in case of high clinical suspicion of SARS-CoV-2 infection and negative test results on at least two nasopharyngeal swabs performed at least 24 h apart; or (3) in the presence of characteristic radiological interstitial pneumonia associated with typical symptoms (fever, dry cough, dyspnea), even with negative RT-PCR, with no other possible aetiologic explanation.
cord-298967-vjyh1xvh	2020	METHODS: A virtual meeting was conducted with the members (n=12) of the European Academy of Facial Plastic Surgery Focus Group to outline the safety protocol for the non‐surgical facial aesthetic procedures for aesthetic practices in order to protect the clinic staff and the patients from SARS‐CoV‐2 infection. While many medical Accepted Article practices are being run with online consultations 10 , some countries have recently decided to allow the opening of practices requiring one-on-one contact like dental, physiotherapy, for emergencies provided they strictly follow the guidelines detailing the infection control measures [12] [13] . In our largely elective field, both staff and resources should ideally be allocated through careful protocols in order to prevent COVID-19 infection. In response to this pandemic, our focus group has developed a process to stratify procedures and clinical levels with protocols that aim to minimize the risk of contagion and the diffusion of COVID-19 infection.
cord-298974-69xjc5yq	2018	The transmission connectivity networks of people infected with highly contagious Middle East respiratory syndrome coronavirus (MERS-CoV) in Saudi Arabia were assessed to identify super-spreading events among the infected patients between 2012 and 2016. e variables considered in this study were age, gender, patient type (whether the patient is a healthcare worker (HCW) or nonhealthcare worker), health outcome (dead or alive) as at the last day of follow-up, patient comorbidity status, types of exposure to known risk factors (animal contact and camel contact indirectly or directly or through consumption of camel products), and place of infection (classified as hospital, community, and household/ family). Patient 1664 was favoured (based on degree, closeness, betweenness, and eigenvector network centrality metrics) as the most important in the transmission network by having the highest number of secondary cases. In this study, several network centrality metrics (degree, betweenness, closeness, eigenvector, and 2-reach) were used to quantify the connectivity among MERS cases and to identify which patient requires prioritization for intervention.
cord-299024-jkqdzt87	2020	We present the case of a patient with a non-bacterial thrombotic aortic valve endocarditis experiencing severe thromboembolic complications and an acute right internal carotid artery occlusion in the context of a paraneoplastic syndrome and an asymptomatic SARS-CoV-2 infection, despite treatment with different and overlapping anticoagulant medication. This case describes a patient with non-bacterial thrombotic aortic valve endocarditis that developed despite treatment with a factor-Xa-inhibitor and who subsequently suffered a myocardial infarction and two strokes within a short period of time in the context of a paraneoplastic syndrome and asymptomatic SARS-CoV-2 infection. Paraneoplastic syndromes are often linked to increased thrombogenicity; however, non-bacterial thrombotic aortic valve endocarditis is rare even in the situation of cancer. 3 This case highlights the many-sided effects of paraneoplastic syndromes and SARS-CoV-2 infection in patients being already at increased risk for thrombotic complications due to underlying disease.
cord-299082-s8bm40vy	2020	5, 6, 9, 10, [12] [13] [14] [15] Several investigators have reported cardiac function and structural abnormalities in patients with SARS-CoV-2 infection, including acute heart failure (HF), 3,10,16 takotsubo syndrome, 17 ,18 viral myocarditis, 19 and acute myocardial infarction. In addition to exacerbating the previous cardiomyopathy and conduction disorders, inducing arrhythmia events, SARS-CoV-2 may also induce electrophysiological abnormalities in patients with no previous history of heart disease under a variety of mechanisms. Clinical features and mechanism of heart injury in patients suffered from severe acute respiratory syndrome. Effect of high vs low doses of chloroquine diphosphate as adjunctive therapy for patients hospitalized with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection: a randomized clinical trial Risk of QT interval prolongation associated with use of hydroxychloroquine with or without concomitant azithromycin among hospitalized patients testing positive for coronavirus disease 2019 (COVID-19)
cord-299124-g70v4crs	2020	Early analysis of patient outcomes following pandemic-related practice changes suggest that patients with chronic limb threatening ischemia (CLTI) have been presenting with more severe foot infections and are more likely to require major limb amputation compared to 6 months prior. As our society and health care system adapt to the new changes required in the post-COVID era, it is critical that we pay special attention to the most vulnerable subsets of patients with vascular disease, particularly those with CLTI and limited access to care. Faculty, fellows, and residents provide care for vascular patients at the main UCSF campus as 10 well as two partner hospitals; the San Francisco Veteran Affairs (SFVA) Medical Center and 11 Providers prioritized in-person clinic visits for patients 9 with advanced lower extremity peripheral artery disease (PAD) with concern for CLTI (e.g. new 10 tissue loss), given that physical examination and vascular studies are essential for evaluation.
cord-299156-1dwsm3ie	2020	The aim of this study was to assess the clinical and molecular ocular involvement among patients with confirmed COVID-19 admitted to a tertiary care facility. CONCLUSIONS: Among patients admitted to a tertiary referral center with confirmed COVID-19, active conjunctival injection was noted in one out of five cases, and was associated with loss of smell and taste. Among patients with COVID-19, active conjunctival injection was associated with loss of smell and loss of taste as part of the clinical presentation (66.7% vs 7.7%, p = 0.018). In this study, we evaluated the ocular signs and symptoms, as well as the presence of SARS-CoV-2 in conjunctival swab samples among patients with COVID-19 in one tertiary referral center during March and April of 2020. To conclude, among patients admitted to a tertiary referral center with confirmed COVID-19, active conjunctival injection was present in 19% of cases and was associated with loss of smell and taste as part of the clinical presentation.
cord-299222-vmofcrim	2020	All rights reserved Due to uncertainty about the risk of an increased prothrombotic state in CAC in association with emicizumab prophylaxis, thromboprophylaxis with low molecular weight heparin (LMWH), enoxaparin 40 mg once daily, was started. Bearing in mind the low risk of thrombosis with emicizumab in SHA without inhibitors, but because some of the mechanisms associated with the risk of thrombosis described above could be risk factors for the development of CAC, and in the absence of literature or guidelines for the management of such patients, our consensus clinical decision was to administer prophylactic doses of LMWH and to monitor laboratory parameters to follow up the disease and cytokine release storm. But we proposed the use of prophylactic dose of LMWH in SHA on emicizumab treatment at diagnosis, based on the low rate of bleeding complications associated with its
cord-299254-kqpnwkg5	2020	In this paper, we proposed a multimodal data acquisition and analysis system called INSMA, with the ability to acquire, store, process, and visualize multiple types of data from the Philips IntelliVue patient monitor. Enormous volumes of multimodal physiological data are generated including physiological waveform signals, patient monitoring alarm messages, and numerics and if acquired, synchronized and analyzed, this data can been effectively used to support clinical decision-making at the bedside [10, 18] . We have been working on building the Integrated Medical Environment (tIME) [10] to address this critical opportunity and in this paper, we discuss an integrated system (INSMA) that supports multimodal data acquisition, parsing, real-time data analysis and visualization in the ICU. Advances in informatics, whether through data acquisition, physiologic alarm detection, or signal analysis and visualization for decision support have the potential to markedly improve patient treatment in ICUs. Clinical monitors have the ability to collect and visualize important numerics or waveforms, but more work is needed to interface to the monitors and acquire and synchronize multimodal physiological data across a diverse set of clinical devices.
cord-299333-qu0bmov5	2020	Since December 2019, infections with severe acute respiratory syndrome coronavirus 2 (SARS-Cov-2), a novel betacoronavirus strain responsible for coronavirus disease 2019 (COVID19) , rapidly progressed from an isolated cluster of cases in the Hubei province of east central China to a pandemic, with significant global health and economic repercussions [4, 5, 10, 24, 25, 27, 28, 44, 58, 80, 91] . Early reports from Italy and China indicated that although pulmonary diseases including ARDS and diffuse pneumonia comprise the predominant lethal complications of COVID-19, patients have also presented with or developed significant cardiac signs and symptoms [50] . COVID-19 musculoskeletal and neurologic manifestations are being reported with increased frequency, particularly in patients with more severe respiratory disease, indicating coronavirus neurotropism possibly directly related with higher viral loads, which are now detectable in cerebrospinal fluid [20] .
cord-299346-f13xly6q	2020	title: Perioperative Considerations in Urgent Surgical Care of Suspected and Confirmed Coronavirus Disease 2019 Orthopaedic Patients: Operating Room Protocols and Recommendations in the Current Coronavirus Disease 2019 Pandemic To reduce the occupational risk in treating suspected or confirmed COVID-19 urgent orthopaedic patients, recommended precautions and preventive actions (triage area, ED consultation room, induction room, operating room, and recovery room) are reviewed. HCPs in high-risk areas should adhere to infection prevention and control practices, which includes the appropriate use of engineering controls (negative pressure rooms), administrative controls, and personal protective equipment (PPE) ( 6 Per CDC recommendations, a clinically suspected/ confirmed COVID-19 patient should wear a cloth face covering, over nose, and mouth and a surgical mask should be reserved for HCP and first responders. It is recommended for an environmental services worker to increase the Flowchart demonstrating the the recommended use of personal protective equipment for different activities at various settings managing suspected/clinically Coronavirus disease 2019 patients.
cord-299449-226dd23u	2020	It is acknowledged that the SARS-CoV-2 pandemic will require center specific discussions of appropriate resource allocation that considers patient and provider safety, resource constraints, and a realistic evaluation of the impact of therapy upon Incurable brain tumors. This international multidisciplinary group of experts in HGG provides a risk-adapted framework for decisions in both pandemic scenarios, considering both ethical issues and resource constraints, in order to minimize the irreparable damage associated with withholding necessary treatments. We recognize that during the pandemic the challenges of ICU capacity, conservation of PPE, availability of health care professional expertise and the risk for patients'' exposure to SARS-CoV-2 may reduce the ability to provide optimal surgical management. Patients and caregivers should be included in the decision-making process as much as possible, and this should include all relevant data on chemotherapy and radiotherapy, as well as the individual risk profile associated with a potential SARS-CoV-2 infection.
cord-299489-6v225vte	2020	So that, before transferring the patient we performed a new PCR test with a negative result. Once here, since the patient had not complied the 14 days of individual isolation after discharge, a serologic test was ordered to verify if the infection was active or passed; the result was positive, but unfortunately there was no possibility to know about which kind of immunoglobulins was elevated (Ig G or Ig M) due to the lack of reactants. Until a few days ago, only urgent procedures and high priority oncological elective surgery in non-COVID-19 patients were performed and always balancing the risk of delaying therapy against the availability of hospital resources and potential exposure of COVID-19 on a case-bycase basis. In addition, whenever possible, the elective surgical activity has been transferred to COVID-free areas to avoid potential contracting intra-hospital infections. Since previous reports have revealed that there are asymptomatic patients infected with SARS-CoV-2 (4,5), all patients needing a surgical intervention should be tested.
cord-299570-1xz5r95f	2020	Métodos: Estudio observacional prospectivo de los pacientes con diagnóstico de COVID-19 por PCR positiva y considerados de alto riesgo que se siguieron con telemedicina y telemonitorización en el Área Sanitaria de Lugo entre el 17 de marzo y el 17 de abril de 2020. Conclusiones: Nuestros datos sugieren que la telemedicina con telemonitorización domiciliaria, utilizada de forma proactiva, permite un seguimiento clínicamente útil y seguro en pacientes con COVID-19 de alto riesgo. Our study suggests that telemedicine with home telemonitoring, used proactively, allows for monitoring high-risk patients with COVID-19 in a clinically useful and secure way. Our study suggests that telemedicine with home telemonitoring, used proactively, allows for monitoring high-risk patients with COVID-19 in a clinically useful and secure way. Los datos de este estudio sugieren que el seguimiento domiciliario con telemedicina y telemonitorización en pacientes COVID-19 es un sistema bien aceptado, útil y seguro.
cord-299621-m4kdkmey	2017	Middle East respiratory syndrome coronavirus (MERS-CoV) was first identified from a 60-year-old Saudi male patient admitted to a private hospital in Jeddah, Saudi Arabia on June13, 2012, with history of fever, cough, expectoration, and shortness of breath who eventually expired 11 days after admission from progressive respiratory failure. In April 2012, a cluster of cases of pneumonia occurred in health care workers of an intensive care unit in a hospital in Zarqa, Jordan, of which 2 patients died, both of whom were confirmed to be infected with the novel coronavirus by retrospective analysis of stored sample. New respiratory illness room with portable High efficiency particulate arrestors (HEPA) was created to isolate suspected MERS-CoV infected patients within the Emergency Medical Services. Until date (July 2017), there are no healthcare associated MERS-CoV Infection among patients, visitors and HCWs of our hospital and improved compliance with the IPC policies and procedures were achieved.
cord-299679-6z9e5gi6	2020	Many intubated patients present with phenotype 4, characterised by pulmonary hypoxic vasoconstriction, being associated with severe hypoxaemia with "normal" (>40 mL·cmH(2)O(−1)) lung compliance and likely representing pulmonary microvascular thrombosis. Phenotype 5 is often associated with high plasma procalcitonin and has low pulmonary compliance, Which is a result of co-infection or acute lung injury after noninvasive ventilation. The clinical spectrum of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection is broad, ranging from asymptomatic infection to flu-like illness (sometimes with digestive disturbances) to viral pneumonia. Phenotype 2 represents 80% of hospitalisations and is characterised by the presence of hypoxaemia or small opacities on chest radiographs and these patients should be referred for close respiratory monitoring ( particularly respiratory rate and oxygen saturation measure by pulse oximetry) because they are at risk of rapid deterioration progressing to death if intubation is not timely instituted.
cord-299681-smhto9em	2020	In this report we describe two cases COVID infection who first presented with herpes zoster. We are here by suggesting that the clinical presentation of HZ at the time of the current pandemic even in patients giving mild or no suggestive history of upper respiratory symptoms should be considered as an alarming sign for a recent subclinical SARS CoV2 infection. Most patients with COVID-19 exhibit mild to moderate symptoms, but approximately 15% of the cases progress to severe pneumonia and about 5% eventually develop acute respiratory distress syndrome (ARDS), septic shock and/or multiple organ failure (3, 4) . We present two cases of clinically diagnosed Herpes zoster infection attending two different clinics, both patients'' showed no or mild symptoms of COVID 19 infection and denied any history of contact with known or suspected COVID19 cases. Clinical Characteristics of 138 Hospitalized Patients With 2019 Novel Coronavirus-Infected Pneumonia in Wuhan
cord-299750-zkrlm3ds	2010	We describe the clinical characteristics and factors associated with the death of patients who were hospitalized with 2009 H1N1 influenza pneumonia in Shenyang, China, from November to December 2009. Therefore, this report summarizes the clinical manifestations, clinical outcomes and the risk factors associated with death in hospitalized pneumonia patients associated with 2009 H1N1 influenza infections in Shenyang, China, during November to December 2009. They used a standardized form that included demographic data, seasonal influenza vaccination history for the previous year, smoking status, underlying medical conditions, clinical signs and symptoms, selected laboratory tests including C reactive protein (CRP), white blood cell classification and count, lactic dehydrogenase (LDH), creatine kinase (CK), glutamic-oxaloacetic transaminase (AST), glutamic alanine aminotransferase (ALT), albumin (Alb), CD4, CD8 and CD3 T cell counts, blood gas analyses, blood or sputum cultures, radiographic findings, intervals between symptom onset and initiation of oseltamivir therapy, treatment course and length of stay.
cord-299784-xxxdjfbc	2020	title: Exploring Personal Protection During High-Risk PCI in a COVID-19 Patient: Impella CP Mechanical Support During ULMCA Bifurcation Stenting The correct management of patients with coronavirus disease 2019 and acute coronary syndrome is still uncertain. We describe the percutaneous treatment of an unprotected left main coronary artery in a patient who is positive for coronavirus disease 2019 with unstable angina, dyspnea and fever. The use of the Impella CP cardiac assist system to provide left ventricular support during high-risk percutaneous coronary interventions is recommended in such settings, because its efficacy is supported by randomized@LBettari. Realworld use of the Impella 2.5 circulatory support system in complex high-risk percutaneous coronary intervention: the USpella Registry Supported high-risk percutaneous coronary intervention with the Impella 2.5 device the Europella registry KEY WORDS COVID-19, high-risk PCI, personal protection equipment APPENDIX For supplemental videos, please see the online version of this paper Personal Protection During High-Risk PCI in a COVID-19 Patient
cord-299835-92karhpl	2004	title: Mild Illness Associated with Severe Acute Respiratory Syndrome Coronavirus Infection: Lessons from a Prospective Seroepidemiologic Study of Health-Care Workers in a Teaching Hospital in Singapore Participating HCWs completed a questionnaire and provided paired serum samples, which were analyzed by 2 different laboratories blinded to clinical data, by use of an enzyme-linked immunosorbent assay based on a protocol developed by the Centers for Disease Control and Prevention and a dot-blot immunoassay, with confirmation by a viral neutralization assay. Of the 372 HCWs participating in the present study, 8 were found to have positive antibodies to the SARS coronavirus in both samples by use of both test methods, and 6 had pneumonia and had been hospitalized for either probable or suspected SARS infection, whereas 2 had fever but did not have changes on chest radiographs.
cord-299881-weptfpa2	2020	This study aims to work out potential adjustments of trauma bay algorithms during a global pandemic in order to reduce contamination and to increase safety for patients and medical personnel. In order to contain spreading of SARS Cov-2, the suggested recommendations of adjusting trauma bay protocols for severely injured patients include (1) minimizing trauma bay team members with direct contact to the patient; (2) reducing repeated examination as much as possible, with rationalized use of protective equipment; and (3) preventing potential secondary inflammatory insults. These guidelines include recommendations for the minimum number of required medical professionals in the trauma bay (e.g., anesthesiologists, traumatologist, neurosurgeons, nurses, technicians etc..), initial assessments according to Advanced Trauma Life Support (e.g., blood pressure measurements, respiratory rate, auscultation and examination of body regions, etc.), and settings around the trauma bay management, such as operation room or computer tomography availability [5, 6] .
cord-300038-1fjb6b8e	2020	According to a recent report 3 , COVID-19, the disease caused by SARS-CoV-2, is characterized by three clinical patterns: no symptoms, mild to moderate disease, severe pneumonia requiring admission to Intensive Care Unit (ICU) in up to 31% of the patients 3 . On this basis, we assessed the safety of baricitinib therapy combined with lopinavir-ritonavir in moderate COVID-19 pneumonia patients and we evaluated its clinical impact. All consecutive hospitalized patients (March 16 th -30 th ) with moderate COVID-19 pneumonia, older than 18 years, were treated for 2 weeks with baricitinib tablets 4 mg/day added to ritonavirlopinavir therapy. The last consecutive patients with moderate COVID-19 pneumonia receiving standard of care therapy (lopinavir/ritonavir tablets 250 mg/bid and hydroxychloroquine 400 mg/day/orally for 2 weeks) admitted before the date of the first baricitinib-treated patient served as controls. These preliminary results on 12 patients with moderate COVID-19 pneumonia confirmed the safety of baricitinib therapy in a clinical context different from RA 7 .
cord-300044-vn4c6wh7	2015	Rare causes, such as pneumonia from atypical agents from an undiagnosed immunodeficiency, congenital heart disease, methemoglobinemia, and pulmonary malformations, should be entertained as possible components of the differential diagnosis in the ED. In this child, the differential diagnosis narrows significantly to a pulmonary etiology in a patient who had infiltrates on chest radiograph and whose respiratory distress and hypoxia responded readily to supplemental oxygen, making the diagnosis of congenital heart disease unlikely. Viral bronchiolitis typically presents with upper respiratory symptoms followed by lower respiratory infection resulting in wheezing and rales in children younger than two years of age. 1 Pneumonia is another common cause of hypoxia and respiratory distress in children and can be the result of both bacterial and viral infections. 6, 7 PCP is one of the opportunistic infections with which patients with Hyper IgM syndrome may present.
cord-300080-l0fyxtva	2015	With the presentation of patients with Ebola to US acute care facilities, ethical questions have been raised in both the press and medical literature as to how US emergency departments, emergency physicians, emergency nurses and other stakeholders in the healthcare system should approach the current epidemic and its potential for spread in the domestic environment. With the presentation of patients with Ebola to US acute care facilities, ethical questions have been raised in both the press and medical literature as to how US emergency departments, emergency physicians, emergency nurses and other stakeholders in the healthcare system should approach the current epidemic and its potential for spread in the domestic environment. WHAT 41 It is anticipated that patients with a confirmed EVD diagnosis will be transferred to these hospitals which will have enough PPE and other treatment requirements (isolation rooms, dedicated equipment and designated physicians, nurses and other necessary health care professionals and staff with proper training under CDC guidelines) to manage patients for at least 7 days, after which governmental agencies would assist in acquiring more supplies and expertise if needed.
cord-300183-z3fwtwqb	2020	Moreover, a comprehensive review of literature is performed to illustrate the potential factors delaying and decreasing timely presentations and interventions for time-dependent medical emergencies like ST-segment elevation myocardial infarction (STEMI). Moreover, a comprehensive review of literature is performed to illustrate the potential factors delaying and decreasing timely presentations and interventions for time-dependent medical emergencies like ST-segment elevation myocardial infarction (STEMI). There is a delay and decrease in presentations and timely interventions for medical emergencies like STEMI during the current era of COVID-19 crisis. ► Several community and healthcare-system-related factors delay and decrease the presentation and intervention for time-dependent non-communicable diseases such as STsegment elevation myocardial infarction (STEMI) in the era of COVID-19 crisis. Delayed Presentation of Acute ST Segment Elevation Myocardial Infarction Complicated with Heart Failure in the Period of COVID-19 Pandemic -Case Report Complication of late presenting STEMI due to avoidance of medical care during the COVID-19 pandemic
cord-300303-d4qmtysd	2020	The global preparedness and response to the rapid escalation to severe acute respiratory syndrome coronavirus (SARS-CoV)-2-related disease (COVID-19) to a pandemic proportion has demanded the formulation of a reliable, useful and evidence-based mechanism for health services prioritisation, to achieve the highest quality standards of care to all patients. The global preparedness and response to the rapid escalation to severe acute respiratory syndrome coronavirus (SARS-CoV)-2-related disease to a pandemic proportion has demanded the formulation of a reliable, useful and evidence-based mechanism for health services prioritisation, to achieve the highest quality standards of care to all patients. The global preparedness and response to the rapid escalation of severe acute respiratory syndrome coronavirus (SARS-CoV)-2-related disease at a pandemic proportion has demanded the prompt development of a reliable, applicable and evidenceinformed mechanism for the priority-setting of health services, to assure the attainment of the highest standards of quality care to all.
cord-300344-57vxlctl	2020	PURPOSE: To report our initial experience with weekly tele-video "virtual" on treatment visits (vOTVs), describe the logistics of implementation, report results of patient and physician surveys, and discuss barriers, limitations, and benefits of vOTVs during the COVID-19 pandemic. Physicians participating in the vOTVs felt very comfortable in their ability to manage patients though this platform (5.0), and on average did not report any difference in terms of efficiency of visits (3.0). Our experience suggests that vOTVs can be implemented rapidly using available technology, and with a high degree of patient and physician satisfaction during this pandemic with similar efficiency to in person OTVs. COVID-19 can cause serious illness or death, particularly in high risk groups. In an effort to further minimize patient, and staff risk of COVID-19 exposure, the American Society for Radiation Oncology (ASTRO) lobbied for coverage of virtual on treatment visits (vOTVs).
cord-300356-oorac5he	2011	20 Risk factors for community-acquired P aeruginosa pneumonia include bronchiectasis, immunocompromised state, use of multiple courses of antibiotics, prolonged glucocorticoids in patients with COPD, and recent hospitalization. One of the most important decisions in the management of pneumonia is to assess the severity of the disease, which can be used to predict mortality risk and may be Nair & Niederman a surrogate measure to define the site of care (outpatient, hospital ward, or ICU). 61, 62 Although administration of therapy within 4 to 6 hours of arrival at the hospital can reduce mortality, it is important to only use antibiotics when the diagnosis is certain, because indiscriminate use of antibiotics in the absence of radiographic pneumonia has limited benefit and a real risk of Community-Acquired Pneumonia antibiotic-associated adverse events, including drug-induced infectious diarrhea.
cord-300445-qzu4gz2d	2020	Chloroquine phosphate and its derivative hydroxychloroquine, which have been used in the treatment and prevention of malaria and autoimmune diseases for decades, were found to inhibit SARS-CoV-2 infection with high potency in vitro and have shown clinical and virologic benefits in COVID-19 patients. However, chloroquine phosphate and its derivative hydroxychloroquine, which have been used for decades in the treatment and prevention of malaria and chronic inflammatory diseases such as rheumatoid arthritis and systemic lupus erythematosus, were discovered to have a high inhibitory potency against SARS-CoV-2 infection in vitro [2] [3] [4] [5] and favorable clinical and virologic benefits in COVID-19 patients [6] [7] [8] [9] [10] , and they have emerged as important therapies for COVID-19 in several countries, including China, France, USA, and India, although the mechanisms of their anti-COVID-19 effects remain unclear.
cord-300458-jeuwaj50	2020	COVID-19-What we know and what we need to know: There are more questions than answers This collection of short statements from the editors of HERZ/Cardiovascular Diseases is a strong signal to the readers of our journal in critical times. But we also fear that with a low herd immunity a second wave of infection might follow, since no proven antiviral treatment for COVID-19 exists and vaccination is not yet available [3] . Pulmonology demonstrates with every ventilated patient that COVID-19 is a potentially lethal lung disease. The first reported Chinese patient with suspected myocarditis from SARS-CoV-2 was treated with ventilation, methylprednisolone, i.v. immunoglobulins and inotropics and survived [4] . A total of 55 authors (!) have described in an observational study with 66 COVID-19 patients without a control group a beneficial effect in the New England Journal of Medicine [5] . 2020) compassionate use of remdesivir for patients with severe Covid-19
cord-300510-fhpkdqr0	2020	7. Perform early intubation if poor response to continuous positive airway pressure in terms of oxygenation: do not trust patients'' relatively good respiratory mechanics and feeling of improved dyspnoea, since these patients may have relatively normal lung compliance and the only clinical sign of fatigue may be high respiratory rate. As soon as possible according to gas exchanges (PaO 2 /FiO 2 > 150 with FiO2 < 50%) and lung ultrasound score (≤ 12), start assisted ventilation with a sigh while maintaining moderate to high positive end-expiratory pressure to prevent derecruitment. Abbreviations SARS-CoV-2: Severe acute respiratory syndrome coronavirus 2; ICU: Intensive care unit Assessment of lung aeration and recruitment by CT scan and ultrasound in acute respiratory distress syndrome patients Risk factors associated with acute respiratory distress syndrome and death in patients with coronavirus disease 2019 pneumonia in Wuhan, China The authors read and approved the final manuscript.
cord-300559-vuuxthx2	2020	Logistic regression analysis showed that male, high body mass index (especially obesity), elevated fasting blood glucose and urinary protein positive are all risk factors for severe young COVID‐19 patients. The analysis showed that a high body mass index (especially obesity), an elevated FBG level, an elevated LDH level, and urinary protein positivity were all risk factors for severe COVID-19 in these young patients. A recently published study from China also showed that in metabolic-associated fatty liver disease patients, obesity can increase the risk for severe COVID-19 by about 6-fold [22] . Notably, in the present study, all of the severely or critically ill COVID-19 patients were males, an observation which may also be related to the distribution of obesity in China. Obesity as a risk factor for greater severity of COVID-19 in patients with metabolic associated fatty liver disease
cord-300608-eju7wnb9	2020	2.1 | Respiratory system SARS-CoV-2 tends to infect the respiratory tract, thus, pneumonia is a primary clinical finding in patients with COVID-19 Li, Guan, et al., 2020; Zhu et al., 2020) . A number of investigations recently conducted on COVID-19 have reported that IL-6 levels was actually higher in the patients with severe disease (Cai, 2020; Chen, Liu, et al., 2020; Xiang et al., 2020) . Impaired liver function tests have been reported for a number of patients with SARS-CoV-2 infection, suggesting hepatic damage as an extrapulmonary complication of COVID-19 in almost one half of the patients (Chen, Zhou, et al., 2020; Wang, Hu, et al., 2020) . Since H7N9 and SARS-CoV-2 can result in similar complications, for example, ARDS and respiratory failure, MSC-based therapy might lead to a new path in treatment of COVID-19-associated pneumonia . Clinical characteristics of 138 hospitalized patients with 2019 novel coronavirus-infected pneumonia in Wuhan
cord-300697-p96i25uc	2020	title: A severe coronavirus disease 2019 patient with high-risk predisposing factors died from massive gastrointestinal bleeding: a case report CASE PRESENTATION: We herein described a case of severe SARS-CoV-2 infected patient with several risk factors for poor prognosis, including male, hypertension, old age, mixed bacterial infection and multilobular infiltration on radiological imaging. After improvement of respiratory status, the onset of gastrointestinal bleeding occurred, probably resulting from direct viral invasion as evidenced by the positive findings for SARS-CoV-2 in the repeat stool specimens. Additionally, despite the clinical manifestations of coronavirus disease 2019 (COVID-19) are dominated by respiratory symptoms, evidences from recent studies have suggested that SARS-CoV-2 has the ability to actively infect and replicate in the gastrointestinal tract [3] . Herein, we described an old-aged COVID-19 patient with multiple risk factors for severe disease and ultimately died from massive GIB at Wuhan Union Hospital.
cord-300774-5mrkmctl	2020	INTRODUCTION: Tocilizumab is an interleukin 6 receptor antagonist which has been used for the treatment of severe SARS-CoV-2 pneumonia (SSP), aiming to ameliorate the cytokine release syndrome (CRS) -induced acute respiratory distress syndrome (ARDS). Patients with severe SARS-CoV-2 pneumonia (SSP) die due to poor oxygenation despite ventilatory support and different treatments including drugs with anti-viral activity, such as remdesivir, lopinavir/ritonavir, interferon beta, hydroxychloroquine; and/or anti-inflammatory drugs, such as corticosteroids, azithromycin and low molecular weight heparin amongst other [2] [3] [4] [5] . However, clinical and pathological studies of SARS-CoV-2 disease indicate that a systemic cytokine storm due to macrophage activation may be the leading cause of death in the vast majority of patients, usually occurring two to four weeks after primary infection [14] [22] [23] .
cord-300811-l4y7df2f	2020	We conducted a meta-analysis of recent studies that reported the association of CVD with worse prognosis and increased mortality in COVID-19 patients. Inclusion criteria were observational case-control or cohort studies on COVID-19 patients with a history of CVD included, which reported outcomes of COVID-19 infection severity, clearly outlined the definition of "severe disease" and with sample size >10. To this end, we carried out a pooled analysis of current studies and evaluate the association between underlying or previous history of CVD conditions and outcomes of infection severity in COVID-19 patients. Pooled analysis of these studies did not find a significant association between previous history of CVD and mortality in severe COVID-19 disease (OR=1.72; 95% CI: 0.97-3.06, I 2 =0%, Cochran''s Q=1.56, p=0.46). A total of 3 (n= 566) studies reported data on mortality in all hospitalized patients COVID-19 disease and pre-existing history of CVD.
cord-300866-cso6l6ze	2020	Both SARS-CoV-2 nucleic acid tests were negative (24 h interval), Fig. 2 The treatment of COVID-19 patients with intracerebral hemorrhage suggesting that antiviral treatment was effective. On February 29, the patient did not have high fever again, the results of the cerebrospinal fluid review showed that it was light red, no clot, protein decreased to 0.8 g/L, sugar increased to 4.45 mmol/L, and white blood cells decreased to 37 × 10 6 G/L, of which monocytes accounted for 74%. The patient''s cerebrospinal fluid showed improvement, and since the two re-examinations of SARS-CoV-2 nucleic acid test was negative, and the antiviral treatment with Abidol, Ribavirin, and Oseltamivir had reached the course of treatment, so it was discontinued. However, in combination with the patient''s high fever, lymphocytopenia, increased neutrophils, and poor antibacterial treatment effect, the clinical manifestations conform to the COVID-19 characteristics, and nucleic acid detection is required.
cord-300963-1n1f8mf2	2020	Previous studies based on SARS-CoV-1 showed that the "cytokine storm" was strongly associated with viral sepsis, inflammation-induced lung injury, and acute respiratory distress syndrome (ARDS) [32, 34] . With regard to IBD-specific risk factors, it is speculated that patients on immunosuppressive agents, those with active IBD symptoms, malnutrition, and frequent visits to clinics or hospitals are at greater risk of acquiring SARS-CoV-2 infection [50] . The International Organization for the Study of Inflammatory Bowel Diseases (IOIBD) maintains a registry for reporting COVID-19 in IBD patients called SECURE-IBD registry. Hence, all the societies have recommended that patients continue their IBD medications to sustain remission, because the risk of disease flare-up outweighs the chance of contracting SARS-CoV-2 infection. The management strategy will depend on multiple factors, such as the patient''s age, the severity of the COVID-19 infection, the clinical status of the IBD, and the presence of other comorbid conditions.
cord-300995-tqz2bkdo	2020	The worldwide medical community is striving to pursue the most appropriate clinical choices in the worst event of pandemic of the modern times [1], with over 1 million patients affected by COVID‐19 (i.e., swab positive patients with or without symptoms) reported so far [1]. The worldwide medical community is striving to pursue the most appropriate clinical choices in the worst event of pandemic of the modern times [1] , with over 1 million patients affected by COVID-19 (i.e., swab positive patients with or without symptoms) reported so far [2] . All rights reserved We therefore propose that the oncological risk and the risk of SARS-CoV-2 infection need to be considered and balanced in order to provide a weighted and controlled strategy to advanced skin cancer patients. A useful approach, as already suggested by other authors, is to identify the different classes of priorities, both for the patients and for health professionals [5, 6] .Only a few national and international societies have released specific recommendations for skin cancer patients [7] .
cord-301011-xbuqd0j5	2020	In line with international initiatives, this article aims to provide guidance and detailed recommendations for hospital-based physical therapists managing patients hospitalized with COVID-19 through a national approach in the Netherlands. A working group conducted a purposive scan of the literature and drafted initial recommendations based on the knowledge of symptoms in patients with COVID-19, and current practice for physical therapist management for patients hospitalized with lung disease and patients admitted to the intensive care unit (ICU). 12 In line with this international study 12 and the consensus statement of Italian respiratory therapists 13 we aim to provide guidance and detailed recommendations for hospital-based physical therapists managing patients hospitalized with COVID-19 through a national approach in the Netherlands. Physical therapist management for patients hospitalized with COVID-19 comprises elements of respiratory support and active mobilization. Physical therapist management for patients hospitalized with COVID-19 comprises elements of respiratory support and active mobilization.
cord-301079-n1nytr6k	2020	Results A total of 367 air and surface swabbing samples were collected from the patient care areas of 15 mild and 9 severe/critical COVID-19 patients. Here we collected air and surface samples from isolation wards and ICU units of a tertiary hospital in Wuhan, with the aim to evaluate environmental contamination after enhancement of infection prevention and control measures (IPC) during the COVID-19 pandemic. We also compared environmental contamination of low-and high-touch surfaces, patient hands and PPE of HCP, and the results were also linked to clinical data of sampling patients. Another study found only 1 out of 14 surgical masks worn by mild and severe COVID-19 patients tested positive for SARS-CoV-2 . Environmental contamination of the SARS-CoV-2 viral RNA could be found even in seroconverted patients in healthcare settings, and the contamination risk was higher in high-touch areas near severe/critical patients.
cord-301087-9vl5pqi7	2014	The epidemiology, risk factors and outcomes of viral respiratory tract infections (vRTI) are not well described in patients with multiple myeloma managed with novel agents, the current standard of care. Whilst the epidemiology, clinical outcomes and risk factors associated with viral RTI (vRTI) are well known in the haematopoietic stem cell transplant (HSCT) setting and supported by appropriate management guidelines, these characteristics have not been reported in myeloma patients managed with novel agents [5, 6] . Patients were identified retrospectively from chemotherapy drug dispensing and microbiology databases using the following criteria: a confirmed diagnosis of multiple myeloma, received active therapy with IMiD or PI and tested positive for respiratory viral (RV) infection by nucleic acid amplification testing (NAT) at Peter MacCallum Cancer Centre (PMCC) from January 2009 to December 2012. Clinical records of eligible patients were reviewed using a standardized tool to capture the following: patient demographics, myeloma therapy, seasonality of infection, radiological changes, clinical features and outcomes (length of stay (LOS)), requirement for intensive care (ICU) management and all-cause mortality at 30 days).
cord-301146-no9pw4gn	2020	authors: Lattenist, R.; Yildiz, H.; De Greef, J.; Bailly, S.; Yombi, J.C. title: COVID-19 in Adult Patients with Hematological Disease: Analysis of Clinical Characteristics and Outcomes However, data on patients with COVID-19 and an underlying hematological disease as well as on specific risks factors in this particularly immunocompromised population are scarce [2] [3] [4] [5] . The association between lower hemoglobin level at presentation and a higher mortality rate was also found by Mehta et al. In our small cohort of patients, we found no association between the myeloid/lymphoid character of the underlying disease and COVID-19 fatality (data not shown) but, to mention, our series did not include any MPN or MDS except under the form of a progression to secondary acute myeloid leukemia. Clinical impact of COVID-19 on patients with cancer (CCC19): a cohort study
cord-301148-duttw9xn	2020	
cord-301281-yur5hs2h	2020	We here report the contribution of complement activation and impact of complement blockade in severe COVID-19, defined as marked respiratory impairment requiring intensive care and ventilation support. Five patients were selected, based on high levels of TCC (above the mean 1 2 SD for controls; 7.14 mg/L) and either treatment failure (patients 1-3) or failure to improve (patients 4 and 5) where death was not considered imminent (clinical judgement), for inclusion in a compassionate use study of complement blockade using LFG316 (tesidolumab; Novartis Managed Access Program), a C5-blocking monoclonal antibody (mAb) that prevents generation of the proinflammatory effectors C5a and membrane attack complex (6) . We describe a preliminary evaluation of the potential benefit of C5 blockade in severe COVID-19; we show that the C5-blocking mAb LFG316 could be administered in critically ill mechanically ventilated patients with COVID-19; a single dose of LFG316 blocked C5 activity and complement activation for at least 4 days in all treated patients.
cord-301340-lhh04pum	1998	Torovirus-like particles purified from stool specimens were further shown to be toroviruses on the basis of their morphology, immunospecific interactions with Breda virus antiserum, ability to elicit an immune response following infection, and the high degree of homology of the 3 end of their genome with that of the Berne and Breda viruses [19] . At a different time from that of study 1, patients whose stool specimens were positive for torovirus, rotavirus, or astrovirus by electron microscopy were enrolled in study 2. In torovirus-positive patients, stool specimens were examined daily by electron microscopy during the hospitalization and at follow-up. Nine additional torovirus-positive patients developed bloody diarrhea within 2-15 days after study enrollment and had no other pathogen in the stool sample. Stool specimens collected on a follow-up visit 2-6 months after study enrollment from 168 patients infected with torovirus showed that 14 were shedding the virus.
cord-301342-ikvpkhfp	2017	Viral variants that arise in the global influenza population begin as de novo mutations in single infected hosts, but the evolutionary dynamics that transform within-host variation to global genetic diversity are poorly understood. Recent deep-sequencing studies of human clinical samples suggest that influenza accumulates relatively limited genetic diversity within hosts during most acute infections (Dinis et al., 2016; Poon et al., 2016; Sobel Leonard et al., 2016; Debbink et al., 2017) , in line with earlier studies in dogs and horses Hoelzer et al., 2010) . We sequenced the full viral genome to high coverage directly from patient nasal wash samples by using influenza-specific reverse transcription and PCR (Hoffmann et al., 2001) to enrich for viral genetic material (Figure 2-figure supplement 1). Strikingly, many of the HA mutations that arise in parallel in multiple patients in our study also reach a high global frequency, which may reflect concordant antigenic selection at the within-host and global scales.
cord-301391-5dvf1mi0	2020	It is a matter of hope that the recent deployment of small-scale technologies like 3D printer, microcontroller, ventilator, Continuous Positive Airway Pressure (CPAP) are mostly used to resolve the problem associated with medical equipment''s for breathing. We described the most recent developed breathing aid devices such as oxygen therapy devices, ventilator, and CPAP throughout the review. The review described breathing aid devices like oxygen therapy devices, ventilators, and CPAP devices. Breathing aid devices are used to support the patients who have acute respiration problem due to pneumonia associated diseases like COVID-19, asthma, and dry coughing. The key feature of this study is that without any respiration tubes, the proposed device can provide necessary ventilation to the patient''s lungs with the blower unit. A lowcost, microcontroller controlled electro-mechanical device is developed in [61] for the respiratory support of COVID-19 infected patients. [66] proposed a multi-powered CPAP device for respiratory support for the patients having a breathing problem.
cord-301402-andxwyi3	2020	
cord-301521-mpm43aga	2020	
cord-301579-q23nhmgs	2020	
cord-301590-70qmpccs	2020	
cord-301592-n5ns3m34	2017	We aimed to document the viral and bacterial aetiology of pharyngitis and to assess the pathogenic role of viruses by determining the myxovirus resistance protein A (MxA) in the blood as a marker of interferon response. We aimed to document the viral and bacterial aetiology of pharyngitis and to assess the pathogenic role of viruses by determining the myxovirus resistance protein A (MxA) in the blood as a marker of interferon response. Methods: In this prospective observational study, throat swabs and blood samples were collected from children (age 1e16 years) presenting to the emergency department with febrile pharyngitis. Methods: In this prospective observational study, throat swabs and blood samples were collected from children (age 1e16 years) presenting to the emergency department with febrile pharyngitis. 23e25 The aim of this study was to document the microbial causes of acute pharyngitis in children and adolescents in an outpatient setting and to evaluate the causative role of viruses by determining myxovirus resistance protein A (MxA) and other biomarker levels.
cord-301779-y07xjnpe	2020	
cord-301800-ssdzd43t	2020	
cord-301805-sb0ij8k7	2020	METHODS: This translational study consists of two studies conducted in parallel: The first study is an observational, multicenter, prospective clinical study in which 340 patients with acute IS will be subcutaneously implanted a sensor to continuously monitor blood glucose levels for 96 h. DISCUSSION: The GLIAS-III study will be the first translational approach analyzing the prognostic influence of GV, evaluated by the use of subcutaneous glucose monitors, in acute stroke. We hypothesized that GV, assessable by means of continuous subcutaneous monitoring devices, could act as a powerful prognostic predictor of mortality, possibly higher than assessment of mean or maximum blood glucose levels and that the different treatment regimens used in routine clinical practice could modify glycemic variability. No laboratory data other than HbA1c will be collected for Discussion: The GLIAS-III study will be the first translational approach analyzing the prognostic influence of GV, evaluated by the use of subcutaneous glucose monitors, in acute stroke.
cord-301811-ykpiorgo	2020	title: Estimation of the percentages of undiagnosed patients of the novel coronavirus (SARS-CoV-2) infection in Hokkaido, Japan by using birth-death process with recursive full tracing We estimated the numbers of undiagnosed symptomatic patients and the lower bound of the number of total infected individuals per diagnosed patient before and after the declaration of the state of emergency in Hokkaido, Japan. The present analysis uses the distributions of the cluster size and patients'' time from onset to diagnosis, which are released by the health officials, to estimate the model parameters. At the same time, the nodes in the connected component containing the diagnosed node are also removed from the network, which corresponds to the contact tracing of the infected individuals (Fig 2, gray open circles) . In this paper, we have formulated a model to describe the spreading of infection and the quarantine of infected individuals, and estimated the number of undiagnosed symptomatic and asymptomatic COVID-19 patients in Hokkaido.
cord-301832-6czrdmzb	2020	This single-site prospective longitudinal study (1998) (1999) (2000) (2001) (2002) (2003) (2004) (2005) (2006) (2007) (2008) (2009) (2010) (2011) (2012) (2013) (2014) (2015) (2016) among nondisabled community-living persons age ≥70 years evaluated risk factors and intervening illnesses and injuries (ie, events) associated with reduced recovery after episodes of progressive and catastrophic SD. To access this article, link to PubMed. Background: Clinical effectiveness is defined as the application of the best knowledge (from research, clinical experience, and patient preferences), to achieve optimum processes and care outcomes. This study evaluated care effectiveness in an Ireland SPCU, including an analysis of the temporal relationship among unit admission, patients'' phase of illness, and different aspects of patient and family distress. To access this article, link to PubMed. Background: Studies evaluating the effects of pre-existing mental health disorders (MHDs) on patients diagnosed with lung cancer universally find mental illness to be associated with increased mortality.
cord-301947-b6nwaost	2020	
cord-301992-oin1m0uq	2020	
cord-302062-wqmynngg	2020	
cord-302115-r39ser2c	2020	
cord-302177-8w3ojgd4	2020	
cord-302215-sqrbj5r4	2020	
cord-302226-0rhgmtbo	2019	
cord-302244-uwicyuhk	2020	
cord-302316-raf5rlkq	2020	
cord-302382-eifh95zm	2020	
cord-302389-h7jm1etb	2020	
cord-302403-kahi8cbc	2009	
cord-302413-7a80jff2	2020	
cord-302448-2r4rtixg	2020	
cord-302459-grs2x26l	2018	
cord-302576-fv2ib5vc	2020	
cord-302667-ei151qpd	2020	
cord-302684-r4ger87o	2020	
cord-302695-vyo3w2a4	2020	
cord-302756-343y63e5	2020	
cord-302788-kg8zwysg	2020	
cord-302800-852w35od	2020	
cord-302806-1e99cygs	2020	
cord-302821-b9ikg0xy	2020	
cord-302862-znnlyz3y	2019	
cord-302864-2xnq1oq7	2020	
cord-302997-39o08tt1	2020	
cord-303017-4zx94rm6	2020	
cord-303054-s1clwunc	2020	
cord-303065-dyg2baog	2020	
cord-303145-rc5luali	2020	
cord-303192-il3s8lgp	2020	
cord-303244-5tfrmsm7	2020	
cord-303349-0kn7apl3	2020	
cord-303363-uu9hb1c9	2020	
cord-303460-abutfxtf	2020	
cord-303483-wendrxee	2020	
cord-303517-8971aq02	2020	
cord-303600-96vtj89w	2020	
cord-303661-etb19d6y	2020	
cord-303703-ekhwb5xb	2020	
cord-303718-7bpap31f	2020	
cord-303787-dx1n8jap	2020	
cord-303791-yw80ndg6	2020	
cord-303816-c4z9ys3q	2020	
cord-303819-w1785lap	2020	
cord-303860-jpy373ph	2020	
cord-303880-zv4nbz9p	2020	
cord-304010-n4gxxl5i	2020	
cord-304090-l5rocsk5	2020	
cord-304248-sxbyxnxn	2020	
cord-304255-7xs9cit7	2020	
cord-304271-vyayyk50	2020	
cord-304280-2a84u4tm	2020	
cord-304321-y177sqee	2020	
cord-304399-7t2mu13s	2020	
cord-304418-k9owyolj	2020	
cord-304457-8g36h1bz	2020	
cord-304474-hfv43e9m	2020	
cord-304479-uxp1kg86	2020	
cord-304573-3nhglbw4	2020	
cord-304593-cugypxp0	2020	
cord-304601-e6qlx1r6	2020	
cord-304602-jpxjiaru	2020	
cord-304791-wv4qu9xm	2020	
cord-304798-j2tyjo1j	2020	
cord-304949-mf3utolt	2020	
cord-304972-aktfbriw	2015	
cord-305076-v56y5nyt	2020	
cord-305134-s7h6bpof	2020	
cord-305139-851v2qr3	2020	
cord-305205-ilxxkm0f	2014	
cord-305283-1bg1ykui	2020	
cord-305304-d3x734nu	2020	
cord-305397-4dx3q6o6	2020	
cord-305405-me4gebvm	2020	
cord-305422-t8azymo7	2020	
cord-305479-o47mv4uw	2020	
cord-305498-8tmtvw1r	2020	
cord-305520-7gxmdo56	2020	
cord-305534-936peb1n	2020	
cord-305582-3hmsknon	2020	
cord-305650-su6furzi	2020	
cord-305786-06dpjik8	2005	
cord-305838-i0ck2oo0	2020	
cord-305959-x061q8t7	2020	
cord-306016-2gudro8v	2020	
cord-306062-g9hk1iq5	2020	
cord-306090-i8sriw08	2020	
cord-306092-5bi2q3jj	2015	
cord-306108-ja0wyr5w	2020	
cord-306149-sd0s0jup	2020	
cord-306154-nm0g79ih	2020	
cord-306266-8qdrshz3	2014	
cord-306351-ka6asw3m	2020	
cord-306377-s9j21zsy	2020	
cord-306595-ru725fbr	2020	
cord-306646-6c7n0xir	2020	
cord-306670-c2jm0g88	2020	
cord-306790-82nltfk3	2020	
cord-306896-khn8epxd	2020	
cord-306997-84pjfawk	2020	
cord-307100-w33e2078	2020	
cord-307160-1vz0gw1w	2020	
cord-307217-0agij3z3	2020	
cord-307258-66lwpblq	2020	
cord-307285-bxy0zsc7	2020	
cord-307287-zpq6byml	2020	
cord-307309-s0t4kp2x	2020	
cord-307653-nyr6mtj1	2020	
cord-307660-onz6vfre	2020	
cord-307690-1qqyixun	2020	
cord-307710-dlpfbnb1	2020	
cord-307758-a4sgt66g	2004	
cord-307808-0t6sw0zp	2020	
cord-307862-a082sghm	2020	
cord-308002-abgv87e4	2020	
cord-308010-ix0xi5jb	2020	
cord-308071-1bk3xuwf	2020	
cord-308075-1ftswsm8	2020	
cord-308112-w96ncfla	2020	
cord-308169-a0ft6wdy	2013	
cord-308184-w8ewm8ve	2020	
cord-308195-nlibv0u4	2020	
cord-308212-l8flyso7	2020	
cord-308252-qwoo7b1l	2020	
cord-308313-3speddao	2020	
cord-308390-ei96iuw3	2020	
cord-308445-3j2q83ll	2012	
cord-308466-f0iu6sje	2016	
cord-308491-fc46k594	2020	
cord-308803-i934doud	2020	
cord-308906-et7duogt	2020	
cord-308907-elz62jlg	2020	
cord-308968-m4pzsfkd	2020	
cord-308979-qhlvd2mt	2005	
cord-309001-erm705tg	2020	
cord-309024-pu830bn9	2020	
cord-309026-l2rh9bie	2020	
cord-309194-jtouafgd	2020	
cord-309207-n8u8ddv7	2020	
cord-309214-v2iqgjc4	2020	
cord-309236-p4c2d5y3	2020	
cord-309238-7lbt0f03	2020	
cord-309302-n6cd2fc3	2020	
cord-309323-yflng8m3	2020	
cord-309360-cpis1l4u	2020	
cord-309370-g8d3w7it	2020	
cord-309395-5yan9fcn	2020	
cord-309421-725u6dau	2020	
cord-309441-obojsf04	2020	
cord-309482-frawgvk7	2020	
cord-309507-oe4i6v5x	2020	
cord-309517-yh4d414y	2020	
cord-309561-m43v332d	2020	
cord-309706-kikx05dj	2020	
cord-309728-7vfotgrr	2020	
cord-309735-bwa1zo07	2020	
cord-309751-7elnvjk3	2020	
cord-309829-3dlfcy31	2020	
cord-309962-phwq8rsf	2020	
cord-310001-qng7h5cj	2020	
cord-310010-oxgb6xnv	2020	
cord-310069-ay4af6xr	2020	
cord-310084-taaz6mhs	2020	
cord-310117-19qsszns	2020	
cord-310166-gt6icwul	2020	
cord-310177-4jw1lkli	2020	
cord-310205-j57x9ke6	2007	
cord-310240-otf9ruvj	2018	
cord-310405-7fah22nu	2020	
cord-310539-8zk3hkgj	2020	
cord-310597-zy6ckr53	2020	
cord-310661-hrvuhkq9	2020	
cord-310663-504p29hv	2020	
cord-310676-125o0o7x	2020	
cord-310685-gi2ycrfk	2010	
cord-310690-50z2kdaj	2016	
cord-310779-4puiao40	2020	
cord-310823-xksu8fn1	2020	
cord-310891-yfouizjb	2020	
cord-310901-oooat8xj	2020	
cord-310902-cfci8lef	2020	
cord-310917-9sk8gdh8	2020	
cord-310974-hz37yf39	2020	
cord-310976-24b3c3a4	2020	
cord-311000-abntwzuy	2020	
cord-311043-nidu7om2	2020	
cord-311044-kjx0z1hc	2020	
cord-311074-j3fw4dfc	2020	
cord-311176-dlwph5za	2018	
cord-311215-x3b7ewo2	2020	
cord-311275-ysr9nqun	2019	
cord-311341-7ox30d2u	2020	
cord-311373-ngs7baoc	2020	
cord-311418-7core0y3	2020	
cord-311579-4jhoatkw	2020	
cord-311673-z4hkw17g	2020	
cord-311682-npi03i7q	2020	
cord-311730-189vax2m	2020	
cord-311752-stqrf50k	2020	
cord-311816-j8c2lk7y	2020	
cord-311838-ymn96yj4	2020	
cord-311847-2czqs84q	2020	
cord-311848-8n9ee57a	2020	
cord-311942-oju4gosw	2020	
cord-311957-3rmm1hfb	2020	
cord-311970-o9xao5rl	2020	
cord-312012-6a7i72bk	2020	
cord-312033-iarl77n0	2020	
cord-312057-4zfaqkxm	2020	
cord-312063-5c2w2ct1	2020	
cord-312065-nqy7m38f	2003	
cord-312192-hxhohtmj	2020	
cord-312199-jy3izkou	2020	
cord-312209-3yi1w44v	2020	
cord-312212-h5j4f0xq	2020	
cord-312249-k7dp776s	2020	
cord-312313-guphuppy	2020	
cord-312388-pc89ybxw	2020	
cord-312467-kbhljong	2020	
cord-312486-rumqopg0	2020	
cord-312572-i7r28wdc	2020	
cord-312609-gv1khfmo	2020	
cord-312614-63qzissw	2020	
cord-312632-g4250q6l	2020	
cord-312677-rwznqiib	2020	
cord-312684-3i2r2ahr	2020	
cord-312748-9v2bmbod	2020	
cord-312754-3yhxcfr2	2020	
cord-312795-0e4esl2o	2020	
cord-312798-2cbgnv1h	2020	
cord-312846-ef7m4875	2020	
cord-312847-2cg3ylfl	2020	
cord-312918-iof45k1r	2020	
cord-313028-0nhgxoim	2020	
cord-313082-n3bo9jw1	2020	
cord-313118-dv5xq2k4	2020	
cord-313136-ab56mg6j	2020	
cord-313227-6zwkfzab	2020	
cord-313239-0gl43af5	2020	
cord-313294-ffgo56gl	2020	
cord-313349-ikjivfce	2020	
cord-313353-uwwih8v3	2020	
cord-313468-lloh1b0y	2020	
cord-313474-1gux1gsi	2015	
cord-313494-a4pms2ub	2020	
cord-313528-rp15vi1o	2020	
cord-313529-xm76ae08	2011	
cord-313628-6610z7xk	2020	
cord-313684-61hkogdh	2020	
cord-313693-qmkrn7pr	2010	
cord-313728-08kwkbmd	2020	
cord-313785-8tipkksu	2020	
cord-313836-mcm0xmzw	2020	
cord-313860-mzs3ya0s	2020	
cord-313894-stgx36h5	2020	
cord-313976-q5j5kr1v	2020	
cord-313989-bc7q8swu	2020	
cord-314070-8qz23nn4	2020	
cord-314088-ktj17dvq	2020	
cord-314106-r3axl3w1	2020	
cord-314152-wd153s1g	2020	
cord-314171-431buxxr	2020	
cord-314218-6znw9zcz	2020	
cord-314280-kf2bo06e	2020	
cord-314349-rhm1ii3d	2020	
cord-314378-cs9ggqwk	2020	
cord-314449-ukqux772	2008	
cord-314537-8a1vqale	2020	
cord-314649-1y3ocvz1	2020	
cord-314694-g0pes5o3	2020	
cord-314826-usfvulc2	2020	
cord-315056-ohyb6oa0	2020	
cord-315116-u7btx7nt	2020	
cord-315149-71bmj5il	2020	
cord-315157-2p45frlk	2020	
cord-315181-emf4i6ir	2020	
cord-315188-a9pvugjt	2020	
cord-315195-m2xqlct8	2020	
cord-315249-yclnl87n	1999	
cord-315297-o8mwmjql	2020	
cord-315311-azamwuzl	2020	
cord-315397-cm3mc7we	2020	
cord-315424-i3nnennw	2020	
cord-315486-pjb5v1tc	2020	
cord-315490-xs5v3uc3	2020	
cord-315569-e56c5g8h	2020	
cord-315574-jq1p5t8w	2020	
cord-315598-qwh72inx	2020	
cord-315696-43wmazxa	2020	
cord-315730-fzgxuak7	2020	
cord-315834-ashjw2xs	2019	
cord-315871-anguylf1	2020	
cord-315970-m5o962yw	2020	
cord-316003-xt59voyt	2020	
cord-316029-z708c3ex	2020	
cord-316067-mlcczr8c	2020	
cord-316083-f1h2j6jx	2020	
cord-316095-jzyb4jn5	2020	
cord-316117-o29773cz	2020	
cord-316118-ph582weg	2020	
cord-316135-kevyw19w	2020	
cord-316137-6zdxfv8v	2020	
cord-316170-ihh0pxov	2020	
cord-316306-vfez5k02	2020	
cord-316370-t802kjpk	2020	
cord-316376-76beuk0c	2020	
cord-316432-xemz7zn9	2020	
cord-316522-fbw9x3ik	2020	
cord-316572-7ei96rrn	2020	
cord-316616-j82q99in	2020	
cord-316647-jj8anf5g	2020	
cord-316666-qif1k62t	2020	
cord-316673-ffkh13xm	2020	
cord-316728-vyfkmniu	2020	
cord-316743-q6gbxghx	2020	
cord-316764-ps89rxuy	2020	
cord-316835-qf0c91vr	2016	
cord-316845-k9zvsfvj	2020	
cord-316873-2gwl9m94	2020	
cord-316938-64jxtg9y	2020	
cord-316987-3nhqx2qn	2020	
cord-317028-f3bpwm5j	2016	
cord-317075-zegearxa	2020	
cord-317085-qc8bfb9g	2020	
cord-317151-cxx5pcln	2020	
cord-317242-e7000i2u	2020	
cord-317265-n6x0r58i	2020	
cord-317344-wznzmssz	2010	
cord-317468-pnxni1x5	2020	
cord-317535-zep5axfo	2020	
cord-317566-6ch6na31	2020	
cord-317575-srg9cyqp	2020	
cord-317604-j8b64a1a	2020	
cord-317689-gp4x54pe	2020	
cord-317809-umb8j63t	2020	
cord-317811-mxsujb5u	2020	
cord-317918-pl625ela	2020	
cord-317932-5sqj2klm	2020	
cord-317952-4oa9hfb4	2020	
cord-317966-ut6tzc8s	2020	
cord-318021-4qrf5m8s	2019	
cord-318063-bainw3d6	2018	
cord-318094-losjbgn6	2020	
cord-318167-b25g6zkp	2020	
cord-318229-29cgwivt	2018	
cord-318262-w8oixzdg	2020	
cord-318282-ocgfgx9r	2005	
cord-318311-aakpbbvl	2020	
cord-318312-v1c3qm7h	2020	
cord-318326-q9fnbg8n	2020	
cord-318333-rzhrgp5q	2020	
cord-318355-38x3f3ee	2020	
cord-318369-y3wtfqrn	2020	
cord-318520-hgjv7ot9	2020	
cord-318694-370ccaoc	2020	
cord-318803-xpa49sxt	2008	
cord-318808-1cfwj5uq	2020	
cord-318830-a3n4c5d1	2020	
cord-318873-zwot69s3	2020	
cord-318909-h5b7mncf	2020	
cord-318944-13zk6cco	2020	
cord-318954-pj5lsvsa	2015	
cord-319013-oytqcifa	2020	
cord-319037-77l9wdyb	2020	
cord-319218-mejvlkfg	2020	
cord-319333-jwbgytwd	2020	
cord-319400-lghjiw5p	2020	
cord-319567-4t5t8bcx	2020	
cord-319615-p2labgd8	2020	
cord-319706-2e9jrv0s	2020	
cord-319742-ypkt01rn	2020	
cord-319805-b6ypt5d0	2020	
cord-319823-sp5wibeh	2020	
cord-319849-3shr5grg	2020	
cord-319930-ymqnb54a	2020	
cord-320149-3q4q98a6	2020	
cord-320184-wacoz5t9	2014	
cord-320267-n21jryi2	2020	
cord-320349-6hbuq0k7	2020	
cord-320445-pdvkyzci	2007	
cord-320477-zbp8a8dr	2020	
cord-320572-94fvtj4a	2020	
cord-320599-hxn4bgec	2020	
cord-320612-vam0bli3	2020	
cord-320632-369kax2m	2020	
cord-320634-x7a3k5xu	2020	
cord-320663-xypg6evo	2020	
cord-320695-gq7k331z	2020	
cord-320788-ln8ddyuj	2005	
cord-320811-9sm7iz5x	2020	
cord-320831-owfnttqr	2020	
cord-320864-k9zksbyt	2020	
cord-320877-1i0hzfjk	2020	
cord-320892-dcfi5u04	2020	
cord-320930-9yiu0080	2020	
cord-321030-isc3p46t	2020	
cord-321064-pe8466n1	2020	
cord-321149-hffj7s4o	2020	
cord-321237-ynhdii60	2020	
cord-321311-v2i1caug	2020	
cord-321346-epsp3bbm	2011	
cord-321461-1s3y9kc5	2020	
cord-321472-n4nnmlv1	2020	
cord-321543-qdmvn44h	2020	
cord-321552-lsz1onrj	2020	
cord-321594-x5wv9p7n	2020	
cord-321651-7e8dwcur	2020	
cord-321697-yua3apfi	2020	
cord-321748-9a54ekac	2020	
cord-321768-oevswvvd	2020	
cord-321784-nubu5fuz	2020	
cord-321788-z2y1ywdq	2020	
cord-321801-w66v5kzh	2017	
cord-321837-0r86qxz1	2016	
cord-321983-566pbuic	2020	
cord-322009-0cwljo0c	2020	
cord-322052-zsbisk3b	2020	
cord-322054-whjisspt	2020	
cord-322063-96suqyfg	2020	
cord-322066-m8dphaml	2020	
cord-322102-4fi0y96f	2020	
cord-322104-f1dukpso	2006	
cord-322259-khknne8s	2020	
cord-322322-woz6lwdu	2020	
cord-322394-b18fv3r3	2020	
cord-322439-86dojc70	2020	
cord-322448-s04e6po9	2016	
cord-322497-hdy3va8e	2020	
cord-322534-eikz07zz	2020	
cord-322552-95bj65qf	2020	
cord-322590-twnlaq24	2020	
cord-322663-a58e6pp8	2020	
cord-322746-28igib4l	2007	
cord-322799-opf1qwgl	2020	
cord-322861-q7uk6rdp	2020	
cord-322867-1yxxe5d3	2020	
cord-322868-o3r0y6bz	2020	
cord-322893-av8hj005	2020	
cord-322957-clf8f90t	2020	
cord-322990-q07yy5k8	2020	
cord-323024-blc3mnbj	2020	
cord-323092-j2u0ny2u	2020	
cord-323133-gdg50omp	2017	
cord-323180-3ih0i81s	2020	
cord-323225-ou7pppum	2020	
cord-323255-elwfiima	2015	
cord-323273-q53wf6au	2020	
cord-323293-4gmnkg09	2020	
cord-323314-y3k9dntf	2020	
cord-323446-w2ci1bfr	2020	
cord-323463-osf6t7cw	2008	
cord-323470-lpeeugdf	2020	
cord-323489-ro7kbnu3	2020	
cord-323538-9dlr6kqh	2020	
cord-323582-7y8pt72r	2020	
cord-323647-q67fa0m3	2020	
cord-323705-n2rec4i8	2020	
cord-323713-bc00vths	2019	
cord-323761-9m177ozm	2020	
cord-323787-9lq8rkih	2020	
cord-323809-bocidwg4	2020	
cord-323816-3m1iu9j2	2020	
cord-323831-1qadv7r1	2020	
cord-323906-ro078y52	2020	
cord-323910-lms3xw4k	2020	
cord-323913-v32c2vda	2006	
cord-323940-ubazgvov	2020	
cord-323965-6mzzibj8	2020	
cord-323980-rcyjthze	2020	
cord-324007-hapzf0fl	2009	
cord-324041-lqokztor	2020	
cord-324060-vvexfg1c	2020	
cord-324125-wau2xq0x	2013	
cord-324148-bllyruh8	2020	
cord-324159-jv3lknl8	2020	
cord-324175-5c4ijkpm	2020	
cord-324232-nupi7f72	2020	
cord-324245-cfiekxr4	2020	
cord-324314-os1btxx1	2020	
cord-324529-xbrdtxnz	2020	
cord-324601-s3rgxtg6	2019	
cord-324619-y7gilopu	2020	
cord-324635-27q3nxte	2020	
cord-324666-fvk72o0p	2020	
cord-324669-qca0uwxo	2020	
cord-324679-rds8o5z4	2016	
cord-324798-qh0cxp10	2020	
cord-324809-16zvqizl	2020	
cord-324810-92fosk3c	2012	
cord-324843-r43u7sld	2019	
cord-324859-0yuhb5dl	2020	
cord-324880-s1oqkqef	2018	
cord-324918-36om8n2d	2020	
cord-324944-ixh3ykrc	2018	
cord-325201-yoy7kdli	2015	
cord-325234-skshcrh1	2020	
cord-325307-agaau27o	2020	
cord-325316-uffxyas1	2020	
cord-325421-1ysn0kyr	2020	
cord-325511-ot66dj3i	2020	
cord-325619-qmszgw66	2020	
cord-325628-pa3dkz2f	2020	
cord-325631-c7jwizpj	2020	
cord-325649-zzhsrytw	2020	
cord-325655-1fktmpbj	2020	
cord-325700-f102uk2m	2020	
cord-325766-hbppklm5	2020	
cord-325783-pqonn0as	2003	
cord-325793-5vrr7msw	2020	
cord-325863-3t73v4ng	2020	
cord-325869-3mvjc805	2020	
cord-325933-1qvpofvp	2020	
cord-325963-d0hvukbu	2020	
cord-325970-ivtunxrd	2020	
cord-325971-volbaipv	2020	
cord-326017-qw4qynqv	2020	
cord-326023-vwukiwe4	2020	
cord-326185-gjte739i	2020	
cord-326272-ya3r0h1t	2020	
cord-326354-fhafg41x	2020	
cord-326468-xcy7v1tf	2020	
cord-326643-obfvi3ms	2020	
cord-326703-akn92p1r	2020	
cord-326747-zwp13awk	2009	
cord-326751-fn43p19j	2004	
cord-326752-45ckkv01	2020	
cord-326785-le2t1l8g	2005	
cord-326807-dii4u9gj	2020	
cord-326834-eeldyj2u	2020	
cord-326851-0jxdnm1l	2020	
cord-326883-j7pbe50g	2020	
cord-326984-o27rp468	2006	
cord-326991-m0lfk0a9	2020	
cord-326994-y8p724s4	2020	
cord-327017-b2refzfw	2020	
cord-327125-86ocr70d	2020	
cord-327148-dzozl70h	2020	
cord-327165-vlyfbiem	2020	
cord-327214-kcbxyhhh	2020	
cord-327349-rxb6zfoc	2020	
cord-327370-zo0n8wf6	2020	
cord-327397-8rxjju0t	2020	
cord-327413-zdbnoy1q	2020	
cord-327415-nu1msnui	2020	
cord-327432-ogw27tob	2020	
cord-327442-e02y93f6	2020	
cord-327481-m9r0p84v	2020	
cord-327545-y3vejwtr	2020	
cord-327577-c0d09cyk	2020	
cord-327597-fgnrujsf	2020	
cord-327609-no58ucyq	2017	
cord-327611-g2ssh0fk	2020	
cord-327622-ezgufe24	2020	
cord-327632-2hz94uuw	2020	
cord-327641-hqnem2zs	2016	
cord-327690-di7hfghi	2020	
cord-327720-m6cofbj6	2020	
cord-327764-4nlg26p5	2020	
cord-327818-1abweqko	2020	
cord-327820-4bm7b934	2020	
cord-327827-oliw4ee5	2020	
cord-327836-6o66a4i5	2020	
cord-327961-ysatxwph	2019	
cord-327989-6p39cx2e	2020	
cord-328039-xt17gvcp	2020	
cord-328040-5qd05e4r	2020	
cord-328068-qoz85x3r	2020	
cord-328113-eczjjc2v	2020	
cord-328147-61gtx2h2	2020	
cord-328214-2azb8789	2020	
cord-328220-toeq4xq0	2020	
cord-328289-3h3kmjlz	2020	
cord-328294-gii1b7s7	2009	
cord-328307-378cfb23	2020	
cord-328384-jzfr2t3p	2020	
cord-328438-irjo0l4s	2020	
cord-328484-4iptwc3n	2020	
cord-328487-glwslgjy	2020	
cord-328513-81yvcgul	2016	
cord-328525-80xk3gln	2018	
cord-328569-1lx3fkv3	2020	
cord-328607-lzai90zq	2020	
cord-328640-4g7revha	2020	
cord-328786-gkd9xcxa	2020	
cord-328814-s3963anw	2020	
cord-328829-yywxmioq	2012	
cord-328895-p75b7jii	2017	
cord-329152-1ixylnny	2020	
cord-329215-awxfetdj	2020	
cord-329344-06uk5sjp	2020	
cord-329351-g9qlo3xh	2020	
cord-329444-t8ixrdpq	2020	
cord-329453-ry1diso2	2020	
cord-329564-tmi1u224	2020	
cord-329582-y4gyw8vz	2020	
cord-329727-h47q76y8	2020	
cord-329741-604gtqx9	2020	
cord-329766-9bwdb6o2	2020	
cord-329856-0m5mc320	2020	
cord-329863-r2vqsg5r	2020	
cord-329877-vish6v8e	2003	
cord-329985-5rji08p7	2020	
cord-329989-176cvimy	2020	
cord-330050-05nnihst	2020	
cord-330061-q4xi260z	2020	
cord-330136-o8df8szx	2020	
cord-330359-c0l5xq5m	2020	
cord-330368-rk31cwl4	2020	
cord-330369-75cotmn2	2020	
cord-330431-9txstz4n	2020	
cord-330492-kbob8z48	2020	
cord-330573-rr2r8245	2020	
cord-330597-nftwj0d5	2020	
cord-330655-crfj5adf	2020	
cord-330666-puhijixa	2007	
cord-330676-urr9oqfc	2020	
cord-330701-k68b0wqe	2020	
cord-330831-3b7vfv9b	2020	
cord-330856-j1wqrc8v	2020	
cord-330869-k5ro0edf	2020	
cord-330870-l0ryikhv	2020	
cord-330877-nsx4b4rm	2020	
cord-330918-hsy8h1vb	2020	
cord-330963-w24q8sn7	2020	
cord-331109-a8e7r80d	2020	
cord-331114-lumfg138	2020	
cord-331165-2yn1n3eq	2020	
cord-331268-kzy33hdb	1996	
cord-331270-12zx0o2p	2020	
cord-331273-1fixwxuo	2020	
cord-331317-q01uos7a	2015	
cord-331434-2x9m37cw	2020	
cord-331449-0sow1im8	2020	
cord-331452-y5lhawqo	2020	
cord-331481-zeaqi1uc	2020	
cord-331487-jh34klbg	2020	
cord-331500-l3hkn2li	2020	
cord-331519-ye4dtna5	2020	
cord-331533-0toegbv8	2020	
cord-331547-uqmjhhna	2020	
cord-331604-jf6ybip5	2020	
cord-331762-b0yufidn	2020	
cord-331827-amg309uz	2019	
cord-331915-7idktu7c	2016	
cord-332013-bl5d4xkc	2020	
cord-332036-op6s8tr4	2020	
cord-332055-lrpfzsog	2015	
cord-332087-xwturwju	2020	
cord-332145-rw16o02g	2020	
cord-332150-j76726no	2020	
cord-332153-fczf3lzc	2020	
cord-332180-dw4h69tp	2020	
cord-332233-01rdlf8l	2009	
cord-332278-2p64ab2z	2020	
cord-332480-3uodkrkp	2020	
cord-332650-05oz5zwz	2020	
cord-332709-0plblo4k	2020	
cord-332774-t5untewz	2020	
cord-332778-rf47ptj6	2020	
cord-332788-8lq9qygn	2020	
cord-332861-7b5pzmk6	2020	
cord-332992-8rmqg4rf	2020	
cord-333024-1yrmun3z	2016	
cord-333113-0k6xlmem	2020	
cord-333142-ek7hct52	2020	
cord-333175-klnxnxwm	2020	
cord-333183-xyuj1j57	2020	
cord-333340-ekok0mp5	2020	
cord-333375-d7cgvjsm	2020	
cord-333429-bq7kfpby	2020	
cord-333451-p2plpeew	2020	
cord-333453-v3gap8kj	2020	
cord-333470-0a0i6vjn	2020	
cord-333528-9mczqtje	2020	
cord-333588-3krh1xzx	2020	
cord-333654-8rg99di5	2020	
cord-333684-j1sg46w9	2020	
cord-333688-bykbyojs	2020	
cord-333696-3ci9re9a	2020	
cord-333698-e73d9lbu	2020	
cord-333749-45v6b4tc	2020	
cord-333808-deifddar	2020	
cord-333816-cznwzcn9	2020	
cord-333876-fhxkpbq7	2020	
cord-334002-irbpehts	2020	
cord-334075-ruqd2c1j	2020	
cord-334092-50r3h7jv	2020	
cord-334188-bggt1i2e	2020	
cord-334212-3gqzeakb	2020	
cord-334235-ymsiihwd	2020	
cord-334324-remrcm2q	2020	
cord-334367-w96iqo6q	2020	
cord-334408-w0yxz7zb	2020	
cord-334495-7y1la856	2020	
cord-334524-8uqnlpvc	2020	
cord-334715-902pfxyz	2020	
cord-334773-yw2qgv13	2020	
cord-334790-lav794w0	2020	
cord-334835-j6u8t8j2	2020	
cord-334881-x9nxxled	2020	
cord-335033-cwhm7v0s	2020	
cord-335078-z7k59k8o	2020	
cord-335095-epsi5qq7	2020	
cord-335140-njg0ln33	2020	
cord-335141-ag3j8obh	2020	
cord-335168-3ofarutr	2020	
cord-335198-qp964238	2020	
cord-335265-kuc3v5m9	2020	
cord-335312-yp73z008	2020	
cord-335338-wzxjn5ip	2006	
cord-335351-8hdok02n	2020	
cord-335382-fk4um9nw	2012	
cord-335465-sckfkciz	2020	
cord-335540-lahu5dno	2020	
cord-335576-b34nc3ay	2020	
cord-335593-cjb0daps	2020	
cord-335597-anrzcsrt	2020	
cord-335680-wsczl68g	1995	
cord-335719-tnimrff9	2020	
cord-335744-haj5a7tf	2020	
cord-335759-io18c6z0	2020	
cord-335795-hdko0zdw	2020	
cord-335802-1kiqfy68	2020	
cord-335892-hwahcec5	2020	
cord-335916-fh28qrt7	2020	
cord-335918-uc225mhn	2020	
cord-335975-m6lkrehi	2018	
cord-335977-f00758o2	2010	
cord-336000-v88bq4bx	2020	
cord-336053-cjq7szcn	2020	
cord-336194-5v395xae	2020	
cord-336201-fl606l3b	2020	
cord-336252-e92omqyr	2020	
cord-336258-dxps48bo	2020	
cord-336268-azgswke8	2020	
cord-336306-hvy9ukhh	2020	
cord-336314-xf6zvvl8	2020	
cord-336336-f01khqqr	2020	
cord-336368-sudi4mdx	2020	
cord-336390-ptnpgh3j	2020	
cord-336395-v157jzvv	2020	
cord-336423-rs4bma9b	2020	
cord-336438-mlgxiyur	2020	
cord-336450-2ndan331	2020	
cord-336462-7dltsav4	2020	
cord-336488-opjjowcq	2020	
cord-336543-ydrmlujj	2020	
cord-336554-n8n5ii5k	2020	
cord-336563-hwemigk7	2020	
cord-336614-u6alc6rs	2020	
cord-336621-0w3rroir	2016	
cord-336782-0zkb39v1	2020	
cord-336784-24qizp9k	2006	
cord-336790-29im4gxw	2020	
cord-336810-77wq9laa	2020	
cord-336882-x9e6r0h0	2020	
cord-337010-dgy7qbl5	2020	
cord-337088-xxyhmn1t	2020	
cord-337094-aa3ourc6	2020	
cord-337115-vtjsigod	2020	
cord-337120-irpm5g7g	2007	
cord-337262-88qpfu6b	2012	
cord-337297-fkw8780t	2020	
cord-337302-fpz2jfuj	2020	
cord-337338-7uj2r0gy	2020	
cord-337431-3rrvm787	2015	
cord-337487-1lbopaso	2020	
cord-337520-qp0ga6q8	2020	
cord-337622-rc9pejmo	2020	
cord-337644-aobdzwpx	2020	
cord-337665-roelk7i5	2020	
cord-337896-mct29erg	2020	
cord-337898-ncrbd8rp	2020	
cord-337906-qis8h3r3	2020	
cord-337926-6ddvqowr	2020	
cord-337965-z39q8ebq	2020	
cord-337994-pkklt77i	2020	
cord-337995-z4rcczki	2020	
cord-338023-gb5jgqcg	2020	
cord-338131-6y96eyoq	2020	
cord-338135-zwo7e7gy	2020	
cord-338146-am5gg1qd	2020	
cord-338182-cetv78ba	2020	
cord-338192-2v9dbc9h	2020	
cord-338346-e3fk6gz2	2020	
cord-338362-6zwvkqag	2020	
cord-338419-n8cmv8mf	2020	
cord-338517-1mxcssjj	2020	
cord-338600-wpfcxnyu	2020	
cord-338602-6n309bnp	2020	
cord-338605-3i5pvcgu	2020	
cord-338666-gg9qcpmz	2020	
cord-338668-z2z4gte2	2020	
cord-338683-nzgnpi6f	2020	
cord-338729-v2suoj3c	2020	
cord-338741-gy3ovkrt	2020	
cord-338756-jzz250o1	2020	
cord-338900-8ojah695	2020	
cord-338965-ewuqsfsf	2017	
cord-338968-b1gg2ha7	2020	
cord-339009-wcoch07b	2012	
cord-339015-qn8wbnlw	2019	
cord-339021-mhdaov1f	2020	
cord-339044-qy4jab37	2020	
cord-339266-glmshsh6	2020	
cord-339267-p3djwg7v	2020	
cord-339333-7tpnbr8q	2014	
cord-339355-zkkj8a83	2020	
cord-339406-81a7fkpj	2020	
cord-339436-0k73tlna	2020	
cord-339455-b8nu34vv	2020	
cord-339467-ewqxf02j	2020	
cord-339471-1510mzmy	2020	
cord-339474-tsdq1rgz	2020	
cord-339504-8svo2w3u	2020	
cord-339517-93nuovsj	2020	
cord-339568-th2xmhb6	2020	
cord-339589-dl2qpc0t	2020	
cord-339614-28s205p8	2020	
cord-339656-u0cpklsv	2010	
cord-339679-9hghy9pd	2007	
cord-339686-oybnk1j8	2020	
cord-339695-3ij5pjjy	2020	
cord-339705-x8l3zgfd	2020	
cord-339737-7qdjea6f	2020	
cord-339811-dms0rlmr	2020	
cord-339885-mpzgrogd	2014	
cord-339913-ps4nvvaz	2020	
cord-339940-80757pwu	2018	
cord-339956-o5o2yz1u	2020	
cord-340000-1e66aqih	2020	
cord-340051-r9kn34wd	2020	
cord-340070-de7sfccy	2020	
cord-340164-vzdyy656	2020	
cord-340204-3gm58qza	2020	
cord-340232-cadu5ah8	2020	
cord-340253-lpner9f8	2020	
cord-340314-5oz3013n	2020	
cord-340383-psjga23p	2020	
cord-340415-6fte7krp	2020	
cord-340430-x4oitcyh	2020	
cord-340536-azlajqbe	2020	
cord-340542-jz7ca041	2020	
cord-340576-dabcs3w5	2020	
cord-340650-mwsa326c	2020	
cord-340651-g3518bq2	2007	
cord-340660-ocvy1ge2	2020	
cord-340687-99ad1rwq	2020	
cord-340710-dmow5p7k	2020	
cord-340766-aic570x8	2015	
cord-340786-12vzsl6p	2020	
cord-340799-1awmtj52	2020	
cord-340811-w4x4falm	2020	
cord-340826-2530zdeq	2020	
cord-340857-teq5txm9	2020	
cord-340880-2qop8tcp	2020	
cord-340908-8q7i5ds3	2020	
cord-340984-blkhfhe2	2020	
cord-341063-3rqnu5bu	2018	
cord-341076-ox2ckhqu	2020	
cord-341118-h5t87vf8	2020	
cord-341197-e8m4oxma	2020	
cord-341202-1pg7rq2d	2020	
cord-341234-2zgfcrwc	2020	
cord-341284-jmqdnart	2020	
cord-341314-1mav631s	2020	
cord-341359-c34gyuv6	2020	
cord-341415-g781zhu6	2020	
cord-341531-w788qwya	2020	
cord-341591-ib8lsvku	2020	
cord-341627-21m8rdhy	2020	
cord-341670-o1v63zg8	2020	
cord-341919-8gnthufw	2020	
cord-341933-dwki1hwu	2020	
cord-341999-nosdj7b2	2020	
cord-342068-zhk3wmou	2020	
cord-342139-t2tukk0z	2020	
cord-342246-tnjtd9n3	2020	
cord-342303-ddulfe06	2020	
cord-342451-yfy5jcw6	2020	
cord-342519-tjr6dvtt	2010	
cord-342555-5r9aa7u5	2020	
cord-342569-ja96xfns	2020	
cord-342603-k0f33p3l	2020	
cord-342786-dl8vjwfn	2020	
cord-342808-yonbowkb	2020	
cord-342809-wrxejwms	2020	
cord-342810-41dghl0c	2020	
cord-342841-b1rucgmg	2020	
cord-342857-vj6sw2ne	2020	
cord-342930-f7cw2ca6	2020	
cord-342979-pvewvmmf	2020	
cord-343023-e1uv7t6p	2020	
cord-343052-dc9s2rau	2020	
cord-343201-98scxky8	2020	
cord-343205-zjw4fbfd	2020	
cord-343308-5i31ysee	2020	
cord-343393-8hdygwip	2020	
cord-343437-cz1w9od9	2020	
cord-343443-ljehete1	2020	
cord-343452-4m0ub9iv	2020	
cord-343490-94vkfrtw	2020	
cord-343566-epvswt7f	2020	
cord-343715-y594iewi	2020	
cord-343743-6k3soh1l	2020	
cord-343773-9f7ew8uj	2020	
cord-343797-kpmz5kwg	2020	
cord-343819-1uki4b3d	2020	
cord-343832-xg3swuzs	2020	
cord-343876-2inr4mcy	2020	
cord-343877-jzkaee16	2020	
cord-343897-f4imrltt	2020	
cord-343917-67qjqxqh	2020	
cord-343970-anocx4y1	2020	
cord-343973-n5ogyxz7	2020	
cord-344004-z7pn7u6u	2020	
cord-344017-qldawc8m	2020	
cord-344104-592r71l1	2020	
cord-344117-lr6roxej	2020	
cord-344120-7t5ce2hb	2020	
cord-344131-e7phs0jd	2012	
cord-344135-pyibu6rj	2020	
cord-344185-jz6ui4w3	2020	
cord-344191-veug3dae	2020	
cord-344270-874i31h8	2020	
cord-344271-5aynmdsk	2007	
cord-344302-p0v6sl9x	2020	
cord-344389-aj9q73f0	2020	
cord-344431-2wq7msqz	2020	
cord-344486-iu5flbcl	2020	
cord-344508-a67vsux2	2020	
cord-344668-9m1vnpmo	2020	
cord-344693-znw3dru4	2020	
cord-344709-5hy1e4t1	2020	
cord-344729-sjjedgws	2020	
cord-344765-agt60ksx	2020	
cord-344853-s2p2csrx	2020	
cord-344939-rgxqobfw	2020	
cord-344967-t88pedeb	2003	
cord-345028-56hg62be	2020	
cord-345044-2fez1gu0	2019	
cord-345092-1ztfcpsb	2020	
cord-345296-4z7yfj5s	2005	
cord-345371-pjbviagq	2020	
cord-345381-9cckppk2	2020	
cord-345445-9t1vebey	2020	
cord-345517-ji4cet51	2020	
cord-345546-v7t26oos	2020	
cord-345611-xv62h83a	2020	
cord-345628-a4c46m2w	2020	
cord-345632-iha2c5zo	2020	
cord-345655-fb4vv4my	2020	
cord-345680-10phij1x	2020	
cord-345727-bcxkycjh	2018	
cord-345762-khvcoqti	2020	
cord-345779-frspku51	2020	
cord-345860-d02x3151	2020	
cord-346015-bzeqs5oh	2020	
cord-346061-pbghgitg	2020	
cord-346062-q0trgj12	2020	
cord-346205-vqgcq3qt	2020	
cord-346241-w076l97s	2020	
cord-346276-1dcp05rd	2020	
cord-346288-9to4sdfq	2020	
cord-346345-jc9bq0zu	2020	
cord-346389-gbmnoo84	2020	
cord-346459-tkt5ldyo	2020	
cord-346496-crhv0gnt	2020	
cord-346539-kxnrf5g5	2020	
cord-346558-u1e0kzmm	2020	
cord-346594-tbsxgz43	2020	
cord-346607-1mewok8l	2020	
cord-346616-kr500kgj	2020	
cord-346664-ilebaqx3	2020	
cord-346721-l6y3n21b	2020	
cord-346894-iy35298o	2020	
cord-346987-fbqqf00i	2020	
cord-347058-kejcwlng	2020	
cord-347064-ljd121no	2016	
cord-347091-wbjpa5st	2020	
cord-347105-my9nioko	2020	
cord-347121-5drl3xas	2020	
cord-347238-yacn6xqk	2020	
cord-347255-fl9lur4h	2019	
cord-347263-ci6mv72z	2020	
cord-347268-vb6z0hzb	2008	
cord-347277-8bmcd22v	2020	
cord-347280-jpwf55l6	2020	
cord-347289-3yi5tz04	2020	
cord-347293-fp8phk0p	2020	
cord-347351-emdj66vj	2020	
cord-347375-5ucemm87	2013	
cord-347414-t88654wo	2020	
cord-347607-ydbyonbg	2020	
cord-347696-rsjwp0b3	2020	
cord-347697-uz0i6wfp	2020	
cord-347752-2ejnva4u	2020	
cord-347905-w0fnc43a	2019	
cord-348051-o1hxoasp	2020	
cord-348130-t9tysvr8	2018	
cord-348172-q3zcn5pf	2020	
cord-348202-6we8e60b	2020	
cord-348364-jb0lvhq5	2020	
cord-348422-werg9ofa	2020	
cord-348423-zq86ms8w	2020	
cord-348430-8xk4dt7t	2020	
cord-348458-dwj90mbq	2020	
cord-348501-8cvtqj7w	2020	
cord-348535-tvs1snq8	2020	
cord-348570-plds5kbn	2020	
cord-348578-chfb4i15	2020	
cord-348672-e34103b1	2020	
cord-348755-2g5gi1du	2020	
cord-348813-v1sdodz9	2020	
cord-348855-lnltoj1n	2020	
cord-348879-opzkodt7	2020	
cord-348881-w0moe21t	2020	
cord-348975-plne3xlz	2020	
cord-349031-tbof9yqi	2020	
cord-349076-x3rjasg0	2020	
cord-349144-cvmebr3f	2020	
cord-349210-8t4a5qqo	2020	
cord-349263-mmfrqyrc	2020	
cord-349280-12hc3mhq	2020	
cord-349329-f0pbd968	2020	
cord-349360-dv4lxx52	2020	
cord-349396-a6zyioc1	2020	
cord-349408-2ser9zjc	2020	
cord-349439-3z0b77r5	2020	
cord-349500-603v8lfb	2020	
cord-349533-51cex2sl	2020	
cord-349561-4mkiwg9k	2020	
cord-349565-g1emvmdu	2020	
cord-349566-zx9kt144	2020	
cord-349678-79zlgjqi	2020	
cord-349740-xed4aybr	2020	
cord-349775-zwslhjju	2011	
cord-349838-p6vfzbla	2020	
cord-349949-jp0hvcg6	2020	
cord-349958-126yb5se	2020	
cord-350052-9431xqu1	2013	
cord-350065-frg7gvf5	2020	
cord-350131-rsrlri8m	2020	
cord-350166-loxe11d6	2020	
cord-350179-ltk5hfc4	2020	
cord-350200-1w5u3w8i	2020	
cord-350232-zml4o93t	2020	
cord-350325-vu8v9epr	2020	
cord-350338-lcsa06gm	2020	
cord-350401-suefuurq	2020	
cord-350408-rqlkwoya	2020	
cord-350437-dq1il88y	2020	
cord-350529-yqtu059x	2020	
cord-350571-6tapkjb6	2017	
cord-350578-wyz5jyjh	2020	
cord-350589-h6hotlqk	2020	
cord-350594-0zxq4lxc	2020	
cord-350639-iguadmw1	2020	
cord-350679-69lv4wbz	2020	
cord-350718-jzliir37	2011	
cord-350737-nrtrhq1f	2004	
cord-350904-wyg8ikph	2020	
cord-350923-532lnnll	2020	
cord-350959-bsbz3a1l	2020	
cord-350990-tywbe4o2	2020	
cord-351020-wde3ki0k	2020	
cord-351046-yq7287k9	2019	
cord-351129-lzzyn570	2020	
cord-351155-5bvo66yb	2020	
cord-351184-kcc3p3ow	2020	
cord-351195-2fdqu2l1	2020	
cord-351223-nnuoadh6	2020	
cord-351224-jeedo5mc	2020	
cord-351340-7y19ystp	2020	
cord-351431-xcqz9d3t	2020	
cord-351446-j4ambec5	2020	
cord-351457-fzj3ciif	2020	
cord-351528-23lbs8al	2020	
cord-351531-wo1ggmmn	2020	
cord-351555-hsgsuor2	2020	
cord-351597-bdazrbsz	2020	
cord-351604-x4rsdwqz	2020	
cord-351625-1we9wi1g	2020	
cord-351722-3mw1te94	2020	
cord-351735-x1lng449	2020	
cord-351762-n95ar9ci	2020	
cord-351776-otx5qwyu	2020	
cord-351819-ovpz36e7	2020	
cord-351823-ldbscq4s	2020	
cord-351825-fdog73g2	2020	
cord-351896-j6h02ab5	2020	
cord-352065-960xqft4	2020	
cord-352159-qx16i7s1	2020	
cord-352177-05sku8a8	2020	
cord-352193-izzqdg3v	2020	
cord-352215-dhkvh45t	2020	
cord-352227-827987jf	2020	
cord-352234-utjne1ef	2020	
cord-352302-are8vvhh	2020	
cord-352304-tt2q5mgs	2020	
cord-352399-2xfzpw9m	2020	
cord-352401-tmt1pmw9	2020	
cord-352544-7b6btzrx	2020	
cord-352557-l7sahv5t	2020	
cord-352577-h3652seb	2014	
cord-352579-ndcbmgfj	2020	
cord-352678-8f2ygul2	2020	
cord-352823-1os3kwp1	2020	
cord-352828-4ecik6xw	2020	
cord-352846-p7hhv297	2020	
cord-352889-fl61z3w3	2020	
cord-352901-ia34l2ml	2020	
cord-352905-ge3u32hm	2020	
cord-352914-jccxzit1	2020	
cord-352937-htmp0avc	2020	
cord-352969-rpt7xja6	2020	
cord-353004-ocnp758o	2020	
cord-353013-7cx0gnum	2020	
cord-353059-39msyuxb	2020	
cord-353180-hbwrzm6s	2020	
cord-353200-5csewb1k	2020	
cord-353228-fxrf5wsp	2020	
cord-353256-7nfklun9	2019	
cord-353281-leb7c7b0	2020	
cord-353293-vjdwh19x	2020	
cord-353340-l0icku0i	2020	
cord-353375-92pu0pp0	2020	
cord-353401-y1mxnth7	2020	
cord-353484-q7d0ysbo	2020	
cord-353594-z1vxamvp	2020	
cord-353599-cw29edwr	2020	
cord-353648-rl9dts7l	2020	
cord-353671-xjpzhsup	2020	
cord-353697-ocxextfj	2020	
cord-353698-gj8sx3zy	2020	
cord-353786-284qn075	2020	
cord-353824-0oyvia6d	2020	
cord-353956-gjv5cg3k	2020	
cord-353987-hj94a04i	2020	
cord-354103-4dldgqzf	2020	
cord-354127-sb8tovy2	2020	
cord-354160-sca9bgeq	2020	
cord-354168-omen8vvq	2020	
cord-354194-hf5ndv5f	2020	
cord-354204-23xkug85	2020	
cord-354216-4khdcjed	2020	
cord-354223-0ckpz0bx	2020	
cord-354337-a70avg2x	2020	
cord-354372-vfvnjmv1	2020	
cord-354373-lldfoptb	2020	
cord-354411-4emzxu09	2020	
cord-354597-xubsodnk	2020	
cord-354619-pftjhtpo	2020	
cord-354658-v451z3jq	2020	
cord-354689-dsv63it1	2020	
cord-354720-fu19u2b0	2020	
cord-354749-zkgb16ae	2020	
cord-354824-7fdcu2f0	2020	
cord-355003-1o2midnh	2020	
cord-355028-1x7w1749	2020	
cord-355031-l0tj7kp2	2020	
cord-355033-txxylmrw	2020	
cord-355038-o2hr5mox	2020	
cord-355039-qi4fwqbc	2020	
cord-355146-6rat5j64	2020	
cord-355177-62v1qhia	2020	
cord-355190-ytdw1d5v	2020	
cord-355191-jghvq3cy	2020	
cord-355264-ygzh8von	2020	
cord-355294-gifsqph6	2020	
cord-355296-46jf56nc	2020	
cord-355384-qa7grviy	2020	
cord-355431-efwuy8p9	2020	
cord-355484-2igc5wzx	2020	
cord-355504-zsyvgm9c	2015	
cord-355524-qx396wq1	2017	
cord-355528-y4a1g6km	2020	
cord-355533-5kgdg2nb	2020	
cord-355549-6xnjj5h5	2020	
cord-355558-r6r1t47c	2020	
cord-355589-3zdv9zim	2020	
cord-355885-pg6mpuk5	2020	
cord-355898-hlkwwaqe	2020	
cord-356040-qdpkidn8	2020	
cord-356056-82bvcuvd	2020	
cord-356057-87kxlqdc	2020	
cord-356084-621qzpqd	2020	
cord-356127-xy5tyd7t	2020	
cord-356195-5pcaxpp9	2020	
cord-356215-0nypfw48	2020	
cord-356246-4p0ok1mc	2020	
cord-356332-t0ahmh0h	2020	
cord-356349-ey5vnddu	2012	
cord-356371-w9ejgzvu	2020	
cord-356379-e8ohc25w	2020