Repurposing antivirals as potential treatments for SARS-CoV-2: From SARS to COVID-19

The novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the agent of the current pandemic of therespiratory disease known as coronavirus disease 2019 (COVID-19). The government and health authorities aroundthe world have advocated social distancing, containment measures, and effective diagnosis as the first measuresto slow down the spread of the disease, but, still, treatment options are urgent, especially for patients evolving tosevere pneumonia. Several pharmaceuticals with antiviral effects were identified and tested, to some extent, duringthe previous SARS-CoV and Middle East respiratory syndrome coronavirus outbreaks. Type I interferons (IFNs),ribavirin, lopinavir/ritonavir, chloroquine/hydroxychloroquine, and remdesivir emerge as the primary options forin-hospital treatment of patients with COVID-19, focused on reducing the viral load. Although more experimental andclinical evidence is required, the accumulated in vitro and clinical knowledge discussed here supports those drugs asfeasible alternatives to face the SARS-CoV infection in the short term, whereas more effective measures arise fromthe world scientific community

Candida auris: a bibliometric analysis of the first ten years of research (2009-2018)

Candida auris (C. auris) is an emerging multidrug resistant fungus considered as the cause of several nosocomialinfections of bad prognosis. This study presents a bibliometric analysis of global scientific research on C. auris sinceit was isolated first in 2009. A systematic search was conducted in Scopus databases in the period of 2009–2018 and atotal of 227 indexed documents were retrieved. A sharp increase in the number of studies related to drug and multidrugresistance of C. auris during 2016–2018 was observed, coinciding with an increase in the number of first-case andoutbreak reports worldwide. The leading countries based on the number of publications were United States, India,and the United Kingdom. Nevertheless, Netherlands ranked first when (i) ratio between the number of citations andnumber of publications, (ii) ratio between the number of publications and gross domestic product (GDP), and (iii) ratiobetween the number of citations and GDP were used as indicators of productivity. Despite the recent emergence of thetopic since the first-case report in 2009, recent research efforts have allowed identifying Ibrexafungerp (SCY-078) andRezafungin (CD101) as possible candidates for facing the actual antifungal resistance of C. auris.

Bibliometric analysis of recent research on multidrug and antibiotics resistance (2017–2018)

Antibiotic resistance is considered, nowadays, as a severe public health problem. In February 2017, the World HealthOrganization (WHO) reported the global priority list of antibiotic-resistant bacteria as a guide for further researchon the field. This contribution presents a bibliometric overview of global research on multidrug and antibioticsresistance. Research articles indexed between 2017 and 2018 on the Scopus database were filtered according to asystematic search strategy and a total of 2,362 records were retrieved. A significative number of studies were foundto be focused on four pathogenic bacteria: Escherichia coli, Pseudomonas aeruginosa, Acinetobacter baumannii, andKlebsiella pneumoniae, which were also included in the critical priority level according to the WHO. The results ofthis study indicate that the United States, China, and India were the most productive countries regarding the numberof publications. Furthermore, publications from the United States, Germany, and the United Kingdom had the highestimpact based on the ratio of the number of citations and the number of publications. Nevertheless, when productivitywas stratified by the number of publications and the number of citations based on the gross domestic product, Iranranked first. This bibliometric approach showed that most of multidrug- and antibiotics-resistance studies focused onthe so-called critical bacteria according to the WHO but less on those bacteria catalogued as high and medium priority

A randomised crossover trial comparing the Airtraq ® NT, McGrath ® MAC and Macintosh laryngoscopes for nasotracheal intubation of simulated easy and difficult airways in a manikin / Estudo cruzado e randômico comparando os laringoscópios Airtraq ® NT, McGrath ® MAC e Macintosh para intubação nasotraqueal em simulação de via aérea fácil e difícil em manequim

ABSTRACT OBJECTIVE: Several devices can aid nasotracheal intubation when managing difficult airways. The McGrath MAC and Airtraq NT were compared with a Macintosh laryngoscope when studying the performance of anaesthetists with different levels of experience, in a manikin model of easy or difficult airway scenarios. METHODS: Sixty-three anaesthetists were recruited into a randomised trial in which each performed nasotracheal intubation with all laryngoscopes, in both scenarios. The main endpoint was intubation time. Additional endpoints included laryngoscopic view, intubation success, number of optimisation manoeuvres, audible dental clicks and the force applied to the upper airway. RESULTS: Intubation time was significantly shorter using the McGrath MAC in both scenarios and using the Airtraq in the difficult scenario, when compared with the Macintosh laryngoscope. Both devices gave more Cormack and Lehane grade 1 or 2 views than the Macintosh in the difficult scenario (p < 0.001). The McGrath MAC had the best first-attempt success rate (98.4% vs. 96.8% and 95.8%, p < 0.001 for the Airtraq NT and Macintosh laryngoscopes respectively). The number of optimisation manoeuvres, audible dental clicks and subjective assessment of the degree of force applied were significantly lower for indirect laryngoscopes versus the Macintosh laryngoscope (p < 0.001). CONCLUSION: In a manikin, the Airtraq and the McGrath laryngoscopes appeared superior to the Macintosh laryngoscope when dealing with simulated airway scenarios. Both devices were associated with better views, intubation times and rates of success, especially in a simulated "difficult airway". Overall satisfaction was highest with the McGrath laryngoscope. Similar clinical studies are needed.

RESUMO OBJETIVO: Vários dispositivos podem ajudar a intubação nasotraqueal no manejo de via aérea difícil. Os laringoscópios McGrath MAC e Airtraq NT foram comparados com um laringoscópio Macintosh em estudo do desempenho de anestesistas com diferentes níveis de experiência, em manequim com cenário de via aérea fácil ou difícil. MÉTODOS: Foram recrutados 63 anestesistas para um estudo randômico, no qual cada um fez intubação nasotraqueal com todos os laringoscópios, em ambos os cenários. O desfecho primário foi o tempo de intubação. Desfechos adicionais incluíram vista laringoscópica, sucesso na intubação, número de manobras de aprimoramento, cliques dentais audíveis e força aplicada nas vias aéreas superiores. RESULTADOS: O tempo de intubação foi significativamente menor com o uso do laringoscópio McGrath MAC em ambos os cenários e com o uso do Airtraq no cenário difícil, em comparação com o laringoscópio Macintosh. Ambos os dispositivos obtiveram mais grau 1 ou 2 de Cormack e Lehane para visualização do que o Macintosh em cenário difícil (p < 0,001). O McGrath MAC teve a melhor taxa de sucesso na primeira tentativa (98,4% vs. 96,8% e 95,8%, p < 0,001, para os laringoscópios Airtraq NT e Macintosh, respectivamente). O número de manobras de aprimoramento, os cliques dentais audíveis e a avaliação subjetiva do grau de força aplicada foram significativamente menores para os laringoscópios indiretos versus o laringoscópio Macintosh (p < 0,001). CONCLUSÃO: Em um manequim, os laringoscópios Airtraq e McGrath pareceram superiores ao laringoscópio Macintosh para lidar com cenários das vias aéreas simuladas. Ambos os dispositivos foram associados a melhores visibilidades, tempos de intubação e taxas de sucesso, especialmente em simulação de "via aérea difícil". A satisfação geral foi maior com o laringoscópio McGrath. Estudos clínicos similares são necessários.