25 years International Bladder Cancer Network (IBCN): The past, the present, and the future.

In 1997 an international group of scientists organized a meeting in Barcelona, Spain, to discuss the use of biomarkers in the management of patients with bladder cancer. This meeting was the offspring of an - initially informal - group that finally resulted in the foundation and incorporation of the International Bladder Cancer Network (IBCN) e.V. in 2005. Over the years the group has supported several research initiatives and generated several recommendations on the use of biomarkers in the diagnosis and treatment of bladder cancer. Meeting quality was generated by inviting experts presenting state-of-the-art lectures or work in progress reports, interdisciplinarity and the limited number of participants supporting an open and personal exchange resulted in a format increasingly attracting participants from all over the world. The recent limitations caused by the Covid-19 pandemic were partially met by organizing several well attended webinars. The future challenge is to maintain the IBCN meeting spirit despite an increasing interest of the scientific community and industrial partners to participate. However, the integration of and interaction between increasingly more specialized disciplines is a challenge that can be better catalyzed by an international multidisciplinary network than mostly national professional associations.

Association of testosterone therapy with disease progression in older males with COVID-19.

IMPORTANCE: Low testosterone levels in males have been linked with increase in proinflammatory cytokines-a primary culprit in COVID-19 disease progression-and with adverse COVID-19 outcomes. To date, however, no published studies have assessed the effect of testosterone therapy on COVID-19 outcomes in older men. OBJECTIVE: To examine whether testosterone therapy reduced disease progression in older men diagnosed with COVID-19. DESIGN, SETTING, AND PARTICIPANTS: Nested within a national cohort of older (aged ≥50 years) male patients diagnosed with COVID-19 between January 1, 2020 and July 1, 2021 from the Optum electronic health record COVID-19 database, two matched case-control studies of COVID-19 outcomes were conducted. Cases-defined, respectively, as persons who (a) were hospitalized ≤30 days after COVID-19 diagnosis (n = 33,380), and (b) were admitted to the intensive care unit or received mechanical ventilation during their COVID-19 hospitalization (n = 10,273)-were matched 1:1 with controls based on demographic and clinical factors. EXPOSURES: Testosterone therapy was defined based on receipt of prescription at ≤60, ≤90, or ≤120 days before COVID-19 diagnosis. MAIN OUTCOMES AND MEASURES: Adjusted odds ratios (ORs) for the risk of hospitalization within 30 days of COVID-19 diagnosis and intensive care unit admission/mechanical ventilation during COVID-19 hospitalization. RESULTS: The use of testosterone therapy was not associated with decreased odds of hospitalization (≤60 days: OR = 0.92, 95% confidence interval [CI] = 0.70-1.20; ≤90 days: OR = 0.87, 95% CI = 0.68-1.13; ≤120 days: OR = 0.97, 95% CI = 0.72-1.32) or intensive care unit admission/mechanical ventilation (≤60 days: OR = 0.67, 95% CI = 0.37-1.23; ≤90 days: OR = 0.63, 95% CI = 0.36-0.11; ≤120 days: OR = 0.58, 95% CI = 0.29-1.19). CONCLUSIONS AND RELEVANCE: This study showed that testosterone therapy was not associated with decreased risks of COVID-19 adverse outcomes. These findings may provide clinically relevant information regarding testosterone treatment in older men with COVID-19 and other respiratory viral infections with similar pathogenesis.

Novel Technique for Nasotracheal Intubation during the COVID-19 Pandemic

Key Words: pediatric, nasotracheal intubation, videolaryngoscopy, COVID-19, SARS-CoV-2 The virus SARS-CoV-2 and the associated disease known as COVID-19 has been declared a global pandemic by the World Health Organization (WHO). According to the WHO, there are over 24 million confirmed cases of COVID-19 as of September 6th, 2020.1 Transmission occurs through aerosolization of large particles (droplets) in the air that eventually come into contact and contaminate a person or surface.2 Healthcare workers are at an increased risk of contracting SARS-CoV-2 while caring for infected patients, especially during aerosolizing procedures such as endotracheal intubation and mask ventilation.2 Additionally, this virus is known to have a long prodromal phase of up to 5 days during which the virus can be transmitted in the absence of symptoms.3 The American Association of Nurse Anesthetists (AANA) and the Anesthesia Patient Safety Foundation (APSF) have released recommendations on management of the patient with COVID19. A standard surgical mask is estimated to provide droplet and contact protection within 1-2 meters from patient.5 The N95 designation is obtained when the mask is tested and demonstrates blocking at least 95% of solid and liquid aerosol test particles.5 Due to the highly contagious nature of this disease and frequent exposure of operating room staff to aerosolizing procedures, airborne precaution PPE is a necessary safety measure. During this case report, videolaryngoscopy was performed once the ETT was advanced through the nasal turbinates and utilization of external cricoid pressure and pilot balloon inflation were utilized to move the ETT tip anteriorly out of the pyriform fossa and into the glottic aperture.