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3.
Anesth Analg ; 133(4): 876-890, 2021 10 01.
Article in English | MEDLINE | ID: covidwho-1412364

ABSTRACT

The coronavirus disease 2019 (COVID-19) disease, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), often results in severe hypoxemia requiring airway management. Because SARS-CoV-2 virus is spread via respiratory droplets, bag-mask ventilation, intubation, and extubation may place health care workers (HCW) at risk. While existing recommendations address airway management in patients with COVID-19, no guidance exists specifically for difficult airway management. Some strategies normally recommended for difficult airway management may not be ideal in the setting of COVID-19 infection. To address this issue, the Society for Airway Management (SAM) created a task force to review existing literature and current practice guidelines for difficult airway management by the American Society of Anesthesiologists Task Force on Management of the Difficult Airway. The SAM task force created recommendations for the management of known or suspected difficult airway in the setting of known or suspected COVID-19 infection. The goal of the task force was to optimize successful airway management while minimizing exposure risk. Each member conducted a literature review on specific clinical practice section utilizing standard search engines (PubMed, Ovid, Google Scholar). Existing recommendations and evidence for difficult airway management in the COVID-19 context were developed. Each specific recommendation was discussed among task force members and modified until unanimously approved by all task force members. Elements of Appraisal of Guidelines Research and Evaluation (AGREE) Reporting Checklist for dissemination of clinical practice guidelines were utilized to develop this statement. Airway management in the COVID-19 patient increases HCW exposure risk. Difficult airway management often takes longer and may involve multiple procedures with aerosolization potential, and strict adherence to personal protective equipment (PPE) protocols is mandatory to reduce risk to providers. When a patient's airway risk assessment suggests that awake tracheal intubation is an appropriate choice of technique, and procedures that may cause increased aerosolization of secretions should be avoided. Optimal preoxygenation before induction with a tight seal facemask may be performed to reduce the risk of hypoxemia. Unless the patient is experiencing oxygen desaturation, positive pressure bag-mask ventilation after induction may be avoided to reduce aerosolization. For optimal intubating conditions, patients should be anesthetized with full muscle relaxation. Videolaryngoscopy is recommended as a first-line strategy for airway management. If emergent invasive airway access is indicated, then we recommend a surgical technique such as scalpel-bougie-tube, rather than an aerosolizing generating procedure, such as transtracheal jet ventilation. This statement represents recommendations by the SAM task force for the difficult airway management of adults with COVID-19 with the goal to optimize successful airway management while minimizing the risk of clinician exposure.


Subject(s)
Airway Management/standards , COVID-19/prevention & control , Health Personnel/standards , Infection Control/standards , Personal Protective Equipment/standards , Societies, Medical/standards , Adult , Advisory Committees/standards , Airway Extubation/methods , Airway Extubation/standards , Airway Management/methods , COVID-19/epidemiology , Humans , Infection Control/methods , Intubation, Intratracheal/methods , Intubation, Intratracheal/standards , Practice Guidelines as Topic/standards
5.
Clin Pediatr (Phila) ; 60(14): 569-573, 2021 12.
Article in English | MEDLINE | ID: covidwho-1390403

ABSTRACT

The coronavirus disease-2019 (COVID-19) pandemic has disrupted inpatient pediatric services across the United States, creating opportunities for innovation. A recent Webinar organized by the Telehealth for Pediatric GI Care Now working group and sponsored by the North American Society of Pediatric Gastroenterology, Hepatology, and Nutrition provided insights into how inpatient pediatric gastroenterology services were affected and how physicians adapted during the crisis. These findings suggest the use of telehealth technologies may augment family communication and facilitate multidisciplinary care in the future. We anticipate that these innovative applications of telehealth will comprise a part of a toolkit for gastroenterologists to be used during this public health emergency and beyond.


Subject(s)
COVID-19/epidemiology , Gastroenterology/education , Pediatrics/education , Telemedicine/methods , COVID-19/therapy , Child , Humans , Societies, Medical/standards , Surveys and Questionnaires , United States
6.
Endocrinol Metab (Seoul) ; 36(4): 757-765, 2021 08.
Article in English | MEDLINE | ID: covidwho-1359308

ABSTRACT

Since the first outbreak of coronavirus disease 2019 (COVID-19), ongoing efforts have been made to discover an efficacious vaccine against COVID-19 to combat the pandemic. In most countries, both mRNA and DNA vaccines have been administered, and their side effects have also been reported. The clinical course of COVID-19 and the effects of vaccination against COVID-19 are both influenced by patients' health status and involve a systemic physiological response. In view of the systemic function of endocrine hormones, endocrine disorders themselves and the therapeutics used to treat them can influence the outcomes of vaccination for COVID-19. However, there are very limited data to support the development of clinical guidelines for patients with specific medical backgrounds based on large clinical trials. In the current severe circumstances of the COVID-19 pandemic, position statements made by clinical specialists are essential to provide appropriate recommendations based on both medical evidence and clinical experiences. As endocrinologists, we would like to present the medical background of COVID-19 vaccination, as well as precautions to prevent the side effects of COVID-19 vaccination in patients with specific endocrine disorders, including adrenal insufficiency, diabetes mellitus, osteoporosis, autoimmune thyroid disease, hypogonadism, and pituitary disorders.


Subject(s)
COVID-19 Vaccines/standards , COVID-19/prevention & control , Endocrine System Diseases , Endocrinologists/standards , Societies, Medical/standards , Vaccination/standards , COVID-19/epidemiology , COVID-19/immunology , COVID-19 Vaccines/administration & dosage , COVID-19 Vaccines/adverse effects , Endocrine System Diseases/epidemiology , Endocrine System Diseases/immunology , Humans , Practice Guidelines as Topic/standards , Republic of Korea/epidemiology
9.
Rocz Panstw Zakl Hig ; 72(2): 209-220, 2021.
Article in English | MEDLINE | ID: covidwho-1267053

ABSTRACT

During the COVID-19 pandemic, care for an adequate diet, well adapted to the body's needs and the current level of physical activity, becomes of particular importance. Many dietary compounds participate in the functioning of the immune system, while vitamins D, C, A (including beta-carotene), E, B6, B12, folic acid, zinc, copper, selenium, iron, amino acids, n-3 and n-6 polyunsaturated fatty acids and intestinal microbiota are crucial in various types of defence processes. There has been no evidence that consumed food and its compounds, including those with pro-/prebiotic properties, play a significant role in preventing SARS-CoV-2 infection or alleviating its course. However, in terms of the nutritional value of food and the prevention of dysbiosis, recommending a varied diet with a high proportion of plant-based foods and an adequate amount of animal-based foods has a sound scientific basis. Malnutrition, underweight and obesity are considered independent and prognostic risk factors of severe SARS-CoV-2 infection, which reduce a patient's chances of survival. Therefore, ensuring good nutritional status, including healthy body weight, is a reasonable approach in the prevention of viral infection SARS-CoV-2 or alleviating its course. The document is accompanied by two catalogues of practical nutritional recommendations during the COVID-19 pandemic, addressed to the general population and children.


Subject(s)
Diet, Healthy/statistics & numerical data , Health Promotion/standards , Nutritional Status , Recommended Dietary Allowances , Societies, Medical/standards , Academies and Institutes/standards , Adult , COVID-19 , Child , Dietary Supplements/statistics & numerical data , Humans , Nutritional Physiological Phenomena , Nutritive Value , Poland , Public Health , Trace Elements/therapeutic use
10.
Leg Med (Tokyo) ; 51: 101880, 2021 Jul.
Article in English | MEDLINE | ID: covidwho-1171980

ABSTRACT

The SARS-CoV-2 pandemic has highlighted discrepancies between surgeons' professional duties and legal protections when acting outside their specialities during the pandemic. These discrepancies between legal and professional standards leave surgeons and the NHS vulnerable to litigation. In the following article, we explore the liabilities that have arisen for surgeons during this period in the United Kingdom and Canada. We recommend, upon review of the literature, that a two-pronged approach be taken to address these discrepancies; (a) a change in policy at the national level to accurately reflect the constraints and demands placed upon the profession in this acute health crisis and (b) the provision of clearer, more stringent legal protection. In the interim, we suggest that individual surgeons utilise a decision-making framework where they consider their personal and professional obligations in regard to resource stewardship, innovation in practice, patient-specific contexts, and patient advocacy while acting outside of their speciality.


Subject(s)
COVID-19 , Government Regulation , Liability, Legal , Societies, Medical/standards , Surgeons/legislation & jurisprudence , Canada , Humans , SARS-CoV-2 , Standard of Care/legislation & jurisprudence , United Kingdom
11.
Anesth Analg ; 133(4): 876-890, 2021 10 01.
Article in English | MEDLINE | ID: covidwho-1133644

ABSTRACT

The coronavirus disease 2019 (COVID-19) disease, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), often results in severe hypoxemia requiring airway management. Because SARS-CoV-2 virus is spread via respiratory droplets, bag-mask ventilation, intubation, and extubation may place health care workers (HCW) at risk. While existing recommendations address airway management in patients with COVID-19, no guidance exists specifically for difficult airway management. Some strategies normally recommended for difficult airway management may not be ideal in the setting of COVID-19 infection. To address this issue, the Society for Airway Management (SAM) created a task force to review existing literature and current practice guidelines for difficult airway management by the American Society of Anesthesiologists Task Force on Management of the Difficult Airway. The SAM task force created recommendations for the management of known or suspected difficult airway in the setting of known or suspected COVID-19 infection. The goal of the task force was to optimize successful airway management while minimizing exposure risk. Each member conducted a literature review on specific clinical practice section utilizing standard search engines (PubMed, Ovid, Google Scholar). Existing recommendations and evidence for difficult airway management in the COVID-19 context were developed. Each specific recommendation was discussed among task force members and modified until unanimously approved by all task force members. Elements of Appraisal of Guidelines Research and Evaluation (AGREE) Reporting Checklist for dissemination of clinical practice guidelines were utilized to develop this statement. Airway management in the COVID-19 patient increases HCW exposure risk. Difficult airway management often takes longer and may involve multiple procedures with aerosolization potential, and strict adherence to personal protective equipment (PPE) protocols is mandatory to reduce risk to providers. When a patient's airway risk assessment suggests that awake tracheal intubation is an appropriate choice of technique, and procedures that may cause increased aerosolization of secretions should be avoided. Optimal preoxygenation before induction with a tight seal facemask may be performed to reduce the risk of hypoxemia. Unless the patient is experiencing oxygen desaturation, positive pressure bag-mask ventilation after induction may be avoided to reduce aerosolization. For optimal intubating conditions, patients should be anesthetized with full muscle relaxation. Videolaryngoscopy is recommended as a first-line strategy for airway management. If emergent invasive airway access is indicated, then we recommend a surgical technique such as scalpel-bougie-tube, rather than an aerosolizing generating procedure, such as transtracheal jet ventilation. This statement represents recommendations by the SAM task force for the difficult airway management of adults with COVID-19 with the goal to optimize successful airway management while minimizing the risk of clinician exposure.


Subject(s)
Airway Management/standards , COVID-19/prevention & control , Health Personnel/standards , Infection Control/standards , Personal Protective Equipment/standards , Societies, Medical/standards , Adult , Advisory Committees/standards , Airway Extubation/methods , Airway Extubation/standards , Airway Management/methods , COVID-19/epidemiology , Humans , Infection Control/methods , Intubation, Intratracheal/methods , Intubation, Intratracheal/standards , Practice Guidelines as Topic/standards
12.
J Peripher Nerv Syst ; 26(2): 148-154, 2021 06.
Article in English | MEDLINE | ID: covidwho-1096870

ABSTRACT

BACKGROUND AND AIMS: To develop recommendations for vaccination for coronavirus-19 (COVID-19) in patients with inflammatory neuropathies. METHODS: Key questions were formulated in order to perform a literature review on the safety and efficacy of vaccines in patients with inflammatory neuropathies. Based on the best evidence and expert opinion, a list of recommendations was formulated to inform decision on vaccination for COVID-19 in patients with inflammatory neuropathies and increase adherence to vaccination programmes. RESULTS: Recommendations addressing safety and efficacy of vaccination in patients with inflammatory neuropathies were formulated. No data are currently available on the safety and efficacy of COVID-19 vaccines in patients with inflammatory neuropathies or other immune-mediated conditions. There is only sparse data on the safety of previous available vaccines in patients with inflammatory neuropathies, but studies on other autoimmune disorders indicate that these are safe and mostly efficacious. Patients with inflammatory neuropathies might be at increased risk for severe illness from COVID-19. INTERPRETATION: Patients with inflammatory neuropathies should be encouraged to adhere to the vaccination campaign for COVID-19. These recommendations provide guidance on the management of vaccinations for COVID-19 in patients with inflammatory neuropathies. More research is needed regarding the safety and efficacy of vaccination in patients with inflammatory neuropathies and other immune conditions.


Subject(s)
COVID-19 Vaccines/therapeutic use , Guillain-Barre Syndrome , Polyradiculoneuropathy, Chronic Inflammatory Demyelinating , Practice Guidelines as Topic/standards , Societies, Medical/standards , Vaccination/standards , COVID-19 Vaccines/adverse effects , Humans , Italy
13.
Fam Syst Health ; 38(4): 495-497, 2020 Dec.
Article in English | MEDLINE | ID: covidwho-1085434

ABSTRACT

Presents a column from the presidents of the CHFA who discuss the current impacts of COVID-19 in the United States and in health care. The inconsistent, unscientific, and divisive response to the COVID-19 pandemic, and the racial inequality made evident by it, may serve historians and future leadership educators of what not to do in times of crisis, painful lessons that may be productive if we learn from our mistakes. The column then discusses the importance of racial and ethnic diversity within CHFA, workforce development, stragetic partnerships and policy. (PsycInfo Database Record (c) 2021 APA, all rights reserved).


Subject(s)
COVID-19/epidemiology , Family Health , Leadership , Societies, Medical/organization & administration , Cultural Diversity , Humans , Pandemics , SARS-CoV-2 , Societies, Medical/standards , Staff Development , United States/epidemiology
14.
Eur J Cancer ; 147: 154-160, 2021 04.
Article in English | MEDLINE | ID: covidwho-1077873

ABSTRACT

The worldwide spread of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and the associated infectious coronavirus disease (COVID-19) has posed a unique challenge to medical staff, patients and their families. Patients with cancer, particularly those with haematologic malignancies, have been identified to be at high risk to develop severe COVID-19. Since publication of our previous guideline on evidence-based management of COVID-19 in patients with cancer, research efforts have continued and new relevant data has come to light, maybe most importantly in the field of vaccination studies. Therefore, an update of our guideline on several clinically important topics is warranted. Here, we provide a concise update of evidence-based recommendations for rapid diagnostics, viral shedding, vaccination and therapy of COVID-19 in patients with cancer. This guideline update was prepared by the Infectious Diseases Working Party (AGIHO) of the German Society for Haematology and Medical Oncology by critically reviewing the currently available data on these topics applying evidence-based medicine criteria.


Subject(s)
COVID-19 Testing/standards , COVID-19 Vaccines/therapeutic use , COVID-19 , Neoplasms , SARS-CoV-2/physiology , Virus Shedding/physiology , Antiviral Agents/therapeutic use , COVID-19/diagnosis , COVID-19/epidemiology , COVID-19/therapy , COVID-19/virology , COVID-19 Testing/methods , Evidence-Based Medicine/standards , Evidence-Based Medicine/statistics & numerical data , Germany/epidemiology , Hematologic Neoplasms/diagnosis , Hematologic Neoplasms/epidemiology , Hematologic Neoplasms/therapy , Hematologic Neoplasms/virology , Hematology/organization & administration , Hematology/standards , Humans , Immunization, Passive/methods , Immunization, Passive/standards , Infectious Disease Medicine/organization & administration , Infectious Disease Medicine/standards , Medical Oncology/organization & administration , Medical Oncology/standards , Neoplasms/diagnosis , Neoplasms/epidemiology , Neoplasms/therapy , Neoplasms/virology , SARS-CoV-2/immunology , Societies, Medical/standards , Vaccination/methods , Vaccination/standards
15.
Rev Endocr Metab Disord ; 22(2): 317-324, 2021 06.
Article in English | MEDLINE | ID: covidwho-1064568

ABSTRACT

SARS-COV2 infection has swiftly become a pandemic disease of historic relevance and widely variable outcomes. This variable prognosis is related both to uneven damage, among others, to lungs, heart and kidneys, and to a multisystemic inflammatory reaction. All these factors are known to disrupt water balance and potentially induce hyponatraemia or hypernatraemia. Water balance disorders are known mortality and morbidity risk factors in several clinical scenarios and their proper management, though often complex and hazardous, can reduce mortality and length of hospitalization. Clinical uncertainty over COVID-19 outcome, the variety of organs involved in both the infection and water balance and difficulties in clinical examination due to risk of contagion might obstruct proper management of dysnatremic disorders. Thus, the Acqua Neuroendocrinology Group of the Spanish Society for Endocrinology (SEEN) has endeavoured to provide evidence and expert based recommendations on the management of hyponatraemia and hypernatraemia in COVID-19 patients.


Subject(s)
COVID-19/therapy , Consensus , Hypernatremia/therapy , Hyponatremia/therapy , Neuroendocrinology/standards , Practice Guidelines as Topic/standards , Societies, Medical/standards , COVID-19/complications , Humans , Hypernatremia/etiology , Hyponatremia/etiology , Spain
17.
Adv Respir Med ; 88(6): 640-650, 2020.
Article in English | MEDLINE | ID: covidwho-1060560

ABSTRACT

At the end of 2019, in Wuhan, the Hubei Province's capital city in China, the first cases of COVID-19 disease caused by the novel coronavirus, SARS-CoV-2, were described. The rapid spread of the infection through the world resulted in the World Health Organization announcing the COVID-19 a global pandemic in March 2020. The main routes of transmission of the novel coronavirus SARS-CoV-2, according to current evidence, are via droplets inhalation, direct contact with contaminated surfaces, and transmission via the mucous membranes of the mouth, nose, and eyes, and probably through airborne particles from the respiratory tract, generated during coughing and sneezing of infected individuals. During the pulmonary function testing (PFTs), which require strenuous breathing maneuvers and generate high-intensity airflow, aerosols, and micro-aerosols are formed from respiratory secretions and may contain viral and bacterial particles. Therefore, such forced respiratory maneuvers pose a significant risk of spreading the infection to patients and laboratory staff. According to current knowledge, the source of infection may also be an asymptomatic and a pre-symptomatic individual. Coronavirus SARS-CoV-2 has been increasingly prevalent in the community, and this increases a potential risk to all patients tested lung function and staff working there. As the patients' and staff's safety is of unprecedented importance, the additional precautions when performing pulmonary function tests are necessary and unquestionable. In consequence, the greater availability of consumables and personal protective equipment is indispensable. The reorganization of daily practice will prolong test time, reduce the number of tests performed, and slow down patients' flow. The guidance provides practical advice to health care professionals on performing pulmonary function tests during the COVID-19 pandemic. It has been developed basing on currently available information and recommendations from relevant health care institutions. As the COVID-19 pandemic is a rapidly evolving situation and the new scientific data has been becoming are available, the guidance will be updated over time.


Subject(s)
COVID-19/diagnosis , Health Promotion/organization & administration , Infection Control/organization & administration , Practice Guidelines as Topic/standards , Societies, Medical/standards , Spirometry/standards , Academic Medical Centers , COVID-19/therapy , Humans , Poland , SARS-CoV-2
18.
Support Care Cancer ; 29(4): 1713-1718, 2021 Apr.
Article in English | MEDLINE | ID: covidwho-1043511

ABSTRACT

This paper chronicles the third decade of MASCC from 2010. There was a generational change in this decade, building on the solid foundation of the founders. It included the first female President, and a new Executive Director with a background in strategy and business development and operations as applied to healthcare. The headquarters moved from Copenhagen to Toronto. The first meeting to be held outside of Europe or North America was held in Adelaide, Australia, and the membership in the Asia Pacific region expanded. A program of international affiliates saw national supportive care organisations formally link with MASCC. In cancer supportive care, there was a raft of new toxicities to manage as immunotherapies were added to conventional cytotoxic treatment. There was also a greater emphasis on the psychosocial needs of patients and families. New MASCC groups were formed to respond to this evolution in cancer management. The MASCC journal, Supportive Care in Cancer, continued to grow in impact, and MASCC published two editions of a textbook of supportive care and survivorship. The decade ended with the challenge of the COVID-19 pandemic, but that served to highlight the importance of good supportive care to patients with cancer.


Subject(s)
Neoplasms/therapy , Palliative Care/history , Palliative Care/trends , Societies, Medical/history , COVID-19/epidemiology , Congresses as Topic/history , Congresses as Topic/trends , Governing Board/history , Governing Board/trends , History, 20th Century , History, 21st Century , Humans , International Agencies/history , International Agencies/organization & administration , International Agencies/standards , International Agencies/trends , International Cooperation/history , Neoplasms/history , Palliative Care/organization & administration , Pandemics , Publications/history , Publications/trends , SARS-CoV-2/physiology , Societies, Medical/organization & administration , Societies, Medical/standards , Societies, Medical/trends
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