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Adoptive T-cell therapies (ACTs) including tumor-infiltrating lymphocytes and engineered T cells (transgenic T-cell receptor and chimeric antigen receptor T cells), have made an important impact in the field of cancer treatment over the past years. Most of these therapies are typically administered systemically in approaches that facilitate the elimination of hematologic malignancies. Therapeutical efficacy against solid tumors, however, with the exception of tumor-infiltrating lymphocytes against melanoma, remains limited due to several barriers preventing lymphocyte access to the tumor bed. Building upon the experience of regional administration in other immunotherapies, the regional administration of adoptive cell therapies is being assessed to overcome this challenge, granting a first round of access of the transferred T cells to the tumor niche and thereby ensuring their activation and expansion. Intralesional and intracavitary routes of delivery have been tested with promising antitumor objective responses in preclinical and clinical studies. Additionally, several strategies are being developed to further improve T-cell activity after reinfusing them back to the patient such as combinations with other immunotherapy agents or direct engineering of the transferred T cells, achieving long-term immune memory. Clinical trials testing different regional adoptive T-cell therapies are ongoing but some issues related to methodology of administration and correct selection of the target antigen to avoid on-target/off-tumor side-effects need to be further evaluated and improved. Herein, we discuss the current preclinical and clinical landscape of intratumoral and locoregional delivery of adoptive T-cell therapies.
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Group A ß-hemolytic Streptococcus (S. pyogenes), also known as GAS, is a Gram-positive bacterium. It can be easily identified in the microbiology laboratory by its ability to hemolyse blood in culture media. This bacterium is highly virulent due to its production of enzymes and toxins, and its ability to cause immunologically mediated diseases such as rheumatic fever and post-streptococcal glomerulonephritis. GAS is the primary cause of bacterial pharyngotonsillitis, although it is typically a benign and non-invasive disease. However, it also has the potential to cause severe skin and soft tissue infections, necrotising fasciitis, bacteraemia and endocarditis, pneumonia and empyema, and streptococcal toxic shock syndrome, without any age or predisposition limits. The term invasive GAS disease (iGAS) is used to refer to this group of conditions. In more developed countries, iGAS disease has declined thanks to improved hygiene and the availability of antibiotics. For example, rheumatic fever has practically disappeared in countries such as Spain. However, recent data suggests a potential increase in some iGAS diseases, although the accuracy of this data is not consistent. Because of this, the COVID and Emerging Pathogens Committee of the Illustrious Official College of Physicians of Madrid (ICOMEM) has posed several questions about invasive GAS infection, especially its current situation in Spain. The committee has enlisted the help of several experts in the field to answer these questions. The following lines contain the answers that we have collaboratively produced, aiming to assist not only the members of ICOMEM but also anyone interested in this topic.
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AIM: This work aims to evaluate whether electronic consultations (e-consults) are a clinically useful, safe tool for assessing patients between primary care and internal medicine. METHODS: This is a retrospective cohort study of all e-consults ordered by the Primary Care Department to the Internal Medicine Department between September 2019 and December 2023. The results of initial consultations, emergency department visits and subsequent admissions, and survival were assessed and complaints and claims filed were reviewed. RESULTS: A total of 11,434 e-consults were recorded (55.4% women) with a mean age of 62.1 (SD19.4) years and a wide range (15-102 years). The mean response time was 2.55 (SD 1.6) days. As a result of the e-consults, 5645 patients (49.4%) were given an in-person appointment. For the remaining 5789 (50.6%), a written response was provided. Among those given appointments, the time between the response and in-person appointment was less than five days (95% of cases). Compared to those not given appointments, in-person appointments were older (pâ¯<â¯0.0001), visited the emergency department more times (one month: pâ¯=â¯0.04; three months: pâ¯=â¯0.001), were admitted to the hospital more times (one month: pâ¯=â¯0.0001; three months: pâ¯=â¯0.0001), and had higher mortality at one year (12.7% vs. 9.8% pâ¯=â¯0.0001). In the Cox analysis, only in-person appointments (RRâ¯=â¯1.11; pâ¯=â¯0.04)) and age (RRâ¯=â¯1.09; pâ¯<â¯0.01) were independent factors of mortality. No complaints or claims of any kind were registered. CONCLUSIONS: These data suggest that e-consults are a clinically useful, safe tool for assessing patients referred from primary care to internal medicine departments.
Subject(s)
Internal Medicine , Primary Health Care , Humans , Female , Primary Health Care/statistics & numerical data , Middle Aged , Male , Retrospective Studies , Aged , Adult , Aged, 80 and over , Adolescent , Young Adult , Emergency Service, Hospital/statistics & numerical data , Remote Consultation/statistics & numerical data , Health Services AccessibilityABSTRACT
OBJECTIVE: There are limited studies on urogenital symptoms in women who experience menopause before the age of 40 years due to primary ovarian insufficiency (POI) or bilateral oophorectomy (surgical POI). This study aimed to compare the urogenital symptoms, including sexuality, of women with POI to those without the condition. METHODS: This cross-sectional study conducted was in seven Latin American countries, in which postmenopausal women (with POI and non-POI) were surveyed with a general questionnaire, the Menopause Rating Scale (MRS) and the six-item Female Sexual Function Index (FSFI-6). The association of premature menopause with more urogenital symptoms and lower sexual function was evaluated with logistic regression analysis. RESULTS: Women with POI experience more urogenital symptoms (MRS urogenital score: 3.54 ± 3.16 vs. 3.15 ± 2.89, p < 0.05) and have lower sexual function (total FSFI-6 score: 13.71 ± 7.55 vs. 14.77 ± 7.57 p < 0.05) than women who experience menopause at a normal age range. There were no significant differences in symptoms when comparing women based on the type of POI (idiopathic or surgical). After adjusting for covariates, our logistic regression model determined that POI is associated with more urogenital symptoms (odds ratio [OR]: 1.38, 95% confidence interval [CI] 1.06-1.80) and lower sexual function (OR: 1.67, 95% CI 1.25-2.25). CONCLUSION: POI, whether idiopathic or secondary to bilateral oophorectomy, is associated with symptoms that affect vaginal and sexual health.
Subject(s)
Menopause, Premature , Primary Ovarian Insufficiency , Sexual Dysfunction, Physiological , Humans , Female , Cross-Sectional Studies , Primary Ovarian Insufficiency/complications , Middle Aged , Sexual Dysfunction, Physiological/etiology , Adult , Surveys and Questionnaires , Ovariectomy/adverse effects , Female Urogenital Diseases , Latin America , Logistic Models , Menopause/physiologyABSTRACT
Type 2 diabetes is a medical condition involving elevated blood glucose levels resulting from impaired or improper insulin utilization. As the number of type 2 diabetes cases increases each year, there is an urgent need to develop novel drugs having new targets and/or complementing existing therapeutic protocols. In this regard, marine sponge-derived compounds hold great potential due to their potent biological activity and structural diversity. In this study, a small library of 50 marine sponge-derived compounds were examined for their activity towards type 2 diabetes targets, namely dipeptidyl peptidase-4 (DPP-4) and protein tyrosine phosphatase 1B (PTP1B). The compounds were first subjected to molecular docking on protein models based on their respective co-crystal structures to assess binding free energies (BFE) and conformations. Clustering analysis yielded BFE that ranged from 24.54 kcal/mol to -9.97 kcal/mol for DPP-4, and from -4.98 kcal/mol to -8.67 kcal/mol for PTP1B. Interaction analysis on the top ten compounds with the most negative BFE towards each protein target showed similar intermolecular interactions and key interacting residues as in the previously solved co-crystal structure. These compounds were subjected to absorption, distribution, metabolism, excretion, and toxicity (ADMET) profiling to characterize drug-likeness and combining the results from these analyses, (S)-6'-debromohamacanthin B was identified as a potential multi-target inhibitor of DPP-4 and PTP1B, having favorable protein interaction, no Lipinski violations, good gastrointestinal (GI) tract absorption, blood-brain barrier (BBB) penetration, and no predicted toxicity. Finally, the interaction of (S)-6'-debromohamacanthin B with the two proteins was validated using molecular dynamics simulations over 100 ns through RMSD, radius of gyration, PCA, and molecular mechanics Poisson-Boltzmann surface area (MMPBSA) confirming favorable interactions with the respective proteins.Communicated by Ramaswamy H. Sarma.
A 50-compound library previously reported from marine sponges was docked to putative T2DM targets, DDP-4 and PTP1B.(S)-6'-debromohamacanthin B was identified as a probable dual-targeting compound based on binding interactions and ADMET evaluation.Interaction of (S)-6'-debromohamacanthin B with DPP-4 and PTP1B was validated by MD simulations.
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Objective@#To compare PhilHealth case rate versus actual charge of hospitalization of common general surgery procedures in a Level 3 government hospital from 2017-2019.@*Methods@#The five most common procedures were determined and records were reviewed. Hospital bills and professional fees (PF) were compared to the PhilHealth rates using t-test. The range of perceived acceptable PF was determined by an online survey.@*Results@#The most common procedures were open appendectomy, open cholecystectomy, initial repair of inguinal hernia, total thyroidectomy and modified radical mastectomy. The study included 1934 charts. For service cases, the hospital bill for appendectomy was significantly lower than the PhilHealth institutional fee, while the rest were significantly higher. For private cases, hospital bills for open cholecystectomy and modified radical mastectomy were significantly higher, while that of open appendectomy was lower. The average PF of private patients in all procedures were significantly higher than the PhilHealth rate, also reflected on the survey.@*Conclusion@#The significant discrepancies between the actual charges and the PhilHealth case rates showed that the PhilHealth rates were insufficient for the five most common general surgery procedures in a Level 3 government hospital.
Subject(s)
Philippines , InsuranceABSTRACT
@#The Sixth Environmental and Occupational Health Forum, conducted virtually on November 23 to 24, 2023, focused on "Accelerating the Development of Healthy and climate-smart Hospitals in the Southeast Asian Region." This forum, a collaborative effort of the University of the Philippines Manila and Health Care Without Harm Southeast Asia, aimed to explore and exchange strategies, challenges, and innovative practices for integrating environmental sustainability in healthcare settings across Southeast Asia. The event gathered healthcare professionals, policymakers, and environmental experts to discuss the transformation of hospitals into health and climate-smart institutions. Keynote speakers from various countries presented case studies and research findings, emphasizing the need for holistic approaches that include policy development, stakeholder engagement, and continuous education. Significant outcomes highlighted were the identification of effective policies for sustainable hospitals, understanding the impact of healthcare facilities on climate change, and the necessity for political acumen in promoting environmental stewardship in healthcare. The forum concluded with a consensus on the critical need for ongoing collaboration and innovation in environmental and occupational health, underscoring the importance of transforming healthcare facilities into entities that prioritize both patient care and planetary health.
Subject(s)
Delivery of Health Care , Occupational HealthABSTRACT
Objetivo Evaluar la captación metabólica de diferentes signos tomográficos observados en pacientes con hallazgos estructurales incidentales sugestivos de neumonía por COVID-19 mediante PET/TC con 18F-FDG. Material y métodos Se analizaron retrospectivamente 596 estudios PET/TC realizados desde el 21 de febrero de 2020 hasta el 17 de abril de 2020. Tras excluir 37 exploraciones (trazadores PET diferentes a la 18F-FDG y estudios cerebrales), se evaluó la actividad metabólica de varios cambios estructurales integrados en la puntuación CO-RADS mediante el SUVmáx de estudios multimodales con 18F-FDG. Resultados Se incluyeron 43 pacientes r COVID-19 en la 18F-FDG PET/TC (edad media: 68±12,3 años, 22 varones). Los valores de SUVmáx fueron mayores en los pacientes con categorías CO-RADS 5-6 respecto a los de categorías CO-RADS inferiores (6,1±3,0 vs. 3,6±2,1, p=0,004). En los pacientes con CO-RADS 5-6, las opacidades en vidrio deslustrado, la bilateralidad y las consolidaciones mostraron valores de SUVmáx más elevados (valores de la p de 0,01, 0,02 y 0,01, respectivamente). La distribución parcheada y el patrón crazy paving también se asociaron a valores de SUVmáx más elevados (valores de p de 0,002 y 0,01). Tras el análisis multivariable, el SUVmáx se asoció significativamente con un diagnóstico estructural positivo de neumonía por COVID-19 (odds ratio=0,63, intervalo de confianza del 95%=0,41-0,90; p=0,02). La curva ROC del modelo de regresión destinado a confirmar o descartar el diagnóstico estructural de neumonía por COVID-19 mostró un AUC de 0,77 (error estándar=0,072; p=0,003). Conclusiones En aquellos pacientes remitidos a 18F-FDG PET/TC por indicaciones oncológicas y no oncológicas estándar (43/559; 7,7%) durante la pandemia, la obtención de imágenes multimodales es una herramienta útil durante la detección incidental de neumonía (AU)
Purpose To evaluate the metabolic uptake of different tomographic signs observed in patients with incidental structural findings suggestive of COVID-19 pneumonia through 18F-FDG PET/CT. Material and methods We retrospectively analyzed 596 PET/CT studies performed from February 21, 2020 to April 17, 2020. After excluding 37 scans (non-18F-FDG PET tracers and brain studies), we analyzed the metabolic activity of several structural changes integrated in the CO-RADS score using the SUVmax of multimodal studies with 18F-FDG. Results Forty-three patients with 18F-FDG PET/CT findings suggestive of COVID-19 pneumonia were included (mean age: 68±12.3 years, 22 male). SUVmax values were higher in patients with CO-RADS categories 56 than in those with lower CO-RADS categories (6.1±3.0 vs. 3.6±2.1, p=0.004). In patients with CO-RADS 56, ground-glass opacities, bilaterality and consolidations exhibited higher SUVmax values (p-values of 0.01, 0.02 and 0.01, respectively). Patchy distribution and crazy paving pattern were also associated with higher SUVmax (p-values of 0.002 and 0.01). After multivariate analysis, SUVmax was significantly associated with a positive structural diagnosis of COVID-19 pneumonia (odds ratio=0.63, 95% confidence interval=0.410.90; p=0.02). The ROC curve of the regression model intended to confirm or rule out the structural diagnosis of COVID-19 pneumonia showed an AUC of 0.77 (standard error=0.072, p=0.003). Conclusions In those patients referred for standard oncologic and non-oncologic indications (43/559; 7.7%) during pandemic, imaging with 18F-FDG PET/CT is a useful tool during incidental detection of COVID-19 pneumonia. Several CT findings characteristic of COVID-19 pneumonia, specifically those included in diagnostic CO-RADS scores (56), were associated with higher SUVmax values (AU)
Subject(s)
Humans , Male , Female , Middle Aged , Aged , Lung/diagnostic imaging , Lung/physiopathology , /diagnostic imaging , /pathology , Pneumonia, Viral/diagnostic imaging , Pneumonia, Viral/physiopathology , Multimodal Imaging , Positron Emission Tomography Computed Tomography , Incidental FindingsABSTRACT
PURPOSE: To evaluate the metabolic uptake of different tomographic signs observed in patients with incidental structural findings suggestive of COVID-19 pneumonia through 18F-FDG PET/CT. MATERIALS AND METHODS: We retrospectively analyzed 596 PET/CT studies performed from February 21, 2020 to April 17, 2020. After excluding 37 scans (non-18F-FDG PET tracers and brain studies), we analyzed the metabolic activity of several structural changes integrated in the CO-RADS score using the SUVmax of multimodal studies with 18F-FDG. RESULTS: Forty-three patients with 18F-FDG PET/CT findings suggestive of COVID-19 pneumonia were included (mean age: 68±12.3 years, 22 male). SUVmax values were higher in patients with CO-RADS categories 5-6 than in those with lower CO-RADS categories (6.1±3.0 vs. 3.6±2.1, p=0.004). In patients with CO-RADS 5-6, ground-glass opacities, bilaterality and consolidations exhibited higher SUVmax values (p-values of 0.01, 0.02 and 0.01, respectively). Patchy distribution and crazy paving pattern were also associated with higher SUVmax (p-values of 0.002 and 0.01). After multivariate analysis, SUVmax was significantly associated with a positive structural diagnosis of COVID-19 pneumonia (odds ratio=0.63, 95% confidence interval=0.41-0.90; p=0.02). The ROC curve of the regression model intended to confirm or rule out the structural diagnosis of COVID-19 pneumonia showed an AUC of 0.77 (standard error=0.072, p=0.003). CONCLUSIONS: In those patients referred for standard oncologic and non-oncologic indications (43/559; 7.7%) during pandemic, imaging with 18F-FDG PET/CT is a useful tool during incidental detection of COVID-19 pneumonia. Several CT findings characteristic of COVID-19 pneumonia, specifically those included in diagnostic CO-RADS scores (5-6), were associated with higher SUVmax values.
Subject(s)
COVID-19 , Positron Emission Tomography Computed Tomography , Humans , Male , Middle Aged , Aged , Aged, 80 and over , Fluorodeoxyglucose F18 , Pandemics , Retrospective Studies , COVID-19/diagnostic imaging , Lung/diagnostic imagingABSTRACT
@#Even after two years, the COVID-19 pandemic still disrupts public activities and services as it exposes vulnerabilities among the population and negatively impacts environmental conditions. The crisis also impeded global progress toward achieving Sustainable Development Goals (SDG). The Fourth Environmental and Occupational Health (EOH) Forum held virtually on November 25 to 26, 2021 provided a venue for learning about local and international COVID-19 responses to help prepare for the next global crisis. Through the systems thinking approach, the discussions prioritized analyses of leadership and governance, financing, human resource, technologies, information management, and service delivery. These analyses focused on community and/or workplace programs and services linked to air quality, waste management, psychosocial wellness, and COVID-19 vaccination. The forum amplified calls for climate actions and public health improvement and emphasized the significance of a collaborative, evidence-based, integrated public health response to a crisis underscoring the apparent interdependence of the SDGs.
Subject(s)
Environmental Health , Occupational Health , Sustainable Development , COVID-19 , Air PollutionABSTRACT
We present the complete genome sequences of 5 species of Sardinella. Illumina sequencing was performed on genetic material from wild-caught specimens. The reads were assembled using a de novo method followed by a finishing step. The raw and assembled data are publicly available via Genbank.
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SARS-CoV-2 infection has had a major impact on donation and transplantation. Since the cessation of activity two years ago, the international medical community has rapidly generated evidence capable of sustaining and increasing this neccesary activity. This paper analyses the epidemiology and burden of COVID-19 in donation and transplantation, the pathogenesis of the infection and its relationship with graft-mediated transmission, the impact of vaccination on donation and transplantation, the evolution of donation in Spain throughout the pandemic, some lessons learned in SARS-CoV-2 infected donor recipients with positive PCR and the applicability of the main therapeutic tools recently approved for treatment among transplant recipients.
Subject(s)
COVID-19 , Organ Transplantation , Humans , SARS-CoV-2 , Pandemics , Tissue DonorsABSTRACT
BACKGROUND: Acetaminophen (APAP) use has been associated with blunted vaccine immune responses. This study aimed to assess APAP impact on immunotherapy efficacy in patients with cancer. PATIENTS AND METHODS: Exposure to APAP was assessed by plasma analysis and was correlated with clinical outcome in three independent cohorts of patients with advanced cancer who were treated with immune checkpoint blockers (ICBs). The immunomodulatory effects of APAP were evaluated on a preclinical tumor model and on human peripheral blood mononuclear cells (PBMCs) from healthy donors. RESULTS: Detectable plasma APAP levels at treatment onset were associated with a significantly worse clinical outcome in ICB-treated cancer patients, independently of other prognostic factors. APAP significantly reduced ICB efficacy in the preclinical MC38 model, as well as the production of PD-1 blockade-related interferon-γ secretion by human PBMCs. Moreover, reduction of ICB efficacy in vivo was associated with significantly increased tumor infiltration by regulatory T cells (Tregs). Administration of APAP over 24 h induced a significant expansion of peripheral Tregs in healthy individuals. In addition, interleukin-10, a crucial mediator of Treg-induced immune suppression, was significantly up-regulated upon treatment with ICB in cancer patients taking APAP. CONCLUSIONS: This study provides strong preclinical and clinical evidence of the role of APAP as a potential suppressor of antitumor immunity. Hence, APAP should be used with caution in patients treated with ICB.
Subject(s)
Acetaminophen , Neoplasms , Acetaminophen/pharmacology , Humans , Immunologic Factors/therapeutic use , Immunotherapy , Leukocytes, Mononuclear , Neoplasms/drug therapy , T-Lymphocytes, Regulatory/pathologyABSTRACT
Immune checkpoint inhibitors (ICIs) show limited clinical activity in patients with advanced soft-tissue sarcomas (STSs). Retrospective analysis suggests that intratumoral tertiary lymphoid structures (TLSs) are associated with improved outcome in these patients. PEMBROSARC is a multicohort phase 2 study of pembrolizumab combined with low-dose cyclophosphamide in patients with advanced STS (NCT02406781). The primary endpoint was the 6-month non-progression rate (NPR). Secondary endpoints included objective response rate (ORR), progression-free survival (PFS), overall survival (OS) and safety. The 6-month NPR and ORRs for cohorts in this trial enrolling all comers were previously reported; here, we report the results of a cohort enrolling patients selected based on the presence of TLSs (n = 30). The 6-month NPR was 40% (95% confidence interval (CI), 22.7-59.4), so the primary endpoint was met. The ORR was 30% (95% CI, 14.7-49.4). In comparison, the 6-month NPR and ORR were 4.9% (95% CI, 0.6-16.5) and 2.4% (95% CI, 0.1-12.9), respectively, in the all-comer cohorts. The most frequent toxicities were grade 1 or 2 fatigue, nausea, dysthyroidism, diarrhea and anemia. Exploratory analyses revealed that the abundance of intratumoral plasma cells (PCs) was significantly associated with improved outcome. These results suggest that TLS presence in advanced STS is a potential predictive biomarker to improve patients' selection for pembrolizumab treatment.
Subject(s)
Sarcoma , Soft Tissue Neoplasms , Tertiary Lymphoid Structures , Antibodies, Monoclonal, Humanized , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Humans , Retrospective Studies , Sarcoma/drug therapy , Sarcoma/etiology , Soft Tissue Neoplasms/drug therapy , Soft Tissue Neoplasms/etiology , Tertiary Lymphoid Structures/etiologyABSTRACT
@#This study aimed to share the authors’ preliminary experience with endoscopic nipple-sparing mastectomy in the Philippines. All medical records of patients who underwent endoscopic mastectomy done by the same surgeons in two institutions from March to October 2019 were collected and analyzed. Surgical margin, operating time, blood loss volume, and post-operative complications were noted. Three cases were recorded during the study period. The mean operative time was 341 minutes and the mean blood loss volume was < 20 mL. All cases had negative margins of resection on final histopathology. One patient developed ecchymosis on the axilla, while the other patients had unremarkable post-operative courses. Endoscopic nipplesparing mastectomy is a potentially safe and feasible alternative in breast cancer management. Further evaluation of the procedure is recommended.
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Environment fluctuations can influence a plant's phytochemical profile via phenotypic plasticity. This adaptive response ensures a plant's survival under fluctuating growth conditions. However, the resulting plant extract composition becomes unpredictable, which is a problem for highly standardized medicinal applications. Here we demonstrate, for the first time, the feasibility of tracking the changes in the phytochemical profile based on real-time measurements of a few environment and extract-preparation variables. As a result, we predicted the chromatograms of Blumea balsamifera extracts through an imputation-augmented convolutional neural network, which uses the image-transformed temporal measurements of the variables. We developed a sensor network that collected data in a greenhouse and a training algorithm that concurrently generated a data representation of the implicit plant-environment interactions leading to the mutable chromatograms of leaf extracts. We anticipate the generic applicability of the method for any plant and recognize its potential for addressing the standardization problems in plant therapeutics.
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BACKGROUND: The outbreak of COVID-19 has become pandemic. Pediatric population has been less studied than adult population and prompt diagnosis is challenging due to asymptomatic or mild episodes. Radiology is an important complement to clinical and epidemiological features. OBJECTIVE: To establish the most common CXR patterns in children with COVID-19, evaluate interobserver correlation and to discuss the role of imaging techniques in the management of children. MATERIALS AND METHODS: Forty-four patients between 0 and 16 years of age with confirmed SARS-Cov-2 infection and CXR were selected. Two paediatric radiologists independently evaluated the images and assessed the type of abnormality, distribution and evolution when available. RESULTS: Median age was 79.8 months (ranging from 2 weeks to 16 years of age). Fever was the most common symptom (43.5 %). 90 % of CXR showed abnormalities. Peribronchial cuffing was the most common finding (86.3 %) followed by GGOs (50 %). In both cases central distribution was more common than peripheral. Consolidations accounted for 18.1 %. Normal CXR, pleural effusion, and altered cardiomediastinal contour were the least common. CONCLUSION: The vast majority of CXR showed abnormalities in children with COVID-19. However, findings are nonspecific. Interobserver correlation was good in describing consolidations, normal x-rays and GGOs. Imaging techniques have a role in the management of children with known or suspected COVID-19, especially in those with moderate or severe symptoms or with underlying risk factors.
Subject(s)
Betacoronavirus , Coronavirus Infections/diagnostic imaging , Pneumonia, Viral/diagnostic imaging , Thorax/diagnostic imaging , Adolescent , COVID-19 , Child , Child, Preschool , Coronavirus Infections/complications , Female , Fever/etiology , Humans , Infant , Infant, Newborn , Male , Pandemics , Pneumonia, Viral/complications , Risk Factors , SARS-CoV-2 , X-RaysSubject(s)
Anti-Bacterial Agents/therapeutic use , Drug Resistance, Multiple, Bacterial , Emergency Service, Hospital/statistics & numerical data , Inappropriate Prescribing/statistics & numerical data , Aged , Female , Gram-Negative Bacteria/drug effects , Gram-Positive Bacteria/drug effects , Humans , Logistic Models , Male , RegistriesABSTRACT
Key Findings@# Current evidence does NOT support use of IgM/IgG rapid test kits for the definitive diagnosis of COVID-19 in currently symptomatic patients. • The present standard for diagnosis of COVID-19 is through qualitative detection of COVID-19 virus nucleic acid via reverse transcription polymerase chain reaction (RT-PCR). • Due to long turnaround times and complicated logistical operations, a rapid and simple field test alternative is needed to diagnose and screen patients. • An alternative to the direct detection and measurement of viral load (RT-PCR) is the qualitative detection of specific antibodies to COVID-19. ELISA (discussed in a separate rapid review) and lateral flow immunoassay (LFIA) IgM/IgG rapid test kits are two currently available, qualitative, antibody tests for COVID-19. • Two low quality clinical trials showed that there is insufficient evidence to support the use of IgM/IgG rapid test kits for the definitive diagnosis of COVID-19. Diagnostic accuracy varies greatly depending on the timing of the test. The test performed very poorly during the early phase of the disease (i.e., less than eight days from onset of symptoms). • Existing guidelines do not recommend serologic antibody tests for the diagnosis of COVID-19 in currently symptomatic patients.