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ALLMedicine™ Detailed topics Center - Guidelines

Super-spreading events and contribution to transmission of MERS, SARS, and SARS-CoV-2 (COVID-19)

There is no clear definition for the term ‘super-spreader’ or ‘super-spreading event’. The World Health Organization refers to a super-spreader as a patient (or an event) that may transmit infection to a larger number of individuals than is usual by one individual (or event). In the severe acute respiratory syndrome (SARS) situation, a super-spreading event was defined as the transmission of SA...

Joint GI society message: COVID-19 clinical insights for our community of gastroenterologists and gastroenterology care providers

The situation involving the COVID-19 pandemic continues to evolve. There is recent evidence suggesting the potential for coronavirus transmission through droplets and perhaps fecal shedding1,2 posing potential risks during endoscopy and colonoscopy to other patients, endoscopy personnel and ourselves. We provide below important information as well as recommendations to consider in your insti...

Pain and dyskinesia in Parkinson's disease may share common pathophysiological mechanisms – An fMRI study
Journal of Neurological Sciences;

May 26th, 2020 - Parkinson's disease (PD) patients develop levodopa induced dyskinesia with disease progression from sensitization of central pathways. Pain pathways are also impacted with suggestions dyskinetic patients may process pain differently.

Antibody Detection and Dynamic Characteristics in Patients with COVID-19

The antibodies against SARS-CoV-2 can be detected in the middle and later stage of the COVID-19. Antibody detection may play an important role in the diagnosis of COVID-19 as complement approach for viral nucleid acid assays.

Disappearance of Antibodies to SARS-Associated Coronavirus after Recovery
The New England Journal of Medicine;

Previous studies have demonstrated that IgG and neutralizing antibodies against coronavirus associated with the severe acute respiratory syndrome (SARS) may persist, in spite of a decline in titer, for 2 years in patients who have recovered from SARS.

Fraudulent Coronavirus Disease 2019 (COVID-19) Products

The U.S. Food and Drug Administration is issuing warning letters to firms for selling fraudulent products with claims to prevent, treat, mitigate, diagnose or cure coronavirus disease 2019 (COVID-19). We are actively monitoring for any firms marketing products with fraudulent COVID-19 prevention and treatment claims. The FDA is exercising its authority to protect consumers from firms selling un...

Colchicine as a possible therapeutic option in COVID-19 infection

In contrast, we consider that colchicine can be a good therapeutic option because of several effects in the immunology system involved in SARS-CoV-2 infection and in the acute respiratory distress syndrome (ARDS). Colchicine has effects on the chemotaxis of inflammatory cells such as neutrophils and monocytes and on the intracellular transportation of vesicles such as endosomes and exosomes.

The D614G mutation in the SARS-CoV-2 spike protein reduces S1 shedding and increases infectivity
https://www.scripps.edu/_files/pdfs/news-and-events/The D614G mutation in the SARS-CoV-2 spike protein reduces S1.pdf

SARS coronavirus 2 (SARS-CoV-2) isolates encoding a D614G mutation in the viral spike (S) protein predominate over time in locales where it is found, implying that this change enhances viral transmission. We therefore compared the functional properties of the S proteins with aspartic acid (SD614) and glycine (SG614) at residue 614. We observed that retroviruses pseudotyped with SG614 infect...

Mutated coronavirus shows significant boost in infectivity

A tiny genetic mutation in the SARS coronavirus 2 variant circulating throughout Europe and the United States significantly increases the virus’ ability to infect cells, lab experiments performed at Scripps Research show.

A silent epidemic
Stephanie Dutchen

Geriatrician Sharon Inouye on the need to combat delirium in COVID-19 patients

Neurologic Features in Severe SARS-CoV-2 Infection

We report the neurologic features in an observational series of 58 of 64 consecutive patients admitted to the hospital because of acute respiratory distress syndrome (ARDS) due to Covid-19. The patients received similar evaluations by intensivists in two intensive care units (ICUs) in Strasbourg, France, between March 3 and April 3, 2020.

‘They Want to Kill Me’: Many Covid Patients Have Terrifying Delirium

To a startling degree, many coronavirus patients are reporting similar experiences. Called hospital delirium, the phenomenon has previously been seen mostly in a subset of older patients, some of whom already had dementia, and in recent years, hospitals adopted measures to reduce it.

Delirium Incidence, Duration and Severity in Critically Ill Patients with COVID-19

Delirium incidence, duration and severity in patients admitted to the intensive care unit (ICU) due to COVID-19 is not known.

Association between Olfactory Deficit and Motor and Cognitive Function in Parkinson’s Disease
Journal of Movement Disorders;

We recruited 228 drug-naïve PD patients who were followed for a mean of 6 years. Patients underwent the Cross-Cultural Smell Identification Test (CCSIT), a neuropsychological test, and N-(3-[18F]fluoropropyl)-2β-carbomethoxy-3β-(4-iodophenyl) nortropane positron emission tomography within 6 months of the baseline evaluation. Olfactory dysfunction was categorized as normosmia (CCSIT score ≥ 9)...

Blood Flow and Glucose Metabolism Dissociation in the Putamen Is Predictive of Levodopa Induced Dyskinesia in Parkinson's Disease Patients
Frontiers in Neurology;

Nov 20th, 2019 - The forefront treatment of Parkinson's disease (PD) is Levodopa. When patients are treated with Levodopa cerebral blood flow is increased while cerebral metabolic rate is decreased in key subcortical regions including the putamen. This phenomenon is especially pronounced in patients with Levodopa-induced dyskinesia (LID).

Expert Perspective on ASCO20 Genitourinary Cancers Research

Jul 2nd, 2020 - The phase III HERO trial (Abstract 5602) investigated the results of relugolix, an orally bioavailable GnRH receptor antagonist, for patients with advanced prostate cancer. Treatment with relugolix resulted in superiority over leuprolide in achieving sustained testosterone suppression. Additionally, treatment was associated with faster testosterone recovery and decreased major adverse cardiovas...

Expert Perspective on ASCO20 Immunotherapy Research

Jul 1st, 2020 - CAR T-cell therapy with BCMA-targeting idecabtagene-vicleucel (ide-cel) has emerged to be a game-changer as shown by this first pivotal phase II trial of CAR T-cell therapy in multiple myeloma (MM). Ide-cel is a first-in-class BCMA-directed CAR T-cell therapy, with 4-1BB costimulatory domain and CD3Z T-cell activation domain.

Expert Perspective on ASCO20 Gastrointestinal Cancers Research

Jul 1st, 2020 - Donafenib, a deuterated derivative of sorafenib, was tested against sorafenib in the frontline setting in hepatitis B– associated hepatocellular carcinoma (HCC) in a large, multi-institutional study in China (Abstract 4506).

Expert Perspective on ASCO20 Gynecologic Oncology Research

Jul 2nd, 2020 - DESKTOP III (Abstract 6000) is a prospective, multicenter, randomized phase III study of > 400 patients with platinum-sensitive, recurrent ovarian cancer that demonstrated a clinically meaningful 7.7 month improvement in median overall survival with secondary cytoreductive surgery (53.7 months) compared with no surgery (46 months).

Immunotherapy and Beyond: Treatment Options and Potential Markers in Recurrent/Metastatic Head and Neck Squamous Cell Carcinoma

Jul 2nd, 2020 - Head and neck cancers account for approximately 4% of all cancers in the United States1 and are the eighth most common cancer affecting men in the United States.2 The diagnosis of recurrent or metastatic head and neck squamous cell carcinoma (R/M HNSCC) carries a poor prognosis, with an overall survival (OS) of approximately 1 year.

White matter hyperintensities and risk of levodopa‐induced dyskinesia in Parkinson’s disease
Annals of Clinical and Translational Neurology;

Feb 6th, 2020 - To investigate whether the burden of white matter hyperintensities (WMHs) is associated with the risk of developing levodopa‐induced dyskinesia (LID) in Parkinson’s disease (PD).

Brief recommendations on the management of adult patients with familial hypercholesterolemia during the COVID-19 pandemic

Individuals with Familial Hypercholesterolaemia (FH) are at very high risk of cardiovascular disease, which is associated with poor outcomes from coronavirus infections. COVID-19 puts strain on healthcare systems and may impair access to routine FH services. On behalf of the International Lipid Expert Panel (ILEP) and the European FH Patient Network (FH Europe), we present brief recommendations...

Familial hypercholesterolaemia and COVID‐19: triggering of increased sustained cardiovascular risk

Early data from Wuhan, China, show that patients with COVID‐19 are typically male, aged 40 to 60 years, and about one‐third have comorbidities. Moreover, of 138 COVID‐19 patients hospitalized in Wuhan and treated in an intensive care unit (ICU), 25% had cardiovascular disease and 58% hypertension; the respective figures for non‐ICU‐treated COVID‐19 patients were10% and 22% [1]. Based on these e...

Plasminogen improves lung lesions and hypoxemia in patients with COVID-19

Lungs from patients with coronavirus disease 2019 (COVID-19) have shown typical signs of acute respiratory distress syndrome (ARDS), formation of hyaline membrane mainly composed of fibrin and ‘ground-glass’ opacity. Previously, we showed plasminogen itself is a key regulator in fibrin degradation, wound healing and infection.

Can a toilet promote virus transmission? From a fluid dynamics perspective

Currently, a novel coronavirus named “SARS-CoV-2” is spreading rapidly across the world, causing a public health crisis, economic losses, and panic. Fecal–oral transmission is a common transmission route for many viruses, including SARS-CoV-2. Blocking the path of fecal–oral transmission, which occurs commonly in toilet usage, is of fundamental importance in suppressing the spread of viruses. H...

Prolonged presence of SARS-CoV-2 viral RNA in faecal samples

We present severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) real-time RT-PCR results of all respiratory and faecal samples from patients with coronavirus disease 2019 (COVID-19) at the Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, China, throughout the course of their illness and obligated quarantine period.

A retrospective cohort study of methylprednisolone therapy in severe patients with COVID-19 pneumonia

Corona Virus Disease 2019 (COVID-19) was first reported in late December 2019, in Wuhan, China. There are over 1,800,000 confirmed cases worldwide.1 The pathological process of severe COVID-19 pneumonia is an inflammation reaction characterized by the destruction of the deep airway and alveolar.2 It is currently considered that lung injury is not only associated with the direct virus-induced da...

Dexamethasone treatment for the acute respiratory distress syndrome: a multicentre, randomised controlled trial

There is no proven specific pharmacological treatment for patients with the acute respiratory distress syndrome (ARDS). The efficacy of corticosteroids in ARDS remains controversial. We aimed to assess the effects of dexamethasone in ARDS, which might change pulmonary and systemic inflammation and result in a decrease in duration of mechanical ventilation and mortality.

Heparin therapy improving hypoxia in COVID-19 patients: a case series

Elevated D-dimer is a predictor of severity and mortality in COVID-19 patients and heparin use during in-hospital stay has been associated with decreased mortality. COVID19 patient autopsies have revealed thrombi in the microvasculature, suggesting intravascular coagulation as a prominent feature of organ failure in these patients. Interestingly, in COVID19, pulmonary compliance is preserved ...

Update Alert: Epidemiology of and Risk Factors for Coronavirus Infection in Health Care Workers

This is the first monthly update alert for a living review on the epidemiology of and risk factors for coronavirus infections in health care workers (HCWs) (1). Searches were updated from 24 April 2020 to 24 May 2020, using the same search strategies as the original review, and we identified 1125 citations. Applying the same inclusion criteria, we identified 37 additional studies for this updat...

COVID-19 Risk Factors Among Health Workers: A Rapid Review

Coronavirus disease 2019 (Covid-19) poses an important occupational health risk to health workers (HWs) that has attracted global scrutiny. To date, several thousand HWs globally have been reported as infected with the severe acute respiratory syndrome coronavirus 2 virus that causes the disease. It is therefore a public health priority for policymakers to understand risk factors for this vulne...

Surgical Treatment of Levodopa-induced Dyskinesia in Parkinson's Disease

The treatment of motor manifestations of Parkinson's disease (PD) is essentially a trade-off between adequate relief of motor symptoms and prevention and control of motor complications, particularly levodopa-induced dyskinesia (LID). Progression of PD is paralleled by a progressive difficulty in achieving the balance. Functional neurosurgical procedures provide sustained relief of LID in carefu...

Cerebellar Connectivity in Parkinson's Disease With Levodopa-Induced Dyskinesia

The precise pathogenesis or neural correlates underlying levodopa‐induced dyskinesia (LID) remains poorly understood. There is growing evidence of the involvement of the cerebellum in Parkinson's disease (PD). The present study evaluated the role of motor cerebellar connectivity in determining vulnerability to LID.

Seasonality of Respiratory Viral Infections

The seasonal cycle of respiratory viral diseases has been widely recognized for thousands of years, as annual epidemics of the common cold and influenza disease hit the human population like clockwork in the winter season in temperate regions. Moreover, epidemics caused by viruses such as severe acute respiratory syndrome coronavirus (SARS-CoV) and the newly emerging SARS-CoV-2 occur during ...

Dietary health and CVD: implications for dietary policy in England
Proceedings of the Nutrition Society;

CVD is a major burden on the health system in the UK. On average, diets are not aligned with current dietary recommendations, including those for salt, saturated fat, fibre, fruit and vegetables. Obesity prevalence is high and the majority of the population is consuming more energy than required. Addressing these issues would reduce the burden of CVD and help reduce inequalities in health. Ther...

Considerations for Obesity, Vitamin D, and Physical Activity Amid the COVID‐19 Pandemic

As the biomedical community races to disentangle the unknowns associated with severe acute respiratory syndrome coronavirus 2, the virus responsible for causing coronavirus disease, the link between diminished immune function and individuals with obesity raises important questions about the possibility for greater viral pathogenicity in this population. Increased adiposity may undermine the pul...