Risultati per: Trattamento domiciliare di un paziente positivo al virus SARS-Cov-2
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Sa1636 NON-INVASIVE TESTING IN CHRONIC HEPATITIS D VIRUS (HDV) INFECTION: WHAT WORKS BEST TO RULE OUT CIRRHOSIS?
Sa1623 HEPATITIS B VIRUS SCREENING RATE IN CANCER PATIENTS BEFORE RECEIVING CHEMOTHERAPY – A SYSTEMATIC REVIEW AND METAANALYSIS
Sa1611 HEPATITIS B VIRUS REACTIVATION IN CANCER PATIENTS RECEIVING CHEMOTHERAPY – A SYSTEMATIC REVIEW AND META-ANALYSIS
Sa1650 REACTIVATION OF HEPATITIS B VIRUS ESCAPE MUTANTS IN A HBSAG NEGATIVE, ANTI-HBS POSITIVE PATIENT AFTER RITUXIMAB THERAPY
Tu1597 EXPLORING THE IMPACT OF CHRONIC LIVER DISEASE ON GASTROINTESTINAL BLEEDING IN PATIENTS WITH SARS-COV-2 INFECTION DURING INDEX HOSPITALIZATION
Diagnosi e trattamento della vescica iperattiva idiopatica: linea guida
Highly Pathogenic Avian Influenza A(H5N1) Virus Infection in a Dairy Farm Worker
New England Journal of Medicine, Ahead of Print.
Sospeso il presidente Agenas, lasciò una garza in un paziente
La presidenza del Consiglio accoglie la richiesta di Schillaci
Effect of acyclovir therapy on the outcome of mechanically ventilated patients with lower respiratory tract infection and detection of herpes simplex virus in bronchoalveolar lavage: protocol for a multicentre, randomised controlled trial (HerpMV)
Introduction
Herpes simplex virus (HSV) is frequently detected in the respiratory tract of mechanically ventilated patients and is associated with a worse outcome. The aim of this study is to determine whether antiviral therapy in HSV-positive patients improves outcome.
Methods and analysis
Prospective, multicentre, open-label, randomised, controlled trial in parallel-group design. Adult, mechanically ventilated patients with pneumonia and HSV type 1 detected in bronchoalveolar lavage (≥105 copies/mL) are eligible for participation and will be randomly allocated (1:1) to receive acyclovir (10 mg/kg body weight every 8 hours) for 10 days (or until discharge from the intensive care unit if earlier) or no intervention (control group). The primary outcome is mortality measured at day 30 after randomisation (primary endpoint) and will be analysed with Cox mixed-effects model. Secondary endpoints include ventilator-free and vasopressor-free days up to day 30. A total of 710 patients will be included in the trial.
Ethics and dissemination
The trial was approved by the responsible ethics committee and by Germany’s Federal Institute for Drugs and Medical Devices. The clinical trial application was submitted under the new Clinical Trials Regulation through CTIS (The Clinical Trials Information System). In this process, only one ethics committee, whose name is unknown to the applicant, and Germany’s Federal Institute for Drugs and Medical Devices are involved throughout the entire approval process. Results will be published in a journal indexed in MEDLINE and CTIS. With publication, de-identified, individual participant data will be made available to researchers.
Trial registration number
NCT06134492.
Swissped-RECOVERY: masked independent adjudication for the interpretation of non-randomised treatment in a two-arm open-label randomised controlled trial (methylprednisolone vs immunoglobulins) in Paediatric Inflammatory Multisystem Syndrome Temporally Associated with SARS-CoV-2 (PIMS-TS) involving 10 secondary and tertiary paediatric hospitals in Switzerland
Objectives
In trials of acute severe infections or inflammations frequent administration of non-randomised treatment (ie, intercurrent event) in response to clinical events is expected. These events may affect the interpretation of trial findings. Swissped-RECOVERY was set up as one of the first randomised controlled trials worldwide, investigating the comparative effectiveness of anti-inflammatory treatment with intravenous methylprednisolone or intravenous immunoglobulins in children and adolescents with Paediatric Inflammatory Multisystem Syndrome Temporally Associated with SARS-CoV-2 (PIMS-TS). We present one approach towards improving the interpretation of non-randomised treatment in a randomised controlled trial.
Design
This is a pre-planned ancillary analysis of the Swissped-RECOVERY trial, a randomised multicentre open-label two-arm trial.
Setting
10 Swiss paediatric hospitals (secondary and tertiary care) participated.
Participants
Paediatric patients hospitalised with PIMS-TS.
Interventions
All patient-first intercurrent events, if applicable, were presented to an independent adjudication committee consisting of four international paediatric COVID-19 experts to provide independent clinical adjudication to a set of standardised questions relating to whether additional non-randomised treatments were clinically indicated and disease classification at the time of the intercurrent event.
Results
Of 41 treatments in 75 participants (24/41 (59%) and 17/41 (41%) in the intravenous methylprednisolone and immunoglobulin arms of the trial, respectively), two-thirds were considered indicated. The most common treatment (oral glucocorticoids, 14/41, 35%) was mostly considered not indicated (11/14, 79%), although in line with local guidelines. Intercurrent events among patients with Shock-like PIMS-TS at baseline were mostly considered indicated. A significant proportion of patients with undifferentiated PIMS-TS at baseline were not attributed to the same group at the time of the intercurrent event (6/12 unchanged, 4/12 Kawasaki disease-like, 2/12 Shock-like).
Conclusion
The masked adjudication of intercurrent events contributes to the interpretation of results in open-label trials and should be incorporated in the future.
Trial registration numbers
SNCTP000004720 and NCT 04826588.
Aviaria in Usa, tracce virus nel latte pastorizzato delle mucche
Non è ancora noto se sia infettivo. Fda: “Latte è sicuro”
Estimating the incidence of COVID-19, influenza and respiratory syncytial virus infection in three regions of Queensland, Australia, winter 2022: findings from a novel longitudinal testing-based sentinel surveillance programme
Objective
The 2022 Australian winter was the first time that COVID-19, influenza and respiratory syncytial virus (RSV) were circulating in the population together, after two winters of physical distancing, quarantine and borders closed to international travellers. We developed a novel surveillance system to estimate the incidence of COVID-19, influenza and RSV in three regions of Queensland, Australia.
Design
We implemented a longitudinal testing-based sentinel surveillance programme. Participants were provided with self-collection nasal swabs to be dropped off at a safe location at their workplace each week. Swabs were tested for SARS-CoV-2 by PCR. Symptomatic participants attended COVID-19 respiratory clinics to be tested by multiplex PCR for SARS-CoV-2, influenza A and B and RSV. Rapid antigen test (RAT) results reported by participants were included in the analysis.
Setting and participants
Between 4 April 2022 and 3 October 2022, 578 adults were recruited via their workplace. Due to rolling recruitment, withdrawals and completion due to positive COVID-19 results, the maximum number enrolled in any week was 423 people.
Results
A total of 4290 tests were included. Participation rates varied across the period ranging from 25.9% to 72.1% of enrolled participants. The total positivity of COVID-19 was 3.3%, with few influenza or RSV cases detected. Widespread use of RAT may have resulted in few symptomatic participants attending respiratory clinics. The weekly positivity rate of SARS-CoV-2 detected during the programme correlated with the incidence of notified cases in the corresponding communities.
Conclusion
This testing-based surveillance programme could estimate disease trends and be a useful tool in settings where testing is less common or accessible. Difficulties with recruitment meant the study was underpowered. The frontline sentinel nature of workplaces meant participants were not representative of the general population but were high-risk groups providing early warning of disease.
Severe Acute Hepatitis of Unknown Etiology in Children: New Virus or Immune Dysregulation
Maria Pia Hospital, robot chirurgico su paziente con un rene
Prima volta per il sistema Hugo Ras a Torino