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Medical News & Perspectives November 3, 2021 Trials Test Mushrooms and Herbs as Anti–COVID-19 Agents Anita Slomski JAMA. Published online November 3, 2021. doi:10.1001/jama.2021.19388 In the COVID-19 pandemic’s early days, integrative medicine specialists Gordon Saxe, MD, PhD, MPH, and Andrew Shubov, MD, watched in frustration as desperate patients infected with the novel coronavirus tried one ineffective remedy after another. “People were t...
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Human Connection in the Time of COVID-19 Human connection has suffered quite significantly during the COVID-19 pandemic. While physical distancing is necessary for our wellbeing, restricting family presence in the ICU has been challenging. There is recent data that show the negative consequences of these policies and restrictions. Moral distress has been reported due to restrictive family visitation policies. It is also believed that patients may be spending mor...
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Ventilator-Associated Pneumonia in COVID-19 Patients The coronavirus has a high incidence of patients with severe acute respiratory syndrome (SARS). Many patients infected with COVID-19 need to be admitted to the ICU for invasive ventilation. They are also at a high risk of developing secondary, ventilator-associated pneumonia (VAP). This is because of breach of natural defences by invasive devices, impairment of coughing and mucociliary clearance, sedation and the imm...
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Precision Therapies for Heterogeneous ARDS Patients ARDS is a heterogeneous syndrome rather than a distinct disease. It is this heterogeneity that often makes it difficult to study treatments for patients with ARDS. Literature on ARDS is rife with clinical trials that do not show any mortality benefit. Recent evidence suggests different sub-phenotypes within the heterogeneous patient population. These sub-phenotypes have variable clinical responses to specific t...
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Editorial October 11, 2021 Antithrombotic Therapy for Outpatients With COVID-19: Implications for Clinical Practice and Future Research Otavio Berwanger JAMA. 2021;326(17):1685-1686. doi:10.1001/jama.2021.17460 COVID-19, the infectious disease caused by the SARS-CoV-2 virus, has been associated with an inflammatory and hypercoagulable state characterized by increases in levels of D-dimers, fibrin, fibrin degradation products, and fibrinogen.1 Observa...
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Safety of Enhanced Thromboprophylaxis Strategies for COVID-19 Patients COVID-19 is associated with a high incidence of thrombotic complications. The burden of thrombin complications, in particular, pulmonary embolism, remains high in patients with COVID-19, especially those requiring admission to the ICU. Data suggest an incidence of thromboembolic events between 27 to 57% in COVID-19 patients despite standard thromboprophylaxis. A review of studies including 1765 ...
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The Evolution of Cerebrovascular Critical Care The Society of Critical Care Medicine (SCCM) was founded in 1970. At that time, there was little to offer for the acute management of patients suffering from an acute cerebrovascular condition other than supportive care. Patients suffering from stroke were rarely found in the intensive care unit. During the 1960s, 25% of stroke patients would die within 24 hours. Approximately 50% would die within 2 to 3 weeks. Even...
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Editorial September 3, 2021 Safety Surveillance of COVID-19 mRNA Vaccines Through the Vaccine Safety Datalink Kimberly G. Blumenthal, Neelam A. Phadke, David W. Bates JAMA. 2021;326(14):1375-1377. doi:10.1001/jama.2021.14808 Vaccines represent one of the greatest public health achievements of modern medicine. They must pass rigorous and predetermined efficacy and safety metrics prior to licensure. Additionally, postmarketing safety surveillance is essenti...
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ICU Management & Practice, Volume 19 - Issue 4, Winter 2019/2020 Future ICU Design: Return to High Visibility Future ICU designs must feature high visibility to ensure safety. The ability for critical care nurses, physician intensivists, and other caregivers to visualise their patients has always been a high priority as it plays a major role in patient and staff safety. Architects and designers have responded with configurations for intensive care units ...
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Early vs Late Tracheostomy and Ventilator-Associated Pneumonia Surgically opening the windpipe, or trachea, within the first seven days of the start of mechanical ventilation decreases the time patients spend on ventilators, shortens their ICU stay and lowers their risk of ventilator-associated pneumonia, according to a new systematic review. "We analysed the existing medical literature to unravel a question that is very pertinent to adult critical care," said s...
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