Wilkinsonabel3199
The treatment of gynecological cancers is the main activity of brachytherapy units. However, during COVID-19 pandemic, precautions should be done in order to reduce the spread of the virus while maintaining all chances to recovery for all patients (Radiother Oncol 148, 227-228, 2020). Despite the extent of the pandemic in our country, limited data are available to establish recommendations with a sufficient level of evidence (Radiother Oncol 148, 227-228, 2020). More recently, the American Brachytherapy Society published some clarifications in this regard and international expert consensus recommendations of radiation therapy for gynecologic malignancies during the COVID-19 pandemic were published (https//www.americanbrachytherapy.org/about-abs/abs-news/abs-statement-on-coronavirus/, Gynecol Oncol 15, 2020). In this commentary, we sought to share the procedures adopted for the management of gynecological cancer patients during COVID-19 pandemic in our brachytherapy unit.Sepsis is the leading cause of death in infants and children worldwide. The growing drug resistance in nosocomial gram-negative bacteria has resulted in treatment challenges. One of the most common multi-drug-resistant bacteria is Pseudomonas aeruginosa. Resistance to antibiotics used in Pseudomonas aeruginosa infections limits the therapeutic options. We present a tigecycline administration in a 5-month-old infant with patent arterial duct, heart failure, and respiratory failure due to respiratory syncytial virus bronchiolitis with subsequent respiratory distress syndrome and severe sepsis caused by multi-drug-resistant Pseudomonas aeruginosa. Despite combined antibiotic therapy with meropenem, amikacin, and colistin, inflammatory markers increased. Because of life-threatening condition, tigecycline was added to the therapy and was administered intravenously twice daily. Within 48 h, inflammatory markers started to decrease and tigecycline therapy continued for 13 days without adverse effects. Tigecycline used in combination with other antibiotics might be a valuable therapeutic approach in the management of multi-drug-resistant bacteria infections in pediatric patients when conventional antibiotics have failed. Further studies are needed to evaluate the efficacy and safety of tigecycline administration in critically ill pediatric patients.At the beginning of 2020, the national health system and medical communities are faced with unprecedented public health challenges. A novel strain of coronavirus, later identified as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has spread globally, marking another pandemic of coronaviruses. This viral disease is responsible for devastating pneumonia, named coronavirus disease of 2019 (COVID-19), and projected to persist until the end of the year. In tropical countries, however, concerns arise regarding the similarities of COVID-19 with other infectious diseases due to the same chief complaint, which is fever. One of the infectious disease of a primary concern is dengue infection, which its peak season is approaching. Others report that there are cases of serological cross-reaction of COVID-19 and dengue infection. In this comprehensive review, we underscore the importance of knowing similar clinical presentations of both diseases and emphasize why excluding COVID-19 in the differentials in the setting of a pandemic is imprudent.The novel coronavirus disease 2019 (COVID-19) is a global epidemic caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). SARS-CoV-2 has a similar structure to severe acute respiratory syndrome coronavirus-1(SARS-CoV-1). The S protein on the surface of the virus is cleaved by host proprotein convertases (PCs) to expose the active N-terminal S1 extracellular domain. Its receptors are angiotensin-converting enzyme 2 (ACE2), and the C-terminal S2 membrane anchoring protein is responsible for translocating the virus into the cell. Among patients with COVID-19, there is a higher prevalence of cardiovascular disease, and more than 7% of patients have suffered myocardial damage due to the infection, but the internal mechanism is still poorly understood. There is currently no specific and effective targeted treatment. Reduction of the patient's morbidity and mortality is an urgent problem that needs to be solved clinically. By exploring the theoretical analysis of PCs and ACE2 in COVID-19 cardiovascular susceptibility, some insights on how to prevent and alleviate adverse cardiovascular prognosis have been provided in this study.With no drugs currently approved for treatment and cure of COVID-19 (coronavirus disease 2019), hydroxychloroquine is one of the many first-line drugs used in the management. However, given the life-threatening adverse effects of HCQ that have been reported, its use as a prophylactic treatment remains debated. HCQ has long been used in India for the treatment of malaria, auto-immune and inflammatory diseases, and even type 2 diabetes mellitus recently. We aimed to review existing literature and relevant Web sites regarding the safety profile of HCQ in the Indian subcontinent. A non-systematic critical analysis of all published literature/studies focused on the Indian population, recording on the use of HCQ for various indications up till April 2020 was done and frequency of occurrence of HCQ related life-threatening and cardiac side effects were noted. Results from PubMed database showed an incidence of 0.6% of cardiac-related side effects and 7.42% of other self-limiting and minor side effects among the Indian population on HCQ. Considering its minimal risk and favorable safety profile, cost-effectiveness, availability, and affordability in India, the use of hydroxychloroquine in the fight against COVID-19 appears rationale. Following the results of our study, we hypothesize that Indians might be less likely to suffer from cardiac-related side effects given their genetic make-up. However, this would need further studies, clinical trials, and a pharmacogenomic understanding of the subject.During novel coronavirus disease (COVID-19) pandemic, major focus of health service is on mitigating the spread of infection and treating the acute severe respiratory syndrome of affected patients. However, from available initial data, it has been shown that cardiovascular and metabolic diseases are responsible for a worse clinical outcome of COVID-19 patients and, on the other hand, myocardial damage might occur as a consequence of infection. find more Therefore, we propose not to forget the heart during pandemic and to focus on cardiac care in at least three phases prevention, acute phase, and rehabilitation. We report rationale, scientific evidence, and clinical model for the proposed three-phase program.