Category: Medicine

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COVID-19 : Hydroxychloroquine Might Not Be Effective

Hydroxychloroquine (HCQ) with or without azithromycin (AZ) is not associated with a lower risk of requiring mechanical ventilation, according to a retrospective study of Veterans Affairs (VA) patients hospitalized with
COVID-19.

The study, which was posted on a preprint server April 21 and has not been peer reviewed, also showed an increased risk of death associated with
COVID-19 patients treated with HCQ alone.

“These findings highlight the importance of awaiting the results of ongoing prospective, randomized controlled studies before widespread adoption of these drugs,” write Joseph Magagnoli, MS, with Dorn Research Institute at the Columbia VA Health Care System, Columbia, South Carolina, and the Department of Clinical Pharmacy & Outcomes Sciences, University of South Carolina, and colleagues.

 

A spokesperson with University of Virginia School of Medicine, where several of coauthors practice, told Medscape Medical News the authors declined to comment for this article before peer review is completed.

The new data are not the first to suggest no benefit with HCQ among patients with COVID-19. A randomized trial showed no benefit and more side effects among 75 patients in China treated with HCQ compared with 75 who received standard of care alone, according to a preprint posted online April 14.

No Benefit in Ventilation, Death Rates

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COVID-19 : International Standardization of Use of Lung Ultrasonography in Patients

The proposal for international standardization of the use of lung ultrasonography (LUS) for patients with COVID-19 was released on March 30, 2020, by an Italian team comprising physicians currently involved in the clinical management of COVID-19 and experts in ultrasound physics and image analysis.[1]

In the setting of COVID-19, wireless transducers and tablets represent the most appropriate equipment for LUS. If such devices are unavailable, portable machines dedicated to exclusive use for patients with COVID-19 can be used, though maximum care for sterilization is necessary. In these cases, transducer and keyboard covers are suggested, and sterilization procedures are necessary.

Acquisition Protocol

Scan 14 areas (three posterior, two lateral, and two anterior on the right and left) per patient for 10 seconds along the lines indicated here. Scans must be intercostal to cover the widest surface possible with a single scan.

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COVID-19 : Guidance on Newborn Screening by AAP

The American Academy of Pediatrics (AAP) strongly supports the continued provision of health care for children during the COVID-19 pandemic unless community circumstances related to the pandemic require necessary adjustments.

Newborn and infant care should be provided consistent with  the Bright Futures Guidelines for Health Supervision of Infants, Children, and Adolescents (4th Edition) and the corresponding  Bright Futures/AAP Recommendations for Preventive Pediatric Health Care (Periodicity Schedule) whenever possible.

The AAP recommends that pediatricians continue to follow federal and state guidelines on newborn screening and the Recommended Uniform Screening Panel set by the Advisory Committee on Heritable Disorders in Newborn and Children. Pediatricians should follow their specific state guidance for procurement and follow up of results.

Newborn Bloodspot Screening 

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Managing Newborns of Mothers With COVID-19 by AAP

Owing to the increased likelihood of maternal virus aerosols and the potential need to administer newborn resuscitation to infants with COVID-19 infection, use airborne, droplet, and contact precautions when attending deliveries from women with COVID-19.

When the physical environment permits, separate newborns at birth from mothers with COVID-19. If the family chooses to have the infant in the mother’s room, they should be educated on the potential risk of COVID-19 development in the newborn.

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