Pharmacotherapy in Coronavirus Disease 2019 and Risk of Secondary Infections: A Single-Center Case Series and Narrative Review

OBJECTIVES: Since the onset of the coronavirus disease 2019 pandemic, immune modulators have been considered front-line candidates for the management of patients presenting with clinical symptoms secondary to severe acute respiratory syndrome coronavirus 2 infection. Although heavy emphasis has been placed on early clinical efficacy, we sought to evaluate the impact of pharmacologic approach to coronavirus disease 2019 within the ICU on secondary infections and clinical outcomes. DATA SOURCES: PubMed (inception to March 2021) database search and manual selection of bibliographies from selected articles. STUDY SELECTION AND DATA EXTRACTION: Articles relevant to coronavirus disease 2019, management of severe acute respiratory syndrome coronavirus 2-associated respiratory failure, and prevalence of secondary infections with pharmacotherapies were selected. The MeSH terms COVID-19, secondary infection, SARS-CoV-2, tocilizumab, and corticosteroids were used for article identification. Articles were narratively synthesized for this review. DATA SYNTHESIS: Current data surrounding the use of tocilizumab and/or corticosteroids for coronavirus disease 2019 management are limited given the short follow-up period and conflicting results between studies. Further complicating the understanding of immune modulator role is the lack of definitive understanding of clinical impact of the immune response in coronavirus disease 2019. CONCLUSIONS: Based on the current available literature, we suggest prolonged trials and follow-up intervals for those patients managed with immune modulating agents for the management of coronavirus disease 2019

A Predictive Model For Use Of An Assistive Robotic Manipulator: Human Factors Versus Performance In Pick-And-Place/Retrieval Tasks

The goal of this study was to model the important individual differences to predict a user\u27s performance when operating an assistive robotic manipulator for a general population. Prior research done led to the identification of ten potential human factors to be observed including dexterity (gross and fine), spatial abilities (orientation and visualization), visual acuity in each eye, visual perception, depth perception, reaction time, and working memory. Eighty-nine individuals completed a test battery of potential human factors and, then, completed several tasks using a robotic manipulator designed to simulate find-and-fetch/pick-and-place tasks. During interaction with the robot, time on task, number of moves, and number of moves per minute were recorded. We successfully developed statistical models predicting performance that revealed several important human factors. Speed of information processing, spatial ability, dexterity, and working memory were all seen to be significant predictors of task performance. For time on task, linear and polynomial models showed roughly similar predictive performance on unseen test data achieving root-mean-square percentage error of about 7.3%; for number of moves per minute, a polynomial model was best with 9.1% error; and for number of moves, a linear model was best with 12.8% error

Global lung initiative spirometry references in healthy 3-15-year-old french children

International audienceGlobal Lung Initiative spirometry references satisfactorily fit data of healthy 3- to 15-year-old French childre

Large sporadic thyroid medullary carcinomas: predictive factors for lymph node involvement

International audienceLymph node involvement (LNI) is one of the most important prognostic factors for poor survival in medullary thyroid carcinoma (MTC). At diagnosis, LNI is found in over 50% of sporadic MTCs, and especially in large tumours. Cervical lymph node dissection is therefore mandatory during MTC surgery. However, some large tumours (responsible for high preoperative basal calcitonin levels) are found to lack LNI, and can be cured definitely. Preoperative detection of these particular tumours might spare patients from undergoing extensive cervical dissection. The objective of the present retrospective study of a series of large sporadic MTCs was to identify clinical, biological and pathological factors that were predictive of LNI. Consecutive cases of large, sporadic MTCs (measuring at least 1 cm in diameter) were retrieved and reviewed. The levels of several mature microRNAs (miRs) in paraffin-embedded samples were assessed using qPCR. Of the 54 MTCs, 26 had LNI and 28 were pN0. Relative to pN0 patients, patients with LNI had a significant higher preoperative basal calcitonin level (p = 0.0074) and a greater prevalence of infiltrative margins (p < 0.0001), lymphovascular invasion (p = 0.0004), extrathyroidal extension (p < 0.0001), a higher pT stage (p = 0.0003) and more abundant desmoplastic stroma (p = 0.0006). Tumour expression levels of miR-21 (p = 0.0008) and miR-183 (p = 0.0096) were higher in the LNI group. The abundance of desmoplastic stroma (p = 0.007) and the miR-21 expression level (p = 0.0026) were independent prognostic factors for LNI. The abundance of desmoplastic stroma and high levels of miR-21 expression were strong indicators of LNI, and may thus help the surgeon to choose the extent of cervical lymph node dissection for large, sporadic MTCs with no preoperatively obvious LNI

sj-docx-1-hpx-10.1177_00185787231222549 – Supplemental material for Impact of a Pharmacist-Driven Medication Diluent Volume Optimization Protocol on Fluid Balance and Outcomes in Critically Ill Patients

Supplemental material, sj-docx-1-hpx-10.1177_00185787231222549 for Impact of a Pharmacist-Driven Medication Diluent Volume Optimization Protocol on Fluid Balance and Outcomes in Critically Ill Patients by Michael L. Behal, Breanne M. Mefford, Chris Donaldson, Melanie E. Laine, Emily G. Cox, Kathryn M. Ruf, Aric D. Schadler, Kat M. Spezzano and Brittany D. Bissell in Hospital Pharmacy</p