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41. Caffeine citrate (Gencebok) - for treating apnoea of prematurity

) An overview of Gencebok and why it is authorised in the EU What is Gencebok and what is it used for? Gencebok is a stimulant medicine used for treating apnoea of prematurity, a condition in which babies born prematurely stop breathing for longer than 20 seconds. Gencebok contains the active substance caffeine citrate. Gencebok is a ‘hybrid’ medicine. This means that it is similar to a ‘reference medicine’ containing the same active substance, but at a different strength. The reference medicine (...) minutes, using a device to closely control the rate at which the medicine is given. To continue treatment, Gencebok is given in lower doses (5 mg caffeine citrate per kilogram of bodyweight) every 24 hours. These lower doses can be given either by infusion over 10 minutes or by mouth (e.g. through a tube into the stomach). Treatment usually continues until the baby can breathe well enough for at least 5 days. For more information about using Gencebok, see the package leaflet or contact your doctor

2020 European Medicines Agency - EPARs

42. Bevacizumab (Aybintio) - various cancers

it is authorised in the EU What is Aybintio and what is it used for? Aybintio is a cancer medicine that is used to treat adults with the following cancers: • cancer of the colon (large bowel) or the rectum, when it has spread to other parts of the body; • breast cancer that has spread to other parts of the body; • a type of lung cancer called non-small cell lung cancer when it is advanced or has spread or come back, and cannot be treated with surgery. Aybintio can be used in non-small cell lung cancer unless (...) to that in Avastin in terms of structure, purity and biological activity. Studies have also shown that giving Aybintio produces similar levels of the active substance in the body to giving Avastin. In addition, a study involving 763 patients with advanced non-small cell lung cancer showed that Aybintio was as effective as Avastin when given with the cancer medicines paclitaxel and carboplatin. The cancer responded to treatment in 50% of those given Aybintio and 45% of those given Avastin, which was considered

2020 European Medicines Agency - EPARs

43. Efficacy and safety of early prone positioning combined with HFNC or NIV in moderate to severe ARDS: a multi-center prospective cohort study.

Worksheet which they were randomized? N/A 4. Were patients in the treatment and control groups similar with respect to known prognostic factors? Patients in the study were similar though with varying disease severity from moderate to severe ARDS, 50% of patients being moderate and 50% severe. Patients were similar in age range and with the majority of ARDS caused by viral respiratory illnesses. Men were over- represented (13/20) at 65%. C. Did experimental and control groups retain a similar prognosis (...) say severe respiratory disease would be similar between our populations. Though these patients were not Covid-19 ARDS patients, they did have viral/bacterial respiratory infections leading to ARDS which I assume shares some overlap. The study shows increased efficacy of adding PP to moderate-severe ARDS patients which would be reasonable to attempt in the emergency department to avoid intubation. 1. Were all clinically important outcomes considered? They considered important short-term outcomes

2020 Emergency Medicine Journal Club

44. Did This Patient Have Cardiac Syncope?: The Rational Clinical Examination Systematic Review

be considered prior to admitting for further cardiac workup and/or ordering biomarkers. Patients with highly specific findings such as structural heart disease, dyspnea, chest pain, cyanosis and seizure warrant further assessment.

2020 Emergency Medicine Journal Club

45. Guidance for influenza vaccine delivery in the presence of COVID-19

tool to be used the day of immunization screening clients by telephone on arrival before they enter the building for example, while still in their car screening arrivals in person, preferably before entering the building Signage at the door should advise visitors not to enter if they are ill, to put on their (depending on jurisdictional advice), use the hand sanitizer provided on entry, practice respiratory etiquette, and maintain physical distancing. If required, masks should be available (...) . This recommendation may be waived for young children for whom mask use is problematic. In addition, non-medical masks or face coverings should not be placed on children under the age of two years, anyone who has trouble breathing, or is unable to remove the mask without assistance. Clinic set up and immunization process Priority clinic modifications for COVID-19 have already been identified in this document (screening for illness, physical distancing, and IPC measures). The following are additional suggestions

2020 Public Health Agency of Canada

48. Systematic review with meta-analysis of the accuracy of diagnostic tests for COVID-19 Full Text available with Trip Pro

. 2020;30:313–324. - Adhikari SP, Meng S, Wu YJ. Epidemiology, causes, clinical manifestation and diagnosis, prevention and control of coronavirus disease (COVID-19) during the early outbreak period: a scoping review. Infect Dis Poverty. 2020;9:29. - - Zhu N, Zhang D, Wang W. A novel coronavirus from patients with pneumonia in China, 2019. N Engl J Med. 2020;382:727–733. - - Ye Z, Zhang Y, Wang Y, Huang Z, Song B. Chest CT manifestations of new coronavirus disease 2019 (COVID-19): a pictorial review

2020 EvidenceUpdates

49. Risk of severe COVID-19 disease with ACE inhibitors and angiotensin receptor blockers: cohort study including 8.3 million people Full Text available with Trip Pro

Excellence, John Radcliffe Hospital, University of Oxford, Oxford, UK. 6 Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK. 7 Clinical Trials Unit, ICNARC, London, UK. 8 Intensive Care National Audit and Research Centre ICNARC, London, UK. 9 Respiratory Medicine Unit and Oxford Respiratory NIHR BRC Nuffield Department of MedicineNDM Research BuildingOld Road CampusUniversity of Oxford, Oxford, UK. 10 Nuffield Department of Clinical Neurosciences, Oxford NIHR BRC (...) , London, UK. 8 Intensive Care National Audit and Research Centre ICNARC, London, UK. 9 Respiratory Medicine Unit and Oxford Respiratory NIHR BRC Nuffield Department of MedicineNDM Research BuildingOld Road CampusUniversity of Oxford, Oxford, UK. 10 Nuffield Department of Clinical Neurosciences, Oxford NIHR BRC, University of Oxford, Oxford, UK. PMID: 32737124 DOI: Item in Clipboard Full-text links Cite Abstract Background: There is uncertainty about the associations of angiotensive enzyme (ACE

2020 EvidenceUpdates

50. Alternative Pricing Models for Remdesivir and Other Potential Treatments for COVID-19

standard of care alone for hospitalized patients with COVID-19 and lung involvement. Methods We first highlight the major updates made to the structure and inputs of the model compared to the initial version that was the basis for the results released on May 1, 2020 (see full listing of model updates in the Appendix): • Newly available peer-reviewed data from the Adaptive COVID-19 Treatment Trial (ACTT-1) were used, including an adjusted hazard ratio for mortality and an adjusted rate ratio for time (...) : short-term decision tree (models duration in highest hospital level of care and probability of death from highest hospital level of care) with long-term Markov model (health states of alive and dead with average age-based costs and consequences) • Population: hospitalized patients with COVID-19 and lung involvement • Discount rate of 3% for costs and outcomes CEA Model Assumptions: • For all those who recover in either the standard of care or remdesivir treatment arm, we assigned age- and gender

2020 California Technology Assessment Forum

51. Standards for Neurologic Critical Care Units

ultrasonography R R O Procedure lamp (if adequate in room lighting not available) R R R Suction machine (in addition to bedside) R R R Thermometers R R R Transport monitor R R R Vascular access equipment R R R Respiratory support equipment: Air compressor R R R Air- oxygen blenders R R R Bag- valve-mask resuscitation devices R R R Chest physiotherapy and suctioning R R R Continuous oxygen analyzers with alarms R R R Mechanical ventilators R R R MRI compatible ventilator R R O Non-invasive mechanical (...) Standards Level I Level II Level III Recognize, interpret, record physiologic parameters R R R Respiratory care techniques (including mechanical ventilation) R R R Resuscitation, including ENLS certification or equiv. R R R Wound care of cranial and spinal post- operative patients R R R Pharmacist Pharmacist dedicated to NCC unit/team R O O Pharmacist with expertise in neurocritical care R R O Pharmacist with residency training or equivalent in high-acuity area R O O Doctorate degree in pharmacy R R R

2020 Neurocritical Care Society

52. Covid-19: Follow Prescrire's independent, evidence-based analysis of the pandemic

 |  Spotlight Covid-19 : Follow Prescrire's independent, evidence-based analysis of the pandemic COVID-19 Prescrire's editors are publishing an ongoing series of news updates featuring independent analysis of developments related to the covid-19 pandemic. Useful and practical information, to help healthcare professionals gain a clear and balanced view. "Covid-19 and severe breathing problems: dexamethasone reduced mortality in one trial" (24 June 2020) "Lack of access to drug evaluation data

2020 Prescrire

53. Follow up of patients with a clinico-radiological diagnosis of COVID-19 pneumonia

1. Hui DS, Joynt GM, Wong KT, et al. Impact of severe acute respiratory syndrome (SARS) on pulmonary function, functional capacity and quality of life in a cohort of survivors. Thorax. 2005;60(5):401-409. 2. Das KM, Lee EY, Singh R, et al. Follow-up chest radiographic findings in patients with MERS-CoV after recovery. Indian J Radiol Imaging. 2017;27(3):342-349. 3. Antonio GE, Wong KT, Hui DS, et al. Thin-section CT in patients with severe acute respiratory syndrome following hospital discharge (...) . An Official Clinical Practice Guideline of the American Thoracic Society and Infectious Diseases Society of America. Am J Respir Crit Care Med. 2019;200(7):e45-e67. Cared for in ICU 1 or HDU 2 or ward care with severe pneumonia* Respiratory follow up of patients with COVID-19 pneumonia Chest X-Ray + Face to face clinical assessment Consider full pulmonary function tests If diagnosed with PE 3 combine with post-PE 3 follow up Consider walk test with assessment of oxygen saturation Assess need for Post

2020 British Thoracic Society

54. COVID-19 Clinical Guidance Summary for Adult Patients with Rheumatic Diseases

, as part of a shared decision-making process, IL-6 inhibitors may be continued (M). Rheumatic disease treatment in the context of documented or presumptive COVID-19 infection: • Regardless of COVID-19 severity, anti-malarial therapies (HCQ/CQ) may be continued, but SSZ, MTX, LEF, immunosuppressants, non-IL-6 biologics, and JAK inhibitors should be stopped or held (M/H). • For patients with severe respiratory symptoms, NSAIDS should be stopped (M). The panel demonstrated low consensus with regards

2020 American College of Rheumatology

55. Suspected cancer: recognition and referral

with unexplained haemoptysis. [2015] [2015] 1.1.2 Offer an urgent chest X-ray (to be performed within 2 weeks) to assess for lung cancer in people aged 40 and over if they have 2 or more of the following unexplained symptoms, or or if they have ever smoked and have 1 or more of the following unexplained symptoms: • cough • fatigue • shortness of breathchest pain • weight loss • appetite loss. [2015] [2015] Suspected cancer: recognition and referral (NG12) © NICE 2020. All rights reserved. Subject to Notice (...) on the diagnostic process). Consider a review for people with any symptom associated with increased cancer risk who do not meet the criteria for referral or investigative action (see the recommendations on safety netting). 1.1 1.1 Lung and pleural cancers Lung and pleural cancers Lung cancer Lung cancer 1.1.1 Refer people using a suspected cancer pathway referral (for an appointment within 2 weeks) for lung cancer if they: • have chest X-ray findings that suggest lung cancer or or • are aged 40 and over

2020 National Institute for Health and Clinical Excellence - Clinical Guidelines

56. Implementing phase 3 of the NHS response to the COVID-19 pandemic

, orthopaedics, plastic surgery and rheumatology • pain management • palliative medicine • physiotherapy • plastic surgery • rehabilitation • renal medicine • respiratory medicine • rheumatology • thoracic medicine • urology • vascular surgery Implementing patient initiated follow-ups Example high-level plan for implementing PIFU Classification: Official 23 | Implementing Phase 3 of the NHS response to the COVID-19 pandemic Example implementation checklist adapted from work by Somerset CCG. Strong clinical (...) been exacerbated during the COVID-19 pandemic. Priority groups for programmes such as obesity prevention, smoking cessation, and alcohol misuse, cardiovascular, hypertension, diabetes and respiratory disease prevention and long-term condition management should be engaged proactively, recognising the extra barriers to engagement which COVID-19 has brought, reflecting the wider strategy for restoring primary care services. For example, local areas should focus on generating referrals into the NHS

2020 NHS England

57. National Patient Safety Alert – Foreign body aspiration during intubation, advanced airway management or ventilation

recognised due to sedation and anaesthesia and may be postoperatively misdiagnosed as asthma, chronic obstructive pulmonary disease (COPD), or stridor. 2 An example incident reads: “patient presented in ED following repeated GP attendance, 4 months post anaesthesia with worsening respiratory symptoms. Symptoms resolved after removal of ECG backing plastic [from the respiratory tract] .” In a recent six-year period, five incidents were identified where a foreign body (FB) was aspirated, and a further four (...) incidents where the FB was identified during intubation and removed. The most common types of FB identified in incident reports were transparent backing plastic from electrocardiogram (ECG) electrodes and plastic caps of unclear origin. This is likely to be an under-estimate of the true number of incidents as many may go unrecognised. During our investigation we also identified that: • some breathing circuit components with untethered caps are still available to purchase • airway trays for routine

2020 NHS England

59. Rehabilitation for adults with complex psychosis

with their psychosis • coexisting mental health conditions (including substance misuse) • pre-existing neurodevelopmental disorders, such as autism spectrum disorder or attention deficit hyperactivity disorder • physical health problems, such as diabetes, cardiovascular disease or pulmonary conditions. T ogether, these complex problems severely affect the person's social and everyday functioning, and mean they need a period of rehabilitation to enable their recovery and ensure they achieve their optimum level (...) impairments (including acquired brain disorders) • depression (see the NICE guideline on depression in adults) • speech, language and communication disorders. 1.7.6 Be aware that people with complex psychosis have a higher prevalence of the following physical health conditions (which may contribute to higher mortality in this population): • cardiovascular disease • chronic obstructive pulmonary disease (COPD) • dental problems and poor oral health • diabetes • metabolic syndrome • obesity Rehabilitation

2020 National Institute for Health and Clinical Excellence - Clinical Guidelines

60. Perioperative care in adults

total abdominal hysterectomy, endoscopic resection of prostate, lumbar discectomy, thyroidectomy, total joint replacement, lung operations, colonic resection and radical neck dissection. Perioperative care in adults (NG180) © NICE 2020. All rights reserved. Subject to Notice of rights (https://www.nice.org.uk/terms-and- conditions#notice-of-rights). Page 14 of 30Recommendations for research Recommendations for research The guideline committee has made the following recommendations for research. Key

2020 National Institute for Health and Clinical Excellence - Clinical Guidelines

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