Marina Galdeano Lozano, Julio Cesar Alfaro Alvarez, Nuria Parra Macias, Rosario Salas Campos, Rosa Coll Colell, Jordi Delas, Sarah Heili Frades, Francesc Lopez Segui, Josep Enric Boada Port, Josep Maria Montserrat, Antoni Rosell,Jorge Abad Capa and Olga Parra Ordaz
Introduction: During the COVID-19 pandemic, the risk of collapse of the health system generated great difficulties. UCRIs allow adequate management of patients with non-invasive respiratory support, which is evident in patients with SARS-VOC-2 pneumonia.
Methods: A prospective observational study of patients with COVID 19 admitted to an ICU of a tertiary hospital from February 25 to April 28, 2020 with a staff of 11 beds. Sociodemographic, comorbidities, pharmacological, respiratory support, laboratory and blood gas variables were collected. The overall cost of the unit was analyzed.
Results: 991 patients were admitted, 56 to the ICU (of the 81 who needed admission to the critical care unit). Mean age of 65 years (SD 12.8), Barthel index 75 (SD 8.3), Charlson 3.1 (SD 2.2), HTN 27%, COPD 89% and obesity 24%. Significant relationship (p <0.05) with higher mortality regarding: fever greater than or equal to 39ºC [OR 5.6; 95% CI (1.2-2.7); p=0.020], protocolized pharmacological treatment [OR 0.3; 95% CI (0.1-0.9); p=0.023] and the IOT [OR 3.7; 95% CI (1.1-12.3); p=0.025]. NIMV showed less negative impact [OR 1.8; 95% CI (0.4-8.4); p=0.423] than IOT. The total cost of UCRI amounted to 66,233 Eur. The cost per day of stay in UCRI was 164 Eur. The cost avoided was 214,865 Eur.
Conclusion: The pandemic has highlighted the importance of UCRI allowing the management of a high patient volume. The treatment carried out in them is effective and efficient, reducing both admissions and stays in the ICU.
Seyi Samson Enitan*
The pursuit of a safe and effective HIV vaccine holds lifesaving potential for people globally; unfortunately, a number of ongoing HIV vaccine safety and efficacy trials are being shortened paused or postponed amidst the Coronavirus Disease-19 (COVID-19) crisis. The COVID-19 outbreak that started in Wuhan, megacity of China late December, 2019, has spread to 188 countries and territories, with more than 9 million total confirmed cases and 470,061 total deaths globally as at 22 June, 2020 and still counting. Currently, no approved vaccines exist to prevent infection with the novel Coronavirus; however, the impact of the pandemic has been enormous with devastating effects on the global health and economy, with many countries introducing stringent response measures to de-escalate the spread of the virus. Recruiting and retaining volunteers for HIV vaccine trials this period has become very challenging due to a lot of factors including fear of potential exposure to the new coronavirus, ethical issues and safety concerns. The protection and safety of participants and clinic staff remain a priority for HIV vaccine investigators worldwide. They are at the moment making conscious efforts to implement measures necessary to prevent potential exposure and transmission of COVID-19 among study participants and clinic staff in various study sites. To this end, the pursuit of a safe and effective HIV vaccine must continue to follow global best practices, devoid of any form of political, religious or racial bias. The pursuit for vaccine to curb the HIV pandemic is on and should not be at the expense of ethical principles such as informed consent and medical privacy. Despite the draw backs experienced so far, it is very important that virologists and vaccine developers do not relent in their quest for safe and effective HIV vaccines. Instead, they should redouble their efforts and build on past lessons. The scientific integrity of each clinical trial must not be compromised for political or economic gains, rather the World Health Organization with other important stakeholders must continue to monitor and ameliorate the impact of COVID-19 on the conduct of the early and large-scale HIV vaccine clinical trials globally
Kazuhiko Nakayama
Pulmonary Arterial Hypertension (PAH) is a progressive disease characterized by increased pulmonary arterial pressure and pulmonary vascular resistance that can lead to right heart failure. Connective Tissue Disease-Associated PAH (CTD-PAH) often has a worse outcome than idiopathic or Hereditary PAH (I/HPAH), suggesting the presence of non-PAH factors that may affect the prognosis of CTD-PAH patients. This study aimed to identify prognostic factors for CTD-PAH.
Yin Li, Ting-Yun Yuan, Jia-Wu Yang, Hai-Feng Liu, Pei-Long Li, Feng Li and Hong-Min Fu
Background: Necrotizing pneumonia is an uncommon, but serious complication of pneumonia in children. The indications and timing of surgical procedures are not outlined and are controversial. Case report: In this report, we presented two pediatric cases, which be diagnosed with necrotizing pneumonia and have recognized indications for aggressive surgical operation. Nevertheless, the two patients were not treated with surgery due to their parents' concerns about complications of thoracotomy and damage to lung function and still achieved complete recovery in manifestations and radiology by conservative modalities including a lengthy course of antibiotics, bronchoscopy lavaging, thoracocentesis, and symptomatic treatment. Conclusion: Necrotizing pneumonia can be successfully treated with a conservative treatment regimen even in patients with a recognized indication for surgery.
Pulmonary & Respiratory Medicine received 1347 citations as per Google Scholar report
