Despite the emergence of high quality randomized trial data with the use of antithrombotic agents to reduce the risk of thromboembolism, end-organ failure, and possibly mortality in patients with coronavirus disease 2019 (COVID-19), questions still remain as to optimal patient selection for these strategies, the use of antithrombotics in outpatient settings and in-hospital settings (including critical care units), thromboprophylaxis in special patient populations, and the management of acute thrombosis in hospitalized COVID-19 patients. In October 2021, the International Society on Thrombosis and Haemostasis (ISTH) formed a multidisciplinary and international panel of content experts, two patient representatives, and a methodologist to develop recommendations on treatment with anticoagulants and antiplatelet agents for COVID-19 patients. The ISTH Guideline panel discussed additional topics to be well suited to a non-Grading of Recommendations Assessment, Development, and Evaluation (GRADE) for Good Practice Statements (GPS) to support good clinical care in the antithrombotic management of COVID-19 patients in various clinical settings. The GPS panel agreed on 17 GPS: 3 in the outpatient (pre-hospital) setting, 12 in the hospital setting both in non-critical care (ward) as well as intensive care unit settings, and 2 in the immediate post-hospital discharge setting based on limited evidence or expert opinion that supports net clinical benefit in enacting the statements provided. The antithrombotic therapies discussed in these GPS should be available in low- and middle-income countries.
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http://dx.doi.org/10.1111/jth.15809 | DOI Listing |
Int J Integr Care
December 2024
Changi General Hospital, Singhealth, Singapore.
This study documents the experience of implementing an adaptation of the Hospital-at-Home (HaH) model to alleviate the constraints in available hospital beds and manpower amid a surge in infection rates in Singapore during the Omicron and XBB COVID waves, addressing challenges and proposing insights for scalable implementation. HaH substitutes inpatient hospitalizations by leveraging existing community healthcare services and remote healthcare technologies. This HaH adaptation was designed to be activated in during surges and deactivated when bed and manpower demands stabilize, making it less intensive on hospital resources.
View Article and Find Full Text PDFInt J Integr Care
December 2024
Discipline of Occupational Therapy, Trinity College, Dublin, Ireland.
Background: Social prescribing link workers support patients to connect with community resources to improve their health and well-being. These roles are prominent in policy, but there is limited evidence on what support is provided by link workers and what factors influence implementation of link worker interventions.
Methods: A convergent, mixed methods process evaluation of an exploratory randomised trial of a one-month general practice-based link worker intervention targeting adults with multimorbidity in deprived areas.
CHEST Crit Care
December 2024
Division of Pulmonary, Allergy, and Critical Care (G. L. A.), University of Pennsylvania Perelman School of Medicine, Philadelphia, PA; the Division of Pulmonary and Critical Care Medicine (S. M. S.), University of Rochester Medical Center, Rochester, NY; the Department of Anaesthesia and Critical Care (A. R., Z. F., and M. T. D. S.), Greys Hospital, KwaZulu-Natal Department of Health, the Department of Anaesthesia and Critical Care (J. I.), Harry Gwala Regional Hospital, KwaZulu-Natal Department of Health, Pietermaritzburg, the Department of Anaesthesia and Critical Care (R. D. W. and M. T. D. S.), School of Clinical Medicine, University of KwaZulu-Natal, Durban, South Africa; the Faculty Medicine and Pharmacy (R. D. W.), Vrije Universiteit Brussel (VUB), Brussels, Belgium; and the Department of Intensive Care (R. D. W.), John Radcliffe Hospital, Oxford University Trust Hospitals, Oxford, England.
Background: A proposed new global definition of ARDS seeks to update the Berlin definition and account for nonintubated ARDS and ARDS diagnoses in resource-variable settings.
Research Question: How do ARDS epidemiologic characteristics change with operationalizing the new global definition of ARDS in a resource-limited setting?
Study Design And Methods: We performed a real-use retrospective cohort study among adult patients meeting criteria for the Berlin definition of ARDS or the global definition of ARDS at ICU admission in two public hospitals in the KwaZulu-Natal Department of Health, South Africa, from January 2017 through June 2022.
Results: Among 5,760 adults (aged ≥ 18 years) admitted to the ICU, 2,027 patients (35.
Cytotechnology
February 2025
Laboratory LR11ES45, Research Group"Biotechnology and Pathology", National School of Engineers of Sfax, Sfax, Tunisia.
The clinical evidence, complications and the pathogenesis of COVID-19 are not clearly understood. In COVID-19 patients, cellular immune response biomarkers and oxidative stress parameters have been used as gravity markers. Indeed, oxidative stress has been proposed to play an essential role in the genesis of COVID-19.
View Article and Find Full Text PDFCureus
December 2024
Colorectal Surgery, Torbay and South Devon NHS Foundation Trust, Torbay, GBR.
Telemedicine in surgical care has undergone rapid advancements in recent years, leveraging technologies such as telerobotics, artificial intelligence (AI) diagnostics, and wearable devices to facilitate remote evaluation and monitoring of patients. These innovations have improved access to care, reduced costs, and enhanced patient satisfaction. However, significant challenges remain, including technical barriers, limited tactile feedback in telesurgery, and inequities arising from digital literacy and infrastructure gaps.
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