Background: In March 2020, the World Health Organization declared COVID-19, caused by the SARS-CoV-2 virus, a pandemic. Patients with severe cases resulting in hospitalization and mechanical ventilation are at risk for COVID-19-associated pulmonary aspergillosis, an invasive fungal infection, and should be screened for aspergillosis if they have persistent hemodynamic instability and fever. Early detection and treatment of this fungal infection can significantly reduce morbidity and mortality in this population.
Objective: To develop an evidence-based care step pathway tool to help intensive care unit clinicians assess, diagnose, and treat COVID-19-associated pulmonary aspergillosis.
Methods: A panel of 18 infectious disease experts, advanced practice registered nurses, pharmacists, and clinical researchers convened in a series of meetings to develop the Care Step Pathway tool, which was modeled on a tool developed by advanced practice nurses to evaluate and manage side effects of therapies for melanoma. The Care Step Pathway tool addresses various aspects of disease management, including assessment, screening, diagnosis, antifungal treatment, pharmacological considerations, and exclusion of other invasive fungal coinfections.
Results: The Care Step Pathway tool was applied in the care of a patient with COVID-19-associated aspergillosis. The patient was successfully treated.
Conclusion: The Care Step Pathway is an effective educational tool to help intensive care unit clinicians consider fungal infection when caring for COVID-19 patients receiving mechanical ventilation in the intensive care unit, especially when the clinical course is deteriorating and antibiotics are ineffective.
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http://dx.doi.org/10.4037/ccn2022237 | DOI Listing |
JMIR Med Inform
January 2025
Department of Medical Informatics, Amsterdam University Medical Center, University of Amsterdam, Amsterdam, the Netherlands.
Background: The field of digital health solutions (DHS) has grown tremendously over the past years. DHS include tools for self-management, which support individuals to take charge of their own health. The usability of DHS, as experienced by patients, is pivotal to adoption.
View Article and Find Full Text PDFBMC Emerg Med
January 2025
Temerty Faculty of Medicine, University of Toronto, Toronto, Canada.
Background: Globally, healthcare institutions have seen a marked rise in workplace violence (WPV), especially since the Covid-19 pandemic began, affecting primarily acute care and emergency departments (EDs). At the University Health Network (UHN) in Toronto, Canada, WPV incidents in EDs jumped 169% from 0.43 to 1.
View Article and Find Full Text PDFBMJ Open
January 2025
Department of Pediatric Surgery, Emma Children's Hospital, Amsterdam UMC, Amsterdam, Noord-Holland, The Netherlands.
Introduction: There is a lack of consensus on the optimal surgical strategy for differentiated thyroid cancer (DTC), partly due to inconsistent reporting of outcomes. This limits the ability to compare study results, hindering the ability to draw conclusions regarding novel treatment strategies. The development of a core outcome set (COS) reduces heterogeneity in the selection and reporting of clinical trial outcomes.
View Article and Find Full Text PDFJ Control Release
January 2025
Oujiang Laboratory (Zhejiang Lab for Regenerative Medicine, Vision and Brain Health), Cixi Biomedical Research Institute, School of Pharmaceutical Sciences, Wenzhou Medical University, Ningbo, China. Electronic address:
Severe corneal injuries can cause visual impairment even blindness. Surgically stitching or implanting biomaterials have been developed, but their implementation requires professional surgeons, failing to address the immediate need of medical treatment. The pressing challenge lies in developing multifunctional biomaterials that enable self-management of corneal injuries.
View Article and Find Full Text PDFPhytomedicine
December 2024
Beijing Key Laboratory of Antimicrobial Agents, Institute of Medicinal Biotechnology, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100073, China. Electronic address:
Background: Adherence of Helicobacter pylori to the surface of the gastric mucosa is the initial and crucial step for its survival and colonization in the harsh conditions of the stomach. We had previously demonstrated that daphnetin has anti-adhesion effect.
Purpose: This study aims to explore the mechanisms of daphnetin to reduce H.
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