In every moment, we have two options either to do what is needed or to run away from it. The right thing means nothing but to do what is necessary and feels right to us, by keeping consequences in mind. If you do the right things just because someone is going to reward you, it may make doing the right thing a selfish thing. No matter what situation you are in, you should always do what is right. Doing the right thing only for gaining attention and publicity is unethical. Irrespective of results or benefits, believe in the process, and do the right thing, give justice. Doing the right is itself a reward.
- Shubham Shukla
This important presentation encompasses all the vaccines of COVID at current point of time; it's mechanism of action, its efficacy data's and advantages and disadvantages
These slides highlight the approved & widely used therapeutics for treating COVID-19 patients (end Q1 2021). At the time of writing, there are 5 therapeutics that have been granted Emergency Use Authorization by the US FDA, mostly being antivirals and monoclonal antibodies (mAbs). The use of corticosteroids and cytokine inhibitors are also showing promise in their ability to reduce case fatalities, progression as well as hospitalization time.
Doubt is crucial in science—in the version we call curiosity or healthy skepticism, it drives science forward—but it also makes science vulnerable to misrepresentation, because it is easy to take uncertainties out of context and create the impression that everything is unresolved. This was the tobacco industry's key insight: that you could use normal scientific uncertainty to undermine the status of actual scientific knowledge. Individual clinicians cannot single-handedly combat this kind of antiscience, a climate that has only been fostered by some political and religious leaders and by the social media.
But at the very least, we can make our patients aware of the forces at play and the mind games that such merchants of doubt employ.
- John D. Halamka, M.D., M.S.
This important presentation encompasses all the vaccines of COVID at current point of time; it's mechanism of action, its efficacy data's and advantages and disadvantages
These slides highlight the approved & widely used therapeutics for treating COVID-19 patients (end Q1 2021). At the time of writing, there are 5 therapeutics that have been granted Emergency Use Authorization by the US FDA, mostly being antivirals and monoclonal antibodies (mAbs). The use of corticosteroids and cytokine inhibitors are also showing promise in their ability to reduce case fatalities, progression as well as hospitalization time.
Doubt is crucial in science—in the version we call curiosity or healthy skepticism, it drives science forward—but it also makes science vulnerable to misrepresentation, because it is easy to take uncertainties out of context and create the impression that everything is unresolved. This was the tobacco industry's key insight: that you could use normal scientific uncertainty to undermine the status of actual scientific knowledge. Individual clinicians cannot single-handedly combat this kind of antiscience, a climate that has only been fostered by some political and religious leaders and by the social media.
But at the very least, we can make our patients aware of the forces at play and the mind games that such merchants of doubt employ.
- John D. Halamka, M.D., M.S.
Global & Malaysia data has consistently shown that after 2 doses of Sinovac, a Pfizer/AstraZeneca booster is more effective than a 3rd dose of Sinovac, especially Omicron. And despite a third dose of Sinovac, levels of ‘neutralizing’ antibodies, tend to remain low.
Millions of people in the United States have received COVID-19 vaccines under the most intense safety monitoring in US history. VITAS Healthcare offer an educational presentation for our partner organizations to use for their own in-house or staff training.
Webinar Series on COVID-19 vaccine: Jointly organized by Malaysian Society of Infection Control and Infectious Diseases (MyICID) & Institute for Clinical Research (ICR), NIH
Speaker: Dr.Benedict Sim Lim Heng is a Consultant Infectious Disease Physician at the Sungai Buloh Hospital, Ministry of Health Malaysia.
This slide presentation historically, statistically and attractively explains various vaccines for covid19 available in India. (Please update the statistical data to current values)
Ομιλία – Παρουσίαση: Αχιλλέας Γραβάνης, Καθηγητής Φαρμακολογίας, Ιατρική Σχολή Πανεπιστήμιο Κρήτης, Ερευνητής, Ινστιτούτο Μοριακής Βιολογίας & Βιοτεχνολογίας του ΙΤΕ
A vaccine is a biological preparation that improves immunity to a particular Disease.
No vaccine is completely safe or completely effective, while all known vaccine adverse events are minor and self limited, some vaccine have been associated with rare but serious health effects.
A brief overview of the process of vaccine production, clinical trials, and licensing, along with a summary of the different vaccines platforms and vaccine candidates.
Update on COVID-19 Innovation: Detection and VaccineRohimah Mohamud
briefly mentioned about the research activities by my research group at Immunology Department, School of Medical Sciences, USM which focusing on both fundamental and applied research. As the theme of this conference is more to ASEAN SDG, I highlighted on the challenges and issues facing by ASEAN as reported in ASEAN SDG Indicators Baseline Report 2020 (only briefly- especially on the data compilation etc - you may refer to this report). Then, I moved on to the diagnosis and vaccine development for COVID-19.
There are a total of 237 vaccine candidates, according to Milken institute COVID-19 treatment and vaccine tracker, as of December 1, 2020. There are 40 confirmed vaccine candidates in clinical evaluation, while 197 vaccine candidates are still in the preclinical stage. There are 9 vaccine candidates in Phase III of clinical evaluation. Studies in clinical trials showed that the vaccine candidates showed good safety and efficacy in terms of producing antibodies and prevent infection.
Global & Malaysia data has consistently shown that after 2 doses of Sinovac, a Pfizer/AstraZeneca booster is more effective than a 3rd dose of Sinovac, especially Omicron. And despite a third dose of Sinovac, levels of ‘neutralizing’ antibodies, tend to remain low.
Millions of people in the United States have received COVID-19 vaccines under the most intense safety monitoring in US history. VITAS Healthcare offer an educational presentation for our partner organizations to use for their own in-house or staff training.
Webinar Series on COVID-19 vaccine: Jointly organized by Malaysian Society of Infection Control and Infectious Diseases (MyICID) & Institute for Clinical Research (ICR), NIH
Speaker: Dr.Benedict Sim Lim Heng is a Consultant Infectious Disease Physician at the Sungai Buloh Hospital, Ministry of Health Malaysia.
This slide presentation historically, statistically and attractively explains various vaccines for covid19 available in India. (Please update the statistical data to current values)
Ομιλία – Παρουσίαση: Αχιλλέας Γραβάνης, Καθηγητής Φαρμακολογίας, Ιατρική Σχολή Πανεπιστήμιο Κρήτης, Ερευνητής, Ινστιτούτο Μοριακής Βιολογίας & Βιοτεχνολογίας του ΙΤΕ
A vaccine is a biological preparation that improves immunity to a particular Disease.
No vaccine is completely safe or completely effective, while all known vaccine adverse events are minor and self limited, some vaccine have been associated with rare but serious health effects.
A brief overview of the process of vaccine production, clinical trials, and licensing, along with a summary of the different vaccines platforms and vaccine candidates.
Update on COVID-19 Innovation: Detection and VaccineRohimah Mohamud
briefly mentioned about the research activities by my research group at Immunology Department, School of Medical Sciences, USM which focusing on both fundamental and applied research. As the theme of this conference is more to ASEAN SDG, I highlighted on the challenges and issues facing by ASEAN as reported in ASEAN SDG Indicators Baseline Report 2020 (only briefly- especially on the data compilation etc - you may refer to this report). Then, I moved on to the diagnosis and vaccine development for COVID-19.
There are a total of 237 vaccine candidates, according to Milken institute COVID-19 treatment and vaccine tracker, as of December 1, 2020. There are 40 confirmed vaccine candidates in clinical evaluation, while 197 vaccine candidates are still in the preclinical stage. There are 9 vaccine candidates in Phase III of clinical evaluation. Studies in clinical trials showed that the vaccine candidates showed good safety and efficacy in terms of producing antibodies and prevent infection.
It's no secret that the healthcare system needs some work. In fact, it's not really a system at all. It's confusing, it's difficult to navigate, and it's too expensive. When you combine that with some of the demographic trends that you see in our country — the population is getting older, we're experiencing more chronic disease — it gets even more complicated and more expensive. And consumer expectations are changing dramatically as well. So, this creates an opportunity for an organization like ours to lead this digital transformation.
Steve Nelson, CEO
UnitedHealthcare
This was a lecture I gave for the Upstate Nurse Practitioners Association. This is a comprehensive overview. I would to thank all health care professionals for doing their jobs as well as they can.
This is a lecture I gave for the Upstate Nurse Practitioner's Association September 29, 2020. Parts may no longer be valid, because the topic is changing so rapidly. I did the best I could.
Breaking news hit early this week regarding potential problems with Johnson & Johnson’s one-shot COVID vaccine, causing the FDA and the CDC to recommend pausing the administration of the vaccine until further investigation can be completed. On top of canceled or rescheduled vaccine appointments, this news left many people wondering what this means for the overall vaccine administration efforts and what changes they could expect to see...
CRITICAL APPRAISAL OF THE EVIDENCE REGARDING EFFICACY/EFFECTIVENESS AND SAFETY OF COVID-19 VACCINES – METHODOLOGICAL LIMITATIONS OF THE COVID-19 VACCINES CLINICAL TRIALS
Pedro Morago, 21st January 2022
Investing in Potential Coronavirus TreatmentsInvestingTips
The gold standard for preventing the spread of coronavirus will be a vaccine but those already infected need treatment. Investing in potential coronavirus treatments could be profitable.
Excuses kill solutions and dilute passion. Kill excuses before it kills you. Focus is key! Obstacles will always exist on your path, but it's important to remember that it is not these challenges that stop us from becoming the amazing people we can be, it is often our own excuses that stop us. - Vijay Eswaran
Audit success comes from service, not from status. The true standards of audit practice are found within the auditor's character: honesty, integrity, self control and high ethical values. The printed standards are merely guidelines for trying to make the art of auditing into a profession. - Michael L. Piazza
Auditors must develop a reputation that proclaims that they know what they are doing... that their reviews are factual and unbiased... that they deserve to be respected... that they are professionals with professional qualifications. A fundamental key to audit success is the reputation for objectivity. That implies independence from activities reviewed. Complete independence is an unattainable goal while practical independence is not only possible but absolutely essential. - Larry Sawyer
The bull rider in the chute apparently couldn't get his grip and kept resetting. - Sara M. Anderson
The rodeo ain't over till the bull riders ride. - Ralph Carpenter
The quality of a person's life is in direct proportion to their commitment to excellence, regardless of their chosen field of endeavor. Individual commitment to a group effort—that is what makes a team work, a company work, a society work, a civilization work. - Vince Lombardi
Two roads diverged in a wood and I - I took the one less traveled by, and that has made all the difference.
- Robert Frost
Sometimes the right path is not the easiest.
- Grandmother Willow
LEADership is the ability to translate vision into reality.
- Warren Bennis
Realize that if a door closed, it's because what was behind it wasn't meant for you.
- Mandy Hale
I believe each of us has a mission in life, and that one cannot truly be living their most fulfilled life until they recognize this mission and dedicate their life to pursuing it. - Blake Mycoskie
A mission statement is not something you write overnight. But fundamentally, your mission statement becomes your constitution, the solid expression of your vision and values. It becomes the criterion by which you measure everything else in your life. - Stephen Covey
There are three kinds of people: Those who make things happen, those who watch things happen, and those who ask, 'What happened?'
- Casey Stengel
Success seems to be connected with action. Successful people keep moving. They make mistakes, but they don't quit.
- Conrad Hilton
The Law is a mighty machine. Woe to the unfortunate man who, wholly or in part innocent, becomes entangled in its mighty wheels, unless his innocence is patent or his rescue planned and executed by able counsel. The machine will grind on relentlessly and ruthlessly, and blindfolded justice does not see that the grist is sometimes stained with blood.
- Edward Johnes, Esq.
Inner harmony means knowing yourself, accepting yourself and delighting yourself. Make your body and mind the best friends to give your best, effortlessly, in any area of your life.
- Savitha Hosamane
Michael Jordan:
Some people want it to happen, some wish it would happen, others make it happen.
I've always believed that if you put in the work, the results will come. I don't do things half-heartedly. Because I know if I do, then I can expect half-hearted results.
Talent wins games, but teamwork and intelligence wins championships.
Write your own book instead of reading someone else's book about success. Great moments are born from great opportunities. This is your time. Their time is done. It's over. This is your time. Now go out there and take it!
- Herb Brooks
No work is insignificant. All labor that uplifts humanity has dignity and importance and should be undertaken with painstaking excellence. - Martin Luther King, Jr.
To do what nobody else will do, a way that nobody else can do, in spite of all we go through; that is to be a nurse.
- Rawsi Williams
Nurses dispense comfort, compassion, and caring without even a prescription. - Val Saintsbury
When a man becomes a fireman his greatest act of bravery has been accomplished. What he does after that is all in the line of work.
I have no ambition in this world but one, and that is to be a fireman. The position may, in the eyes of some, appear to be a lowly one; but we who know the work which the fireman has to do believe that his is a noble calling. Our proudest moment is to save lives. Under the impulse of such thoughts, the nobility of the occupation thrills us and stimulates us to deeds of daring, even of supreme sacrifice.
- Edward F. Croker, Chief, New York City Fire Department
(FDNY) (1899-1911)
If you ignore the dragon, it will eat you. If you defy the dragon it will overpower you. But if you ride the dragon, you will take advantage of its strength and power. - Ancient Chinese Proverb
More from Clifton M. Hasegawa & Associates, LLC (20)
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
Phone Us ❤85270-49040❤ #ℂall #gIRLS In Surat By Surat @ℂall @Girls Hotel With...
Hawaii - American Medical Association - Advancing Science - Ethics and Professional Responsibility - Vector Control
1. AMERICAN MEDICAL ASSOCIATION (AMA)
<https://m.facebook.com/AmericanMedicalAssociation/photos/a.10151410277225109/10163952007265109/?type=3&p=7>
Loretta Lynn NY
Unfortunately most people still do not understanding these simple facts.
(Mainly because the media propaganda is not reporting all the true facts about it.)
#1 - There is “No” Vaccine to give you immunization against the SARS2 Coronavirus.
#2 - Covid-19 is “Not” the virus.
It is only the name given to the Respiratory Symptoms of the SARS2 Coronavirus.
#3 - You can “Not” have Immunization to a Respiratory Symptom if you do not have immunity
against contracting the actual disease (virus) that causes it.
#4 - The reason it is being called a “Covid-19 Vaccine” instead of what is really is, a Therapeutic
Drug, is because ALL manufacturers of any drug that they refer to as a “Vaccine” gives these
companies complete immunity against ANY Liability under the “1986 Prep Act”.
So therefore, you can not sue Pfizer or Moderna or any other company that uses the word vaccine
for their drug if you experience any injury and or death from taking one of their so called
vaccines.
#5 - The Experimental Drug (Not FDA Approved) that is being referred to as the COVID-19
Vaccine is “NOT” a vaccine that gives immunization to the SARS2 Coronavirus.
It is “ONLY” a possible “Therapeutic Drug” that MIGHT help reduce the respiratory symptoms,
called Covid-19.
But the list of FDA Adverse Side Effects out weight the possible benefits and can also be
permanent side effects for the rest of your life.
It will take years for the conclusion of the results of this “Experimental Drug Trial” with using all
the data from all the people whom have volunteered to take part in this experiment.
#6 - The Experimental Drug Trial is considered “Voluntary” and may “not” be covered by your
Medical Insurance if you need medical help for any of it’s adverse side effects.
(Check your medical insurance first before you volunteer to take part in any Experimental Drug
Trial.)
#7 - If you were to die from having a severe adverse side effect by “Volunteering” to participate
in an “Experimental Drug Trial” and have a Life Insurance Plan it may cancel it out because it
might not cover deaths from an Experimental Drug Trial.
(Check your Life Insurance Policy before volunteering in any Experimental Drug Trial.)
2. #8 - There are plenty of medical therapeutic drugs that physicians are successfully using but do
not have the dangerous adverse side effects that the FDA has listed in their documents for this
Experimental Drug being called the “Covid-19 Vaccine”.
But unfortunately these Physicians are being censored by Big Tech, Big Pharm, the CDC and so
on, because the FDA can only allow an unapproved drug to be used as an EUA if they don't
allow any other drug to be considered.
Thus, why all other FDA approved therapeutic drugs are not being considered for the treatment
of the SARS2 Coronavirus Respiratory Symptoms.
______________________________________________________
HYDROXYCHLOROQUINE
The American Medical Association did not change its stance from opposing to supporting the use
of hydroxychloroquine as a treatment for COVID-19. The association supports the ability of
health practitioners to prescribe drugs based on their professional judgement, but insists
that practitioners rely on evidence-based medicine. So far, there is no scientific support for the
claim that hydroxychloroquine can prevent COVID-19 deaths.
Source:
The American Medical Association does not reject nor support hydroxychloroquine as a treatment for
COVID-19, nor did it change its position on the use matter
By Brian C. Joondeph, American Thinker, 18 December 2020
<https://healthfeedback.org/claimreview/the-american-medical-association-does-not-reject-nor-support-hydroxychloroquine-as-a-treatment-for-covid-19-nor-did-it-change-its-
position-on-the-use-matter/>
IVERMECTIN
The Food and Drug Administration (FDA) echoed the CDC's warning against the use of
ivermectin for prevention or treatment of COVID-19. That is because ivermectin is not
approved or authorized by the FDA for COVID-19. Additionally, the National Institutes of
Health's (NIH) COVID-19 Treatment Guidelines Panel determined that there is insufficient
evidence and data to recommend ivermectin for treatment of COVID-19. This
recommendation is consistent with the Infectious Disease Society of America's Guidelines on the
Treatment and Management of Patients with COVID-19, which speaks against the use of
ivermectin in hospitalized patients and ambulatory persons with COVID-19, outside of the
context of a clinical trial. There is also no evidence to suggest that ivermectin can be used to
successfully prevent COVID-19 infection.
“Clinical trials and observational studies to evaluate the use of ivermectin to prevent and treat
COVID-19 in humans have yielded insufficient evidence for the NIH COVID-19 Treatment
Guidelines Panel to recommend its use,” the CDC health alert explains. “Data from adequately
sized, well-designed and well-conducted clinical trials are needed to provide more specific,
evidence-based guidance on the role of ivermectin in the treatment of COVID-19.”
A recent study cited by the CDC found that ivermectin dispensing from outpatient retail
pharmacies in the U.S. increased from an average of 3,600 prescriptions per week at the pre-
pandemic baseline to a peak of 39,000 prescriptions in the week ending Jan. 8, 2021.
3. Then, since early July, outpatient ivermectin dispensing was on the rise again, rapidly increasing
to more than 88,000 prescriptions in the week ending Aug. 13. According to the CDC, this
represents a 24-fold increase. This growing interest in ivermectin to treat humans with COVID-
19 has led to an increase in calls to poison control reporting overdoses and adverse effects.
[Emphasis Supplied]
Source:
Why ivermectin should not be used to prevent or treat COVID-19
By Sara Berg, American Medical Association, August 27, 2021
<https://www.ama-assn.org/delivering-care/public-health/why-ivermectin-should-not-be-used-prevent-or-treat-covid-19>
______________________________________________________
COVID-19 THERAPEUTICS: WHAT THE EVIDENCE SHOWS
By Tanya Albert Henry, American Medical Association, March 29, 2021 [Extract]
<https://www.ama-assn.org/delivering-care/public-health/covid-19-therapeutics-what-evidence-shows>
Effective vaccines mean that the COVID-19 pandemic may be more controlled in the coming
months, but the SARS-CoV-2 virus will likely remain a part of our everyday lives. That makes it
important for physicians to have therapeutics in their toolbox to treat patients at all stages of
disease progression—today, as well as in the future.
Treatments for mild COVID-19
Since the earliest days of the pandemic, a few options for treating patients with mild to moderate
COVID-19 have been discovered and they are aimed at keeping high-risk patients out of the
hospital and preventing mortality, said John Farley, MD, director of the FDA’s infectious
diseases office in the FDA Center for Drug Evaluation and Research (CDER). Monoclonal
antibodies (mAbs) are designed to block SARS-CoV-2 viral attachment and entry into human
cells, neutralizing the virus. At this article's deadline, there were three emergency use authorized
products:
Bamlanivimab
Bamlanivimab and etesevimab administered together
REGN-COV: casirivimab and imdevimab administered together.
The mAbs have been authorized to use for mild to moderate COVID-19 and can be used in adults
and children 12 or older and weighing at least 40 kilograms who are at high risk of developing
severe COVID-19 or progressing to hospitalization. These treatments are not authorized for
patients who are already hospitalized for COVID-19 or those who require oxygen therapy. At
least two trials have suggested using the treatment on patients already on ventilators may do more
harm than good, Dr. Farley said.
In a phase 3 trial for patients receiving the bamlanivimab and etesevimab versus placebo, there
was a 70% reduction in patients who required hospitalization or died after 29 days, he said. There
were 10 deaths for patients who received a placebo and no deaths among those who received the
treatment.
Some challenges have emerged for treating patients with these mAB infusions and the uptake of
their use has been limited, including the need to administer the mABs via infusion and short
window of time to administer them—treatment must be given within 10 days of symptom onset.
Additionally, research has indicated that circulating SARS-CoV-2 viral variants may be
associated with resistance to mABs.
4. Information on resistance can be found in the FDA fact sheets and from state and local public
health authorities.
Treatments for sicker patients
Remdesivir. This intravenous drug can be used in hospitalized adult patients and children 12
years or older who weigh at least 40 kilograms.
Immonomodulators. Several immunomodulator therapies have also been used with some success,
said Sally Seymour, MD, the deputy director for safety in the pulmonary, allergy and
rheumatology products division at CDER. They are dexamethasone, baricitnib and tocilizumab.
Dexamethasone can be used for hospitalized patients on oxygen or a ventilator after a study
published in The New England Journal of Medicine found that, overall, the treatment resulted in
a 3% reduction in mortality. For those on a ventilator, there was 12% reduction in mortality, Dr.
Seymour said.
Baricitnib was authorized for emergency use in November for COVID-19 patients in
combination with remdesivir for patients 2 and older on supplemental oxygen, a mechanical
ventilator or extracorporeal membrane oxygenation machine. A National Institutes of Health
(NIH)-sponsored study showed it reduced recovery time by one day, to seven days, and that it
reduced the odds of a patient dying or going on a mechanical ventilator.
Tocilizumab trials have had mixed results, but recently released data in a nonpeer-reviewed
preprint article shows absolute mortality reduced by 4%. NIH issued a statement for use in
certain patients.
Early in the pandemic, researchers turned to existing drugs to determine whether they could
effectively treat COVID-19. While research continues on that front, scientists are also looking at
new or repurposed, never approved antivirals that can treat COVID-19 early in the disease, Dr.
Woodcock said. Dr. Farley said it’s important to look for treatments that have clinical benefit for
the patient. For example, there are companies working medication that would improve symptoms
faster. The idea is to obtain drugs to help alleviate COVID-19 symptoms in the way that
oseltamivir (marketed as Tamiflu) can help treat patients with influenza. The priority, he said, is
“to keep our highest-risk patients out of the hospital right now, and hopefully we are getting
those high-risk patients vaccinated as quickly as possible.”
Journal of Applied Biological Sciences
Dr. Mehmet Karataş
Responsibility Of Physicians