Interim Guidelines Research Articles

Expert Consensus for Treating Cancer Patients During the Pandemic of SARS-CoV-2.

The sudden pandemic of SARS-Cov-2 (also known as novel coronavirus disease 2019, COVID-19) poses a severe threat to hundreds of millions of lives in the world. The complete cure of the virus largely relies on the immune system, which becomes particularly a challenge for the cancer subjects, whose immunity is generally compromised. However, in a constant evolving situation, the clinical data on the prevalence of SARS-Cov-2 for cancer patients is still limited. On top of a wide range of medical references and interim guidelines including CDC, NCI, ASCO, ESMO, NCCN, AACR, ESMO, and the National Health Commission of China, etc., we formed into a guideline based on our experience in our specialized cancer hospital in Wuhan, the originally endemic center of the virus. Furthermore, we formulated an expert consensus which was developed by all contributors from different disciplines after fully discussion based on our understanding and analysis of limited information of COVID-19. The consensus highlighted a multidisciplinary team diagnostic model with assessment of the balance between risks and benefits prior to treatment, individualizing satisfaction of patients’ medical needs, and acceptability in ethics and patients’ socio-economic conditions.

Anesthesia department Interim guidelines in managing airway and surgeries regaring COVID-19 hepatic patients in national liver institute, Menoufia university, Egypt

Anesthesiologists, intensivists, anesthesia nursing/operating room staff the first and may be the only category dealing with patients airway, secretions for this anesthesia department took the responsibility to train and protect all team members with the lines of infection control and tailoring internal guidelines from international ones to suit the facilities and the fund in National Liver Institute (NLI), Menoufia, Egypt. And the unique category of patients we are serving.

Possible deferral of diagnostic and therapeutic procedures for patients with abnormal screening tests results in cervical cancer secondary prevention in current SARS-CoV-2 pandemic Interim guidelines of the Polish Society of Gynecologists and Obstetricians and the Polish Society of Colposcopy and Cervical Pathophysiology.

The Polish Society of Gynecologists and Obstetricians and Polish Society of Colposcopy and Cervical Pathophysiology Interim Guidelines goal at aiding gynecologists in providing a cervical cancer prevention care during the evolving SARS-CoV-2 pan-demic. Presented guidelines were developed on a review of limited data and updated when new relevant publications were revealed. Timing for deferrals of diagnostic-therapeutic procedures were mostly covered in the guidelines. Also, a support for the existing Polish recommendations on abnormal screening results in a subject of minor and major screening abnor-malities terminology were given. The guidelines are obligatory for the specified COVID-19 pandemic period only and they might be changed depending on the new available evidence.

How Local Governments Are Caring for the Homeless During the COVID-19 Pandemic

This article discusses the plight of the homeless during public health emergencies and the coronavirus disease of 2019 (COVID-19) pandemic. It reviews the role of public administrators that grounds their efforts by examining their foundational purpose to serve the most vulnerable in our society. Using subsidiarity principle as the context, it discusses homelessness in America and the role of the federal Department of Housing and Urban Development and their Continuum of Care program. It also highlights the role of the Centers for Disease Control and Prevention during public health emergencies and their interim guidelines for local governments in providing for the homeless during emergencies. Finally, through a case study on the city of Dallas, Texas, the article examines how local governments have responded to address the needs of the homeless during the COVID-19 pandemic. It concludes that it is imperative that public administrators at all levels of government explore areas of shared competence, cooperation, and allocate responsibility where it would yield the most efficient result.

Barrier Techniques to Reduce Aerosolization During Cardiopulmonary Resuscitation.

Preventing the dispersion of virulent particles during aerosol generating procedures has never been more relevant than during the current coronavirus pandemic. The American Heart Association released interim guidelines to assist in limiting exposure during advanced cardiovascular life support. These include maintaining a closed circuit on the ventilator for intubated patients and to use a high-efficiency particulate air filter during airway management of nonintubated patients. We developed additional modifications to the suggested guidelines such that providers are even further protected from unnecessary aerosolization, and illustrate a sample protocol for provider safety during advanced cardiovascular life support in the coronavirus pandemic. For the intubated patient, our protocol maintains the patient to the ventilator in addition to being draped with a plastic barrier over the mouth and nares. In the nonintubated patient, a plastic drape or a non-rebreather mask is used to help reduce aerosolization during manual chest compressions. Our modified protocol allows providers to perform advanced cardiac life support by further minimizing exposure risk.

Interim Guidance for Basic and Advanced Life Support in Adults, Children, and Neonates With Suspected or Confirmed COVID-19: From the Emergency Cardiovascular Care Committee and Get With The Guidelines-Resuscitation Adult and Pediatric Task Forces of the American Heart Association.

Interim Guidance for Basic and Advanced Life Support in Adults, Children, and Neonates With Suspected or Confirmed COVID-19: From the Emergency Cardiovascular Care Committee and Get With The Guidelines-Resuscitation Adult and Pediatric Task Forces of the American Heart Association.

CRITICAL PREPAREDNESS, READINESS AND RESPONSE TO COVID-19 PANDEMIC: A NARRATIVE REVIEW

Background: The COVID-19 was declared as a pandemic by the World Health Organization (WHO). Globally, countries took actions to slow the spread and avoid overwhelming the health system. The WHO issued interim guidelines on critical preparedness, readiness and response actions against COVID-19 to assist level of preparedness and readiness.Aim: This study reviewed the work of Australia, Singapore, Sri Lanka and the United Kingdom on actions and priority areas of work as described in interim guidelines by the WHO in relation to the first two phases of disease transmission scenario.Methods: A non-systematic narrative review was conducted. Relevant documents available in selected websites were searched. The data generated were compiled, and information was synthesised within the WHO framework for critical preparedness, readiness and response actions against COVID-19. Further, scenarios of “no cases” and “sporadic cases” were analysed against the actions and priority areas of work of said framework.Results: Study revealed differences in implementation approach of strategic actions and priority areas of work, such as in terms of activation, timeliness of implementing emergency response plans, variations in case management strategies as seen in contact tracing, management of asymptomatic contacts, isolation, quarantine and selection of cohort for laboratory investigation. Besides, gaps were found in availability and activation of business continuity plans.Conclusion: Global political and health authorities need much robust mechanisms for preparedness, response and coordination of contagious diseases with similar nature. Even the occurrence of one case shall trigger stringent transmission prevention measures and initiate the actions and priority areas of work as stated in the WHO interim guideline.Keywords: pandemics, emergency response, health policy, COVID-19, emergency preparedness.

PSE/PHA Interim Guidelines for Enhanced Quality and Safety at the Echocardiography Laboratory amidst Emerging Infections: Recommendations from the Task Force on Quality and Safety during Echocardiography of the Philippine Society of Echocardiography, Inc. and the Philippine Heart Association Council on Echocardiographys

Quality and safety go hand in hand in the practice of echocardiography. This fact becomes increasingly relevant amidst the pandemic that poses a number of extraordinary challenges to the healthcare community. The field of cardiovascular ultrasonography is no exception, as physicians, sonographers and allied health professionals carry out their tasks in the backdrop of a more intimate patient setting. The Philippine Society of Echocardiography, recognizing its key leadership role not only in the country but in the Asia-Pacific region, teamed up with the Philippine Heart Association Council on Echocardiography and the heads and training officers of various cardiovascular laboratories and training centers in the country to come up with a summary of best practices that are intended to elevate quality and infection control in echocardiography. KEYWORDS: echocardiography, cardiovascular laboratory, quality, safety, infection control

PPS/PIDSP Interim Guidelines on Resumption of Out- Patient Pediatric Clinics Post– Enhanced Community Quarantine During COVID Pandemic

none

Interim Guidelines on the Screening, Assessment and Clinical Management of Pediatric Patients with Suspected or Confirmed Coronavirus Disease 2019 (COVID-19) Version 2, 12 April 2020

none

PSPS Interim Guidelines for Pediatric Surgery During the COVID-19 Pandemic

PSPS Interim Guidelines for Pediatric Surgery During the COVID-19 Pandemic

PSTS Interim Guidelines and Recommendations on the Resumption of Kidney Transplantation and Related Practices Post-ECQ

PSTS Interim Guidelines and Recommendations on the Resumption of Kidney Transplantation and Related Practices Post-ECQ

Новый коронавирус SARS-COV-2 и беременность: обзор литературы

Having emerged in China, the new coronavirus SARS-CoV-2 has spread rapidly worldwide. Pregnant women are patients who have risk factors for severe/complicated acute respiratory viral infections and influenza; however, there have been presently only few works that highlight the specific features of the course of COVID-19, a disease caused by the novel coronavirus SARS-CoV-2, in pregnant women and newborns. The aim of the review was to search for and analyze publications considering the characteristics of the course of COVID-19 in pregnant women and newborns. Pregnancy and childbirth do not seem to aggravate the course of COVID-19; on the contrary, the latter can deteriorate the course of pregnancy: it can cause respiratory distress syndrome and lead to premature birth and miscarriage. There is no current evidence for mother-to-fetus placental transmission of COVID-19 and mother-to-baby transmission during breastfeeding. A large number of interim guidelines for the management of pregnant women with COVID-19 have been published.

Anticoagulation Options for Coronavirus Disease 2019 (COVID-19)-Induced Coagulopathy.

As the coronavirus disease 2019 (COVID-19) pandemic is evolving, coagulopathy induced by the disease and its severe complications are raising concerns in the medical community. Because coagulopathy caused by COVID-19 has been difficult to control, it is important to have a better understanding of what therapies have been studied thus far and what therapies have demonstrated better outcomes for hospitalized patients. This review is focused on literature, research, and expert clinical judgments published in 2020 with a few references to articles published earlier. The review introduces the interim guidelines of the International Society of Thrombosis and Haemostasis (ISTH) for management of COVID-19-induced coagulopathy, discusses the efficacy of these guidelines in clinical settings, and summarizes the response of the scientific community to these guidelines and their clinical implications. Due to the failure of patients to respond to the prophylactic doses of heparin recommended by ISTH, higher doses of heparin may be necessary to achieve adequate anticoagulation. Patients’ resistance to prophylactic doses of heparin could be due to low levels of anti-thrombin and high levels of fibrinogen, which would reinforce the use of therapeutic doses of heparin in the early stages of hospitalization. The review also compares low-molecular-weight heparin (LMWH) and unfractionated heparin (UFH) as anticoagulant choices for COVID-19 patients. Given the complications specific to COVID-19, UFH may be a better choice of anticoagulant. Outpatient anticoagulation options are also reviewed. Changing qualified patients from vitamin K antagonists (VKA) to direct-acting oral anticoagulant (DOAC) for the convenience of less frequent monitoring may be appropriate. New anticoagulant, nafamostat, used in Japan is also discussed as a possible potentiate for heparin therapy.

From guidance to practice: Promoting risk communication and community engagement for prevention and control of coronavirus disease (COVID-19) outbreak in China.

Integrating risk communication and community engagement into the national public health emergency response is crucial. Considering the difficulties and challenges faced by China in the prevention and control of coronavirus disease (COVID‐19) and based on interim guidelines from the World Health Organization, this article makes several recommendations addressing the outbreak in China. These include improvements in the internal governmental risk communication systems, enhancing the coordination between internal and partner governmental emergency management, and promoting public communication in response to societal concerns. Regarding these recommendations, we emphasize community engagement in joint prevention and control, confronting uncertainty and countering rumors effectively, and strengthening international cooperation and evidence‐based decision making for prevention and control measures.

Should Colchicine be used in the treatment of COVID-19?

KEY FINDINGS
 There is currently insufficient evidence on the use of colchicine in the treatment of COVID-19 patients, but there are 4 ongoing trials awaiting completion this 2020.
 
 Colchicine is an anti-inflammatory agent currently being used for a variety of inflammatory conditions such as gout, familial Mediterranean fever, Behcet’s syndrome and pericarditis.
 Its powerful anti-inflammatory properties may have the potential to prevent the development of COVID-19 complications.
 There are currently no evidence for its use on COVID-19 patients, but there are 4 ongoing studies that may be released from the period of May 2020 to September 2020.
 Common adverse events include gastrointestinal effects such as diarrhea but does not exhibit serious and life-threatening adverse events.
 There is no mention of colchicine in the WHO Interim Guidance, US CDC Clinical Interim Guidelines and Chinese Clinical Guidance for COVID-19 management.

Recrudescence of COVID-19: A review of literature and Indian perspective

: The present article aims to describe the sudden emergence of 2019 novel Corona virus its incidence and spread among the neighbouring countries and preventive measures that the World Health Organization and The Central Government of India is taking to ensure early detection and management of cases. : The study is cumulative of the recent literature released by the Central Government of India DHR and ICMR, the Chinese scientists handling the samples and Interim measures on controlling the 2019n-Corona virus by World Health Organization and American National Institute of Health. Inclusion criteriaArticles that discussed corona virus history and epidemiology. Case reports and Interim guidelines by WHO. Articles related to treatment of SARS and MERS in the past 10 years. The study was conducted at GIMS-VRDL, Department of Microbiology, Gulbarga Institute of Medical Sciences, Kalaburagi, Karnataka and articles were selected using PRISMA 2009 checklist. Exclusion criteria: Articles with no proves. : In a short period of 58 days 2019n-CoV has affected more than 82138 people globally and caused 2801 casualties (2744 deaths in mainland China and 57 deaths in the neighbouring countries). The novel corona virus has challenged human technology and development with its undetected highly efficient spread and mutation rate. The role of WHO and ICMR in providing interim guidelines to health care professionals and Research Scientists in identification, isolation, specimen collection and management of affected cases is commendable. On 17 February UNICEF has appealed an estimate of 42.5 million USD to financially support the outbreak response. With growing numbers of cases the fight against the corona virus is still at stake, research needs to be conducted for better understanding different routes of spread including vertical transmission in humans and the detailed genomic sequence, for developing diagnostic kits and efficient anti corona virus drugs and vaccinations.

Innovative Partnerships for the Elimination of Human African Trypanosomiasis and the Development of Fexinidazole.

Human African Trypanosomiasis (HAT or sleeping sickness) is a life-threatening neglected tropical disease that is endemic in 36 sub-Saharan African countries. Until recently, treatment options were limited and hampered by unsatisfactory efficacy, toxicity, and long and cumbersome administration regimens, compounded by infrastructure inadequacies in the remote rural regions worst affected by the disease. Increased funding and awareness of HAT over the past two decades has led to a steady decline in reported cases (<1000 in 2018). Recent drug development strategies have resulted in development of the first all-oral treatment for HAT, fexinidazole. Fexinidazole received European Medicines Agency positive scientific opinion in 2018 and is now incorporated into the WHO interim guidelines as one of the first-line treatments for HAT, allowing lumbar puncture to become non-systematic. Here, we highlight the role of global collaborations in the effort to control HAT and develop new treatments. The long-standing collaboration between the WHO, Sanofi and the Drugs for Neglected Diseases initiative (Geneva, Switzerland) was instrumental for achieving the control and treatment development goals in HAT, whilst at the same time ensuring that efforts were led by national authorities and control programs to leave a legacy of highly trained healthcare workers and improved research and health infrastructure.

Induction-remission response in peadiatric acute lymphoblastic leukaemia, Lahore protocol versus UKALL 2011 interim guidelines.

To compare the outcome of induction-remission in acute lymphoblastic leukaemia patients treated according to two different guidelines. The descriptive retrospective cohort study was conducted at The Children's Hospital Lahore, Pakistan, and comprised clinical information sheets of acute lymphoblastic leukaemia patients from September 2014 to August 2015. Data regarding demographics, risk categorisation, rapid early response and induction-remission assessment was collected separately for Group 1 patients treated with Lahore protocol and Group 2 patients using United Kingdom acute lymphoblastic leukaemia-2011 interim guidelines. Data was analysed using SPSS version 20.0. Of the 98 patients who had a median age of 6.4 years (interquartile range: 1.5-16 years), 48(49%) were in Group 1 and 50(51%) in Group 2. There were 14(29%) patients with standard risk in Group 1 while 34(71%) were high-risk. The corresponding numbers in Group 2 were 30(60%) and 20(40%) in Group 2. Rapid early response was noted in 18(37.5%) patients in Group 1 and 11(28%) in Group 2. Remission was achieved in 38(79%) patients in Group 1 and 36(72%) in Group 2. There was significant association of rapid early response with induction-remission in Group 2 (p<0.05) but not in Group 1 (p>0.05). Induction-remission rate was comparable in the two treatment groups, but significant association of rapid early response with induction-remission was observed only in patients treated using United Kingdom acute lymphoblastic leukaemia-2011 interim guidelines.

Clinical characteristics of skin manifestations with the novel coronavirus infection COVID-19 caused by SARS-CoV-2

В настоящее время сведения об эпидемиологии, клинических особенностях, профилактике и лечении новой коронавирусной инфекции COVID-19, вызванной SARS-CoV-2 постоянно дополняются и обновляются. Новый коронавирус SARS-CoV-2 — это одноцепочечный РНК-содержащий вирус семейства <i>Coronaviridae</i>, линии Beta-CoV B. SARS-CoV-2 включен во II группу патогенности наряду с другими вирусами этого семейства (вирус SARS-CoV, MERS-CoV). Определение случая заболевания и диагностика COVID-19 проводится согласно временным методическим рекомендациям «Профилактика, диагностика и лечение новой коронавирусной инфекции (COVID-19)» Министерства здравоохранения Российской Федерации (вер. 6, 28.04.20). Наиболее распространенным клиническим проявлением COVID-19 является двусторонняя пневмония, у 3–4% пациентов развивается острый респираторный дистресс-синдром (ОРДС). В связи с продолжающейся пандемией COVID-19 в клинической симптоматике болезни появляются новые симптомы полиорганного поражения, включая поражения кожного покрова. Клинические симптомы COVID-19, характеризующиеся поражением кожи, могут быть первыми симптомами заболевания. В статье представлены материалы по краткой характеристике новой коронавирусной инфекции COVID-19, а также клинические характеристики поражений кожи при этой инфекции, по данным зарубежных исследователей и на основании собственных наблюдений пациентов в стационарах медицинских организаций Департамента здравоохранения Москвы.