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Multilevel onsite training and mentorship model to accelerate early childhood cancer diagnosis in Northwest Ethiopia: A quasi-experimental mixed method study.

BACKGROUND: Childhood cancer survival in low-income countries remains below 20%, with late recognition and delayed referral commonly reported. In Northwest Ethiopia, care providers often lack the knowledge, skills, and support systems for recognizing early warning signs of pediatric malignancies. Community caregivers often present only after symptoms become advanced. The University of Gondar Comprehensive Specialized Hospital piloted a quality improvement initiative aimed at achieving earlier diagnoses. This study reports whether a multilevel onsite training and mentorship model could improve

[Impact of active surveillance for carbapenem-resistant organisms on healthcare-associated infections and clinical prognosis of patients in intensive care unit: a propensity score-matching historical cohort study].

OBJECTIVE: To evaluate the impact of active surveillance for carbapenem-resistant organisms (CRO) on healthcare-associated infections and clinical prognosis of patients in intensive care unit (ICU), and to provide real-world clinical evidence for developing scientific CRO active surveillance protocols in medical institutions. METHODS: A prospective intervention study with a post-hoc retrospective historical control cohort design was conducted. ICU inpatients at the General Hospital of Ningxia Medical University from January 1, 2024 to December 31, 2025 were enrolled. The routine testing group

Association between brain fog, cardiac injury, and quality of life at work after hospitalization due to COVID-19.

BACKGROUND: To evaluate incidence and search for possible predictors of brain fog and quality of life at work (QoL-W) among low-to-moderate … 81 hospitalized subjects (age Me = 57 years), 37.02% women. Most had low disease severity (Modified Early Warning Score = 1, 77.90%) and low comorbidity (Charlson Comorbidity Index 0: 28.72%, 1-2: 34.09%), with no intensive care unit treatment needed. COVID-19 led to almost 3-fold increased brain fog symptoms, with incidence of 58.56%, 53.59%, and 49.17% within 4, 4- …

Lassa fever outcomes and prognostic factors in Nigeria (LASCOPE): a prospective cohort study.

BACKGROUND: Lassa fever is a viral haemorrhagic fever endemic in parts of west Africa. New treatments are needed to decrease mortality, but … reshold (Ct) lower than 30. From admission to end of follow-up, 120 (25%) of 484 reached a National Early Warning Score (second version; NEWS2) of 7 or higher, 67 (14%) of 495 reached a Kidney Disease-Improving Global Outcome (KDIGO) stage of 2 or higher, and 41 (8%) of 510 underwent dialysis. All patients received ribavirin for a median of 10 days (IQR 9-13). 62 (12 …

A novel digital health approach to improving global pediatric sepsis care in Bangladesh using wearable technology and machine learning.

Sepsis is the leading cause of child death globally with low- and middle-income countries (LMICs) bearing a disproportionate burden of pediatric sepsis deaths. Limited diagnostic and critical care capacity and health worker shortages contribute to delayed recognition of advanced sepsis (severe sepsis, septic shock, and/or multiple organ dysfunction) in LMICs. The aims of this study were to 1) assess the feasibility of a wearable device for physiologic monitoring of septic children in a LMIC setting and 2) develop machine learning models that utilize readily available wearable and clinical data

Combining baloxavir marboxil with standard-of-care neuraminidase inhibitor in patients hospitalised with severe influenza (FLAGSTONE): a randomised, parallel-group, double-blind, placebo-controlled, superiority trial.

BACKGROUND: Neuraminidase inhibitors (NAIs) are considered the standard of care for hospitalised patients with influenza. We aimed to test w … ere hospitalised with laboratory-confirmed influenza (by RT-PCR or a rapid test) and had a National Early Warning Score 2 (NEWS2) of 4 or greater were included. Recruitment took place in 124 centres across 25 countries. Using a permuted-block method and an interactive response system, patients were randomly assigned (2:1) to receive either baloxavir plus NAIs (hereaf …

Clinical characterisation, treatment outcomes, and case fatality risk of patients with different SARS-CoV-2 variants in Bangladesh.

BACKGROUND: Bangladesh underwent four waves of the coronavirus disease 2019 (COVID-19) pandemic. Analysing them is essential for understandi … (aRR = 5.29; 95% CI = 1.58-17.7); critical disease (aRR = 6.45; 95% CI = 1.89-21.99), and modified early warning score ≥4 (aRR = 2.58; 95% CI = 1.71-3.88). We observed an 85% (aRR = 0.15; 95% CI = 0.03-0.72) reduction in case fatality among patients with any oxygen (L/min) compared to those without oxygen. However, individuals requiring ≥15 L/min of oxygen showed a …

Tocilizumab, netakimab, and baricitinib in patients with mild-to-moderate COVID-19: An observational study.

OBJECTIVE: The aim of the study was to assess inflammatory markers and clinical outcomes in adult patients admitted to hospital with mild-to-moderate COVID-19 and treated with a combination of standard-of-care (SOC) and targeted immunosuppressive therapy including anti-IL-17A (netakimab), anti-IL-6R (tocilizumab), or JAK1/JAK2 inhibitor (baricitinib) or with a standard-of-care therapy alone. METHODS: The observational cohort study included 154 adults hospitalized between February and August, 2020 with RT-PCR-confirmed SARS-CoV-2 with National Early Warning Score2 (NEWS2) < 7 and C-reactive pr…

Determining Whether a Definitive Causal Relationship Exists Between Aripiprazole and Tardive Dyskinesia and/or Dystonia in Patients With Major Depressive Disorder, Part 3: Clinical Trial Data.

This series of columns has 3 main goals: (1) to explain class warnings as used by the United States Food and Drug Administration, (2) to increase awareness of movement disorders that may occur in patients treated with antipsychotic medications, and (3) to understand why clinicians should refrain from immediately assuming a diagnosis of tardive dyskinesia/dystonia (TD) in patients who develop abnormal movements during treatment with antipsychotics. The first column in the series presented a patient who developed abnormal movements while being treated with aripiprazole as an augmentation strateg

Antiviral and immunomodulatory interferon-beta in high-risk COVID-19 patients: a structured summary of a study protocol for a randomised controlled trial.

OBJECTIVES: The primary objective of the study is to demonstrate the efficacy of low-dose IFN-β in reducing the risk of SARS-CoV-2 recently … n of patients experiencing a disease progression, during at least 5 days, according to the National Early Warning Score (NEWS2). The NEWS2 score is a standardized approach aimed at promptly detecting signs of clinical deterioration in acutely ill patients and establishing the potential need for higher level of care. It is based on the evaluation of vital signs, inclu …

Anti-influenza hyperimmune intravenous immunoglobulin for adults with influenza A or B infection (FLU-IVIG): a double-blind, randomised, placebo-controlled trial.

BACKGROUND: Since the 1918 influenza pandemic, non-randomised studies and small clinical trials have suggested that convalescent plasma or a … , 24·75 g maximum; hIVIG group) or saline placebo (placebo group). Eligible patients had a National Early Warning score of 2 points or greater at the time of screening and their symptoms began no more than 7 days before randomisation. Pregnant and breastfeeding women were excluded, as well as any patients for whom the treatment would present a health risk. Separate r …

Norwegian Coronavirus Disease 2019 (NO COVID-19) Pragmatic Open label Study to assess early use of hydroxychloroquine sulphate in moderately severe hospitalised patients with coronavirus disease 2019: A structured summary of a study protocol for a randomised controlled trial.

OBJECTIVES: The hypothesis of the study is that treatment with hydroxychloroquine sulphate in hospitalised patients with coronavirus disease 2019 (Covid-19) is safe and will accelerate the virological clearance rate for patients with moderately severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) when compared to standard care. Furthermore, we hypothesize that early treatment with hydroxychloroquine sulphate is associated with more rapid resolve of clinical symptoms as assessed by the National Early Warning Score 2 (NEWS2), decreased admission rate to intensive care units and mortality…

[Establishment and validation of a risk prediction model for disseminated intravascular coagulation patients with electrical burns].

Objective: To establish and validate a risk prediction model of disseminated intravascular coagulation (DIC) by the screening independent risk factors for the occurrence of DIC in patients with electrical burns. Methods: The retrospective case series study was conducted. The clinical data of 218 electrical burn patients admitted to Baogang Hospital of Inner Mongolia from January 2015 to January 2023 who met the inclusion criteria were collected, including 198 males and 20 females, with the age of (38±14) years. The patients were divided into DIC group and non DIC group based on whether they we

Procalcitonin testing combined with NEWS2 evaluation compared with usual care based on NEWS2 for identification of sepsis and antibiotic initiation in the emergency department in England and Wales (PRONTO): a multicentre, randomised, controlled, open-label, phase 3 trial.

BACKGROUND: Sepsis is a common and serious condition, defined as a dysregulated host response to infection, that leads to life-threatening o … s in the usual care group were assessed according to standard clinical management based on National Early Warning Score 2 (NEWS2). In the procalcitonin-guided care group, rapid procalcitonin testing was used in combination with NEWS2 assessment by use of a guidance-only algorithm for clinicians. This algorithm for clinical management was used for both usual care and …

Characteristics of patients with abdominal and/or pelvic injuries presenting to Emergency Departments.

&lt;b&gt;Introduction:&lt;/b&gt; This study characterizes patients with abdominal and/or pelvic trauma admitted to Emergency Departments (ED … cases involving lowenergy blunt trauma. Expanding on existing assessment tools, including modified early warning scores (MEWS) and geriatric trauma triage criteria, could help differentiate stable but at-risk patients from those who can be safely discharged.

Sepsis Care Pathway 2019.

Background: Sepsis, a medical emergency and life-threatening disorder, results from abnormal host response to infection that leads to acute organ dysfunction1. Sepsis is a major killer across all ages and countries and remains the most common cause of admission and death in the Intensive Care Unit (ICU)2. The true incidence remains elusive and estimates of the global burden of sepsis remain a wild guess. One study suggested over 19 million cases and 5 million sepsis-related deaths annually3. Addressing the challenge, the World Health Assembly of the World Health Organisation (WHO) passed a res

Long-term intravenous treatment of Pompe disease with recombinant human alpha-glucosidase from milk.

OBJECTIVE: Recent reports warn that the worldwide cell culture capacity is insufficient to fulfill the increasing demand for human protein drugs. Production in milk of transgenic animals is an attractive alternative. Kilogram quantities of product per year can be obtained at relatively low costs, even in small animals such as rabbits. We tested the long-term safety and efficacy of recombinant human -glucosidase (rhAGLU) from rabbit milk for the treatment of the lysosomal storage disorder Pompe disease. The disease occurs with an estimated frequency of 1 in 40,000 and is designated as orphan di

Review of the Longitudinal Management of Autoimmune Encephalitis, Potential Biomarkers, and Novel Therapeutics.

Purpose of reviewIncreasing awareness and earlier diagnosis of autoimmune encephalitis (AE) have led to a greater number of patients being cared for longitudinally by neurologists. Although many neurologists are now familiar with the general approach to diagnosis and acute immunosuppression, this review aims to provide neurologists with guidance related to management beyond the acute phase of disease, including long-term immunosuppression, monitoring, potential biomarkers of disease activity, outcome measures, and symptom management.Recent findingsObservational studies in AE have demonstrated

Clusterin and pentraxin 3 are markers of severity during febrile neutropenia in adults with haematological malignancies receiving intensive chemotherapy.

The identification of predictive biomarkers of severity can improve patient management because febrile neutropenia can be associated with significant morbidity and mortality. We prospectively studied pentraxin 3 (PTX3), a soluble innate immunity receptor, and clusterin (CLU), a chaperone protein that binds extracellular histones during sepsis, in patients experiencing febrile neutropenia after intensive treatment for haematological malignancies. One hundred and forty-three adult patients were included, with 158 episodes of neutropenia analysed. Febrile neutropenia was observed in 119 patients

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… Other so‐called ‘Early Warning Scores’, such as the NEWS (National Early Warning Score), 37 could be used to identify the risk of mortality at an earlier stage. It appears to be as effective as qSOFA in assessing mortality risk, 38 and further studies are needed to compare the added value of each. … Comparison of early warning scoring systems for hospitalized patients with and without infection at risk for in‐hospital mortality and transfer to the intensive care unit. JAMA Netw Open. 2020;3(5):e205191. 10.1001/jamanetworkopen.2020.5191 38. …

Monoclonal Antibodies Approved for Cancer Therapy

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