Drug discoveries & therapeutics
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Review
Review of current clinical management guidelines for COVID-19 with special reference to India.
The healthcare sector has been overwhelmed by the global rise in the number of COVID-19 cases. The primary care physicians at the forefront of this pandemic are being provided with multiple guidelines (state, national, international). ⋯ A discordance was noted between the national and state guidelines with respect to indication, duration and dosage of antivirals, steroids/immunomodulators, anticoagulation and convalescent plasma. The lack of concordance between various guidelines mandates the need for a unified national guideline that is regularly updated.
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The world is in the midst of the coronavirus disease 2019 (COVID-19) pandemic. Interleukin 6 (IL-6) inhibitor (tocilizumab) had been suggested for the treatment of acute respiratory distress syndrome (ARDS) patients based on the concept of "cytokine storm" in COVID-19. ⋯ Furthermore, IL-6 inhibitor has potential hazards of inducing infectious diseases. The efficacy of IL-6 monoclonal antibody-directed therapy remains to be fully evaluated.
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The SARS-CoV-2 virus emerged in December 2019 and then spread rapidly worldwide, particularly to China, Japan, and South Korea. Scientists are endeavoring to find antivirals specific to the virus. Several drugs such as chloroquine, arbidol, remdesivir, and favipiravir are currently undergoing clinical studies to test their efficacy and safety in the treatment of coronavirus disease 2019 (COVID-19) in China; some promising results have been achieved thus far. This article summarizes agents with potential efficacy against SARS-CoV-2.
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Observational Study
Exploring the causes of peripheral intravenous catheter failure based on shape of catheters removed from various insertion sites.
The risk of peripheral intravenous catheter failure varies according to the insertion site. This study examined catheter shape just after removal to evaluate the causes of catheter failure according to site. This study was a secondary analysis of previous study data. ⋯ Catheter curvature was related to catheter failure (14.8% of failed catheters had curvature; p = 0.035) and occlusion (35.3% of occluded catheters had curvature; p = 0.008) in upper arm and forearm placements. The median distance from the elbow to the insertion site was shorter for failed catheters than for surviving catheters. To prevent catheter failure, especially occlusion resulting from catheter curvature, a catheter should be inserted at an appropriate insertion site far from the antecubital fossa.
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Hepatocellular carcinoma (HCC) is the most common type of hepatic malignancies, with poor prognosis. Treatment for HCC are limited, especially for patients with advanced disease who are not eligible for curative hepatectomy or hepatic transplantation. Mechanisms of immune response during tumor development have been investigated for decades. ⋯ Here we reviewed the immunotherapy strategies for HCC, as well as the particularity of liver immune system and the immune tolerance of HCC. Vaccines, adaptive therapy, immune checkpoint blockades and cytokines are included. We hope this review will give us an integral concept on HCC immunotherapy and help the readers to understand the mechanism of immune tolerance in liver cancer.