Articles: disease.
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Early treatment of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections can prevent hospitalisation and death in patients with coronavirus disease 2019 (COVID-19) who have one or more risk factors for serious COVID-19 progression. While early treatment presents a range of logistical challenges, clinicians are nevertheless aided by a growing number of approved medications for early treatment of COVID-19. Medications include drugs that inhibit SARS-CoV-2 viral replication, anti-SARS-CoV-2 monoclonal antibody formulations that provide passive immunisation, and immunomodulatory drugs that suppress the body's inflammatory response. ⋯ As new drugs and new data on use of existing approved drugs become available, clinicians face a growing challenge in determining the optimal treatments from the array of options. As it stands, early treatment of COVID-19 needs to be individualised depending on age, pregnancy status, existing medications, and renal and liver disease status. Future treatments in development might have roles in patients with lower risk profiles and in reducing transmission as we learn to live with SARS-CoV-2.
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Randomized Controlled Trial Comparative Study
Evaluation of mRNA-1273 Vaccine in Children 6 Months to 5 Years of Age.
The safety, reactogenicity, immunogenicity, and efficacy of the mRNA-1273 coronavirus disease 2019 (Covid-19) vaccine in young children are unknown. ⋯ Two 25-μg doses of the mRNA-1273 vaccine were found to be safe in children 6 months to 5 years of age and elicited immune responses that were noninferior to those in young adults. (Funded by the Biomedical Advanced Research and Development Authority and National Institute of Allergy and Infectious Diseases; KidCOVE ClinicalTrials.gov number, NCT04796896.).
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Drug therapy for rheumatic diseases has changed fundamentally in recent decades with the introduction of many new agents. As these drugs may have to be taken for many years, and many of them are of similar efficacy, their safety profiles play an important role in therapeutic decisionmaking. ⋯ A suitable, safe antirheumatic drug can be chosen for each patient in consideration of individual risk profiles. Regular monitoring enables the early detection of adverse effects. The risk profile of JAK inhibitors, in particular, will be studied in further trials.
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Children and adolescents are a relevant and increasing proportion of travelers. Injuries and infectious diseases in children are safety concerns when traveling. However, data on diseases and injuries during international travels in children are not available. The aims of this study were to analyze travel-related diseases and injuries among pediatric travelers during and after international trips, to identify risk factors for travel-associated disease, and to evaluate the compliance and effectiveness of the recommendations provided in pre-travel appointments. ⋯ Disease/injury occurred in 15.2% of pediatric travelers. Even though 47.1% of the travelers required an urgent medical appointment, the developed conditions were not severe enough to warrant hospitalization. Travels to Africa and longer trips seem to be associated with a higher risk of disease and injury.