- NHL delays Vancouver Canucks' return to play...on April 15, 2021 at 3:40 pm
The Canucks, who have not played a game since March 24 due to a COVID-19 outbreak, had been scheduled to host the Edmonton Oilers on Friday night.
- Stanford begins testing Pfizer COVID-19 vaccine...on April 15, 2021 at 3:10 pm
As statewide eligibility for the COVID-19 vaccine expands to residents 16 and older, researchers at Stanford Medicine have set their sights on an even younger group: children ages 2 to 5. The medical ...
- NHL COVID-19 protocol list tracker: More than 150...on April 15, 2021 at 2:55 pm
Players that have appeared on the league's COVID-19 Protocols List can be the result of several factors including: An initial positive test which remains unconfirmed until confirmatory testing is ...
- CDC: 'breakthrough case' numbers show vaccines...on April 15, 2021 at 2:49 pm
Almost 6,000 "breakthrough cases" of infections have been reported – far less than 1% of the 76M Americans who are fully vaccinated. Latest COVID news.
- Spring wave of coronavirus crashes across 38...on April 15, 2021 at 2:33 pm
Vaccines drive down covid-19 mortality, even as the CDC reports 5,800 “breakthrough” infections in people who had received shots.
- Coronavirus Briefing: What Happened Todayon April 15, 2021 at 2:16 pm
This is the Coronavirus Briefing, an informed guide to the pandemic. Sign up here to get this newsletter in your inbox. Workers in India are fleeing large cities as the country logs 200,000 daily ...
- The Latest: COVID-19 blamed for large increase in...on April 15, 2021 at 1:59 pm
NEW YORK — New U.S. government data shows that the country saw somewhere around 600,000 more deaths than usual during a 13-month span. COVID-19 was blamed for most of those deaths.
- Annual Covid-19 Vaccine Booster Shots Likely...on April 15, 2021 at 1:02 pm
Due to variants of the coronavirus, people likely will need a booster shot within a year to suppress the pool of those individuals susceptible to Covid-19, Pfizer Chief Executive Albert Bourla said ...
Continuous Renal Replacement Therapies (CRRT) are dialysis treatments that are provided as a continuous 24 hour per day therapy.
GiViTI COVID19 MEETING 10 March 2020 – ICU PATIENTS
- The average age of patients is about 70 years old.
- The most frequent co-morbidity is OBESITY.
- A clear majority of patients are males.
- On admission PaO2/FiO2 < 100.
- CXR on presentation usually bilateral interstitial pneumonitis (can be asymmetric if co-infections).
- Beware of swab results as they may be negative initially. Clinical impression is more reliable. Confirmation often comes only later via BAL, as pulmonary involvement is lower.
- Pro-calcitonin (PCT) = 0 (in the absence of co-infections).
- High CRP.
- High LDH.
- Elevated liver enzymes (from virus +/- medications).
- High CK especially in younger patients (who usually have high fever, chills etc.).
- Extreme elevation of, and difficult to control blood glucose levels, often causes ketoacidosis.
- Low albumin (collected in the lungs??).
- Lymphopenia (low CD4).
- BNP normal.
- Lopinavir/ritonavir (KALETRA) 200/50 mg po BID.
- Chloroquine 500 mg po BID or hydroxychloroquine 200 mg po BID.
- Prophylactic antibiotics (variable according to local practice: piperacillin/tazobactam, ceftriaxone, TMP/SMX, antifungals (the use of azithromycin has been abandoned).
- Acetylcysteine 300 mg po TID (secretions not abundant, but dense when present).
- Steroids? Only in cases with fibrosis (do not use prematurely).
- Tocilizumab? IL-6 receptor inhibitor. Rationale is vast inflammation BUT use must be evaluated in setting of lymphopenia. At the moment NO indication for routine use and NO precocious use.
- Profound sedation.
- Fluid balance net NEGATIVE: the lungs act like sponges due to inflammation.
- Protective ventilation (require high PEEP, even > 15 cm H20, monitor carefully for possible complications such as subcutaneous emphysema, PNX – tolerate pH up to 7.3 – in contrast to classical ARDS, patients usually have good compliance and can be ventilated without high driving pressure).
- PRONE POSITION (18-24 hour duration – fundamental principle of management = extremely effective – require up to 7 rotations – do not trust initial improvement and continue this therapy at least until clear signs of progress with therapy).
- Tracheostomy often within 7 days allows for earlier and safer weaning attempts (high risk of relapse).
- CRRT? Reserve for patients with greatest chance of favorable outcome for the following reasons: increases labor burden on nursing staff, greater difficulties with prone position, creates problem of disposal of infected bags/waste.
- Nitric Oxide: have not seen significant beneficial effects, but can be useful in gaining time for the most critical patients (extreme therapy).
- ECMO: rarely necessary, because patients are very responsive to adequate ventilation. Indicated in cases of patients not responsive to therapy and extreme hypoxia.
- CXR to define clinical presentation. May be repeated but imaging does not correlate strictly with clinical condition.
- CT Chest NOT indicated because great difficulty of transport, great risk of spreading contagion
- U/S Chest highly indicated for daily assessment of pulmonary condition (PATTERN 1: diffuse B lines, PEEP responder – PATTERN 2: anterior zone clear, posterior zone consolidation, responsive to prone position) – useful in evaluating complications from high PEEP and recruiting maneuvers.
- Echocardiography: look out for dyskinesia (myocarditis?).
- Decrease in inflammatory parameters (CRP, LDH).
- PEEP < 12 cm H2
- PaO2/FiO2 > 150.
- FiO2 ≤ 50%.
- Do not trust initial improvement, because patients may experience early relapse.
- Maxi-Peel #3by Trader in LA on January 25, 2021 at 5:06 am
Strongest exfoliant solution in MaxiPeel's 1-2-3 skin renewal system. Available in 30mL and 60mL. Price is subject to change. * LOW STOCK The post Maxi-Peel #3 appeared first on Trader in LA.
- Maxi-Peel #2by Trader in LA on December 24, 2020 at 5:05 pm
Medium-strength exfoliant solution in MaxiPeel's 1-2-3 skin renewal system. tretinoin hydroquinone 0.025 | 2% Solution Available in 30mL and 60mL. ** LOW STOCK ** Price is subject to change. The post Maxi-Peel #2 appeared first on Trader in LA.
- Maxi-Peel #1by Trader in LA on November 25, 2020 at 12:48 am
The mildest exfoliant solution in MaxiPeel's 1-2-3 skin renewal system. Currently only the smaller 30mL size is available. Price is subject to change. *** LOW STOCK *** The post Maxi-Peel #1 appeared first on Trader in LA.
- Polvoron Moldersby Trader in LA on May 1, 2020 at 3:00 pm
Stainless-steel molds for shaping the Filipino treats called polvoron. Prices on eBay are subject to change. The post Polvoron Molders appeared first on Trader in LA.