Presumption & Prevention

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Presumption & Prevention

49  articles in this collection
Written by Mathias Castonguay, Laurie-Anne Duquette, Camille Blouin, Noémie Desgagnés, 

Adapting treatment strategy for neovascular age-related macular degeneration in the current pandemic context

The proposed treat-and-plan (TAP) regiment, which involved two types of visits: Assessment visits should be allocated time as per standard practice as those include: check-in (5 min), visual acuity (5 min), dilation (10 min), optical coherence tomography (OCT) (5 min), ophthalmic examination, and injection (10 min) For OCT evaluations, authors recommend obtaining only the necessary […]

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05/20/2020

Infection Control Measures in Ophthalmology

Administrative control Reschedule appointments and arrange drug refill, in order to lower patient attendance. Establish a patient triage system to minimize cross infection of COVID-19 (identify patient with fever, respiratory symptoms, acute conjunctivitis or recent travel). Promote infection control training and staff monitoring (measure their own body temperatures before work and promptly report any symptoms). […]

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05/20/2020

Health Literacy

Almost half of adults in Europe have reported having problems with health literacy and not having enough competencies to take care of their health and that of others. It is difficult to enhance health literacy because the COVID-19 pandemic has emerged rapidly and immediate actions are required by governments and citizens. Irrational behaviors in non-compliance with COVID-19 policies might be […]

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05/27/2020

Guidelines: Aesthetic Clinic Reopening

1. Guidelines for patient scheduling:  Advance scheduling on the phone or online should be compulsory and walk-in patients should be discouraged.  Time gap between the appointments should be evaluated according to the clinic’s features to allow social distancing.  Patient should be encouraged to visit the clinic alone, with a mask and their own pen if […]

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05/26/2020

Ultrasound Considerations in Early Pregnancy

 Scan should be offered without delay in cases of abdominal/pelvic pain with no previous scan showing live intrauterine pregnancy, heavy bleeding with systemic symptoms or high suspicion of ectopic pregnancy. In cases of moderate bleeding or resolved heavy bleeding, it is suggested to use teleconsultation and ask the patient to take a pregnancy test. If […]

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04/15/2020

Postpartum Care and Breastfeeding

Delayed umbilical cord clamping does not seem to increase pathogens transmission. Leaving vernix caseosa in place 24h after birth can be considered due to the presence of antimicrobial peptides. The majority of neonatal infections are caused by the environment and droplet transmission from the mother and other relatives.  Physical separation at birth can be considered […]

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03/28/2020

Gynecological Ultrasound Management

Indications for immediate assessment : Acute persistent pelvic pain, to rule out ovarian torsion, ruptured ovarian cyst, PID and tubo-ovarian abscess; Suspicion for postoperative complications or hyperstimulation syndrome; Abdominopelvic mass provoking systemic symptoms; AUB causing hemodynamic instability or severe anemia.   Indications to delay scan for 2-4 weeks : Risk for malignancy : family history […]

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04/10/2020

Sleep Disturbance During the Confinement

1. Because of quarantine, sleep quality may be affected by major changes in routines (less physical activity, less exposure to daylight, homeworking and homeschooling), living with uncertainty (for example, about duration of the situation) and with insecurity (for example, about health and financial situation), social isolation and lack of rewarding activity. 2. Insomnia is a […]

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05/21/2020

Vaccine Development Landscape

This list shows candidate vaccines and their research stage on May 20th, 2020.  Candidate vaccines in clinical evaluation: 9 Vaccine  Platform Developer/ Location Stage Ad5-nCoV Non- Replicating Viral Vector CanSinoBiological Inc./ Beijing Institute of Biotechnology (China) Phase II ChiCTR2000031781  Phase I ChiCTR2000030906  mRNA-1273 RNA Moderna/NIAID (U.S.) Phase 2 (IND accepted) Phase 1 NCT04283461 ChAdOx1 nCoV-19 […]

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04/26/2020

Understanding the Role of Vitamin D

Does vitamin D supplementation have a role in COVID-19? A striking observation about COVID-19 is the greater severity among different populations. Indeed, statistics show that older age, non-Caucasian individuals, male gender, obesity and patients with multiple comorbidities have poorer outcomes. Moreover, most respiratory viruses peak during winter. Vitamin D deficiency, which is more prevalent in […]

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05/17/2020

Epidemiology and Transmission in Pregnancy

Epidemiology : Epidemiological and transmission tendencies are like those seen in non-pregnant adults.  Consistent with findings in non-pregnant adults, the cases were predominantly classified as mild or common in terms of severity. Lag time between onset of symptoms and diagnosis was directly related to the severity of the infection.   Transmission via the reproductive system […]

Written by and
04/05/2020

Dermatological Surgery

Clinics should be triaged to review only urgent patients in person, and using telemedicine where possible. Consider cancelling all elective surgeries.  To minimize COVID-19 spread during office-based excisional surgery:  All surgical patients should be considered as potentially COVID-19 positive.  Smoke extractor systems are the most effective way to minimise risk. Using bipolar diathermy rather than […]

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04/16/2020

Neuroinvasive Potential of COVID-19

Previous studies have shown that CoVs, like SARS-CoV, have a tropism for the central nervous system. Due to its high similarity with SARS-CoV,  SARS-CoV-2 may also possess a similar neuroinvasive potential, which may partially explain the acute respiratory failure of COVID-19 patients. Review of past studies on coronaviruses’s propensity for neuroinvasion.   Source:  Li YC, […]

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03/28/2020

Psychological Consequences of Quarantine

Quarantine triggers a wide range of psychological symptoms and disorders, such as anxiety, irritability, anger, confusion, post-traumatic stress and depressive symptoms. The impact of quarantine on mental health may have long lasting consequences. A longer quarantine duration, fears of infection, frustration, boredom, inadequate supplies, inadequate information, financial loss, and stigma were reported as stress factors. […]

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04/04/2020

Artificial Intelligence to Prevent Suicides

COVID-19 pandemic has adverse effects on mental health and mental illness, and suicide risk factors are increased (such as anxiety, PTSD, depression, isolation, loss of employment and financial stressors).1 Some people experiencing mental distress might not seek help because of social distanciation.1 Development of artificial intelligence (AI) algorithms and machine learning could help identify individuals […]

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05/06/2020

Outpatient Management of COPD

Fundamental facts of interest for COPD management: The upregulation of ACE-2 is seen in smoker and COPD patients2. Gene expression levels of ACE-2 are also inversely related to individual’s forced expiratory volume in 1 second (FEV1)2. ACE-2 could protect animals from severe lung injury. This has been shown in a study using mice in a […]

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05/05/2020

Shared Decisions in Managing Neonates

Neonatal resuscitation: Could be performed either in a separate room or in the delivery room; If done in the delivery room, should at least be 6 feet/2m away from the mother. Infant placement: Can be placed either in a separate negative pressure room or in the same room; If mother wants to visit, she should […]

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05/04/2020

Carefully Resuscitating Newborns from Suspected or Confirmed Mothers

Generally: Assign a specific neonate resuscitation team to attend deliveries to minimize health care providers and non-infected mothers and infants’ exposure; Owing to an immature immune system, neonates, especially premature ones, could be at more risk of being infected postnatally; Predicting which infant will require intubation or deep suctioning is hard; consider airborne PPE for […]

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05/04/2020

Rationale Behind Coronaviruses’ Vaccines

What we know about SARS-CoV: Caused an outbreak in 2002; Immune responses are mediated by both humoral and cellular immunity; S protein is responsible for 3 important mechanisms:  attachment of the virus by binding to the ACE2; entry in the host cells and membrane fusion; allowing release of the viral RNA. This makes S protein the […]

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04/06/2020

Advice for Families

Honest conversations with your kids about the situation and what you parents do to keep them safe is a key to stress management; Parents should maintain routine as much as possible; Pay special attention to social media exposure and misinformation. Choose trusted sources; Take the time to teach good preventive habits: handwashing techniques, washing surfaces […]

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04/17/2020

Multiple Myeloma : Management Suggestions

Regarding smoldering multiple myeloma (SMM): Standard-risk patients should be monitored without active intervention, as usual. For high-risk patients, the possibility of enrollment in clinical trials might be limited; consider a conservative approach with close monitoring and observation. Regarding newly diagnosed active multiple myeloma (MM): All patients should be screened for COVID-19 before starting induction therapy. […]

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05/03/2020

Should We Discontinue ACE-I and ARB?

Despite some evidence of up-regulation of ACE2 by RAAS inhibition, with its theoretically associated higher susceptibility to COVID-19 infection and increased viral load, there is currently no data suggesting a causal relationship between ACE2 activity and COVID-19 associated mortality; therefore, based on currently available data, the assumption of a causal relationship between ACE-I or ARB […]

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04/03/2020

Origin of SARS-CoV-2

The evidence strongly suggests that SARS-CoV-2 is not a laboratory creation nor an intentionally manipulated virus. The RBD (receptor-binding domain) sequence of the SARS-CoV-2 spike protein appears to bind with high affinity to human ACE2, but this sequence is different than those predicted to be optimal for receptor binding based on previous computational analyses on […]

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04/02/2020

Neuro-Oncologic Disease: Management Suggestions

Regarding surveillance and follow-up: Telemedicine appointments should replace routine in-clinic visits whenever possible. Outpatient radiology should remain accessible for patients and providers; radiology departments must establish protocols to limit risk of viral exposure for patients and staff. Regarding treatment and procedures: Consider whether treatment can be reasonably postponed until recovery; if it cannot, appropriate management […]

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04/27/2020

Impacts on Patients with Acute Leukemia

Missed or delayed diagnosis In the context of SARS-CoV-2 screening/diagnosis, full blood counts are performed only in a minority of symptomatic patients, as they are generally reserved to those with confirmed SARS-CoV-2 infection with associated signs of severity. The presenting symptoms of hematologic malignancies can be similar to those of COVID-19 infection; in fact, 50-75% […]

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04/17/2020