Panminerva medica
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The aim of this study was to summarize the administration model of a COVID-19 designated hospital transformed from a community hospital to improve the emergency capacity of community hospitals and the efficiency of diagnosis and treatment of medical staff in the COVID-19 pandemic. This study analyzed the surrounding environment, ward layout, area management, treatment process, medical staff, and patient management of the designated community hospital. From February 5, 2020, to February 18, 2020, the designated community hospital has received 198 COVID-19 mild and general patients (including 41 in the hospital at the beginning of the period). ⋯ Its diagnosis and treatment model has completed the treatment of COVID-19 patients successfully. After adjustment, this community hospital can shoulder the critical task of being a designated hospital for COVID-19, which includes admission, isolation, and therapy of suspected and mild COVID-19 patients, reducing the medical burden of superior hospitals. Our experience provides concepts for community hospitals to temporarily undertake medical responsibilities to reduce the spread of COVID-19 during the pandemic.
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In patients admitted for acute myocardial infarction (MI), it has been demonstrated that reducing LDL cholesterol (LDL-c) is associated with a reduction in major adverse cardiovascular events. We describe a consensual proposal made by a French group of experts for lipid-lowering therapy at the acute phase of acute myocardial infarction. ⋯ We describe a strategy for the use of statins, ezetimibe and and/or proprotein convertase subtilisin-kexin type 9 (PCSK9) inhibitors, with a view to reaching target LDL-c levels as early as possible. This approach, which is currently feasible in France, could considerably improve lipid management in patients after ACS, thanks to its simplicity, rapidity and the magnitude of the decrease in LDL-c that it achieves.
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To assess the clinical effectiveness of Tocilizumab (TCZ) in moderate-to-severe hospitalized COVID-19 patients and factors associated with clinical response. ⋯ Our real-life study suggests clinical efficacy of TCZ in moderate-to-severe COVID-19 patients but not in end-stage disease. Thus, to enhance TCZ effectiveness, patients should be selected before grave compromise of clinical conditions.
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Cardiac amyloidosis (CA) often mimics heart failure with preserved ejection fraction (HFpEF). Due to very different treatment strategies, an exact diagnosis and differentiation between pure HFpEF and CA-related heart failure (HF) is important. In the present study, we assessed the recently published H
2 FPEF score in patients with pure HFpEF, transthyretin (ATTR), as well as light chain (AL) amyloidosis-related HFpEF and tested whether it differentiates between these entities. ⋯ The H2 FPEF score should be used with caution, as there is a significant overlap between HFpEF and CA-related HF.