Clinical medicine (London, England)
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While vaccines against COVID-19 are being rolled out, an ongoing need remains for therapies to treat patients who have symptomatic COVID-19 before vaccination or in whom breakthrough infection develops. Dexamethasone and interleukin-6 inhibitors have been the mainstay of treatment for severe to critical COVID-19 requiring hospitalisation. ⋯ In particular, the development of neutralising monoclonal antibodies and novel antivirals represents a welcome expansion in the armamentarium against COVID-19, not only therapeutically to reduce mortality but also because they can be used in mild or moderate disease to prevent hospitalisation. This update is based on guidance from NHS England as well as the World Health Organization, and provides practical support and guidance to all clinicians involved or interested in the management of COVID-19 patients, whether based in community, outpatient or inpatient settings.
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Lack of clinical trial awareness has been identified as a barrier to clinical trial recruitment. Identifying factors associated with clinical trial knowledge could inform ongoing efforts to improve diversity in clinical trials. ⋯ There is a gap in knowledge about clinical trials among the US population. Development of multimodal approaches, including online and offline information broadcasting, is needed to improve knowledge and clinical trial recruitment in diverse populations.
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People who inject drugs are disproportionately affected by acute/chronic bacterial and viral infections that are a cause of significant morbidity. Clinical presentations to the acute medical take vary from skin and soft tissue infections to complications of bacteraemias, and can be challenging with difficulties in adherence, pain management, early self-discharges and loss to follow-up. This review summarises the most recent UK epidemiology of injecting drug use and infection as well as clinical presentation and management.