Updates Covid-19
Activity
26 April 2022
Paxlovid, Remdesivir, Molnupiravir: anti-viral drugs against Sars-Cov-2. Antiviral drugs against the SARS-CoV-2 virus have an exclusive indication in the phase of active viral replication, which corresponds to the first week of illness. Paxlovid and remdesivir have been provenly effective in educing the occurrence of complications such as the Severe Acute Respiratory Syndrome (ARDS) and reducing mortality through 28 days. On the other hand, Molnupiravir (Lagevrio) after the presentation of the data of the interim analysis, whereby the Merck company obtained the authorization for marketing by the Food and Drug Administration, did not resist criticism in the final analysis. This is why Molnupiravir is not held as a drug of first choice.
28 March 2022
Cardiopathy: vaccination against Sars-Cov-2 or exemption ? Myocarditis, pericarditis and even both may complicate common flu, Covid-19 and sometimes they are an adverse reaction to vaccination against SARS-Cov-2 virus, no matter the brand of the vaccine. Face to chronic heart diseases, the vaccinator may be puzzled whether it is of higher risk the vaccination or Covid-19 infection. The literature about epidemiology and severity of histological damages to the heart was reviewed and some practical advices given by some experts. The multimedia tutorial is complementary to the clinical review we made about SARS-COV-2 vaccination adverse reactions.
12 March 2022
Practical clinical cases to be exempt from the anti-Sars-Covid2 vaccination. Beyond its merits in containing the pandemic, vaccination is a delicate medical act and the doctor must carefully evaluate the risk for the patient's and her own protection. Therefore, if the vaccinator or general practitioner considers that risk to be too high, they should promptly take steps to formally exempt the patient on a temporary or permanent basis. Practical clinical cases encountered in which exemption from vaccination is recommended are reported here. Clinical cases include myocardio-pericarditis, heart failure, anaphylactic shock, urticaria and allergies in general, abnormal febrile reactions in previous vaccinations, Guillain-Barré polyneuritis, pulmonary embolism in close temporal correlation with vaccination without other predisposing factors.
21 May 2021
Results of controlled clinical trials on drugs used in Covid-19. Over the course of 16 months of the Covid-19 pandemic, a wide range of drugs were used and then adequately evaluated in randomized clinical trials. Most of these drugs have proven to be ineffective, if not harmful. Only monoclonal antibodies directed against the Spike protein have shown some efficacy in reducing the occurrence of severe acute respiratory syndrome. In Italy, there has also been an excess of hospitalizations for the execution of therapies that could have been carried out at home successfully and completely safely, including the supply of oxygen at low and medium flows, through the monitoring of clinical teleconsultation. Therefore, local medicine and Special Continuity of Care Units have failed to select patients according to criteria of therapeutic efficacy and resource saving, not having contributed to distributing patients more effectively than has happened in China where there are no local primary care facilities. Furthermore, it is likely that, at hospital level, the excessive use of prolonged positive pressure mechanical ventilation in elderly patients has contributed to increasing the fatality rate compared to other European countries.
07 Februray 2021
Anti-Covid vaccines as of February 2021. The vaccines for the SAS-Cov-2 virus available on the market are increasing. They all have the common characteristic of eliciting an immune reaction against the spike surface protein, which is responsible for attachment to the cells of the respiratory system, inoculating the messenger RNA, which encodes this protein, built in the laboratory. The immune reaction includes both the production of antibodies and the formation of a clone of immunocompetent T lymphocytes. For the moment, the difference between the various vaccines lies in the messenger RNA vehicle, which can be both a lipid nanoparticle and a non-pathogenic adenovirus. The challenge lies in the fact that SARS-Cov-2, like all coronaviruses, mutates very rapidly and therefore a variant could arise that encodes a modified spike protein that does not cross-react with the antibodies of the various vaccines.
18 November 2020
Rapid immunochromatographic test for Covid-19: how, when and why. The panic caused by Covid-19 has led to conflict between the three categories with violations of the privacy law and disclosure of professional secrecy. This video would like to stimulate the various parties to play their roles without interfering with the roles of others. In particular:
a) the non-medical employer must not become aware of the workers' sensitive data, much less handle it.
b) is the general practitioner who diagnoses and draws up certificates for absence from work.
c) the employer's responsibilities are confined to preventive measures only on work environments and procedures.
16 September 2020
Rapid immunochromatographic test for Covid-19: how, when and why. The general practitioner has received the rapid immunochromatographic test for the detection of IgM and IgG antibodies against the SARS-Cov-2 virus. Through interviews with family doctors, the indications, limitations, methods of execution and communication of the results are illustrated.
20 August 2020
Serological tests for Covid-19. The most reliable methods for the detection of anti-Covid19 antibodies are the immuno-enzymatic method (Elisa) and chemoiluminescence. Antibodies directed against the Spike protein are those most likely to be neutralizing. The immunohematologist Doctor Staffolani, with great experience as Director of Laboratories of the Marche Regional Health Authority (ASUR), illustrates the state of the art of Covid-19 serology.
14 August 2020
The Polymerization Chain Reaction (PCR) in the diagnosis of Covid-19 infection. The search for the RNA of the SARS-Cov-2 virus, responsible for the Covid-19 infection, is carried out on a nasopharyngeal swab and, on hospitalized and intubated patients, on bronchiolo-alveolar lavage fluid. The Chain Polymerization Reaction amplification technique is applied to these biological samples. Doctor Luigi Pianese of the Clinical Pathology - Analysis Laboratory of the Vast Area 5 of the ASUR Marche, illustrates the technique.
02 August 2020
Isolation of the SARS-Cov-2 virus in cell cultures. After its identification via Polymerase Chain Reaction in the nasopharyngeal swab or in bronchiolo-alveolar lavage, the SARS-Cov-2 virus may have a variable infecting capacity, measurable, together with other biological-clinical data, through isolation in cultures mobile phones. Doctor Laura Di Sante, from the Polytechnic University of Marche, illustrates the isolation technique.
28 June 2020
Pulmonary sequelae of Covid-19 infection and ventilatory support. To what extent are lung lesions from Covid-19 truly reversible? How can the discrepancies observed in the clinical course of lung lesions be explained genetically? What are the choices for ventilatory support in case of respiratory failure? These are the questions on which the bibliographic update of 6/28/2020 focuses.
12 May 2020
Bibliographic review updated on 10.05.2020. This is a bibliographical review updated to 10/5/2020. Computerized axial tomography images and autopsy histological findings are shown, in an attempt to reconstruct the histo-pathogenesis of the Covid-19 infection. Intravascular coagulation of the lung, subsequently extended to other organs, represents the most frequent cause of death. Furthermore, remote lung ultrasound techniques are explored in depth, the success factors of televideo consultation are analysed, the causes of errors in sampling and analysis of PCR on nasopharyngeal swab and the doubts that still plague the acquired immunity to the disease.
12 April 2020
Interview with Dr. Nando Campanella. Interesting interview carried out by Rado Tua of Ancona with Dr. Nando Campanella, medical biologist and WHO consultant and rebroadcast by Radio Idea and the broadcasters of the Airplay circuit.
3 April 2020
Clinical televideo consultation for patients suffering from Coronavirus Covid-19. The clinical televideo consultation procedures to support patients isolated at home during the Covid-19 pandemic are described,
19 March 2020
Scientific updates. The most qualified scientific literature on Covid-19 for the benefit of healthcare workers engaged in this difficult unexpected battle.