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Clinical Efficacy of Inhaled Nitric Oxide in Preventing the Progression of Moderate to Severe COVID-19 and Its Correlation to Viral Clearance:Results of a Pilot Study

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Infectious Microbes & Diseases 2022年第1期4卷 26-33页

作者： Merlin Moni thushara Madathil dipu t.sathyapalan Veena Menon Georg Gutjahr Fabia Edathadathil Deepthi Sureshkumar Preetha Prasanna Soumya Jose Roshni Jerome Ajai Krishnan Indulekha C.L.Pillai Geetha Kumar Bipin Nair Victor Nizet Aveek Jayant Department of Medicine Division of Infectious DiseasesAmrita Institute of Medical ScienceAmrita Vishwa VidyapeethamKochiKeralaIndia Department of Cardiac Anaesthesiology Amrita Institute of Medical ScienceAmrita Vishwa VidyapeethamKochiKeralaIndia Clinical Virology Laboratory Amrita Institute of Medical SciencesAmrita Vishwa VidyapeethamKochiKeralaIndia Center for Research in Analytics and technologies for Education(CREAtE) Amrita Vishwa VidyapeethamAmritapuriKollamKeralaIndia Department of Infection Control and Epidemiology Amrita Institute of Medical ScienceAmrita Vishwa VidyapeethamKochiKeralaIndia School of Medicine Amrita Institute of Medical ScienceAmrita Vishwa VidyapeethamKochiKeralaIndia School of Biotechnology Amrita Vishwa VidyapeethamAmritapuriKollamKeralaIndia Skaggs School of Pharmacy and Pharmaceutical Sciences University of CaliforniaSan DiegoLa JollaCaliforniaUSA Department of Pediatrics University of CaliforniaSan DiegoLa JollaCaliforniaUSA

Hypoxic patients with coronavirus disease 2019(COVID-19)are at high risk of adverse *** nitric oxide(iNO)has shown anti-viral and immunomodulatory effects in ***,in vivo evidence of efficacy in hypoxic COVID-19 is *** open label feasibility study was conducted at a single referral center in South India and evaluated the effectiveness of repurposed iNO in improving clinical outcomes in COVID-19 and its correlation with viral *** recruited hypoxemic COVID-19 patients and allocated them into treatment(iNO)and control groups(1:1).Viral clearance on day 5 favored the treatment group(100%vs 72%,Pthe speed of viral clearance as adjudged by normalized longitudinal cycle threshold(Ct)values was positively impacted in the treatment *** proportion of patients who attained clinical improvement,defined as a≥2-point change on the World Health Organization ordinal scale,was higher in the iNO cohort(n=11,79%)as compared to the control group(n=4,36%)(odds ratio 6.42,95%confidence interval 1.09–37.73,P=0.032).the proportion of patients progressing to mechanical ventilation in the control group(4/11)was significantly higher than in the treatment group(0/14).the all-cause 28-day mortality was significantly different among the study arms,with 36%(4/11)of the patients dying in the control group while none died in the treatment *** numbers needed to treat to prevent an additional poor outcome of death was estimated to be *** study demonstrates the putative role of repurposed iNO in hypoxemic COVID-19 patients and calls for extended validation.

关键词： nitric oxide COVID-19 antiviral activity WHO ordinal scale

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Role of endoscopic ultrasound guided fine needle aspiration/biopsy in the evaluation of intra-abdominal lymphadenopathy due to tuberculosis

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World Journal of Gastrointestinal Endoscopy 2021年第12期13卷 649-658页

作者： Harshavardhan Rao B Priya Nair S Krishna Priya Archana George Vallonthaiel dipu t sathyapalan Anoop K Koshy Rama P Venu Department of Gastroenterology Amrita Institute of Medical SciencesKochi 682041KeralaIndia Department of Pathology Amrita Institute of Medical SciencesKochi 682041KeralaIndia Department of Internal Medicine Amrita Institute of Medical Sciences and Research CentreKochi 682041KeralaIndia

BACKGROUND Intra-abdominal lymphadenopathy due to tuberculosis(tB)poses a diagnostic challenge due to difficulty in tissue *** endoscopic ultrasound guided fine needle aspiration/biopsy(EUS-FNA/B)has shown promise in the evaluation of mediastinal lymph nodes,its role in the evaluation of intra-abdominal lymphadenopathy is not *** to assess the role of EUS-FNA/B in the evaluation of intra-abdominal lymphadenopathy due to *** this was a retrospective study where patients with intra-abdominal lymphadenopathy who underwent evaluation with EUS-FNA/B were *** was diagnosed if the patient had any one of the following:(1)Positive acid fast bacilli(AFB)stain/tB GeneXpert/tB-polymerase chain reaction/AFB culture of tissue sample;and(2)Positive Mantoux test and response to anti-tubercular ***-FNA reports,clinical reports and imaging characteristics of patients were recorded for a detailed analysis of patients with *** A total of 149 patients underwent an EUS-FNA/B from lymph nodes(mean age 51±17 years,M:F=1.2).Benign inflammatory reactive changes were seen in 45 patients(30.2%),while 54 patients(36.2%)showed granulomatous inflammation with/without *** these,51 patients(94.4%)were confirmed to have tB as per pre-defined *** with tB were more likely to have hypoechoic and matted nodes[40 patients(67.7%)].EUS-FNA/B was found to have a sensitivity and specificity of 86%and 93%respectively,with a diagnostic accuracy of 88%in the evaluation of intra-abdominal lymphadenopathy due to *** EUS-FNA/B has a high diagnostic yield with a good sensitivity and specificity in the evaluation of intra-abdominal lymphadenopathy due to ***,the validity of these findings in populations with low prevalence of tB needs further evaluation.

关键词： Endoscopic ultrasound Lymph nodes tuberculosis Mesenteric Intraabdominal

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