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Clinical considerations for critically ill COVID-19 cancer patients:A systematic review

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World Journal of Clinical Cases 2021年第28期9卷 8441-8452页

作者： Chidambaram Ramasamy Ajay Kumar Mishra Kevin John John amos lal Department of Internal Medicine Saint Vincent HospitalWorcesterMA 01608United States Department of Medicine Bangalore Baptist HospitalBangalore 578954India Department of Medicine Division of Pulmonary and Critical Care MedicineMayo ClinicRochesterMN 55902United States

BACKGROUND The World Health Organization(WHO)on March 11,2020,had declared the novel coronavirus disease 2019(COVID-19)outbreak a global *** COVID-19 infection continues to be a pandemic and is currently causing overwhelming challenges to healthcare across the *** patients represent a unique population vulnerable to COVID-19 infection due to their advanced age,intrinsic frailty,medical comorbidities,immunosuppression,and frequent health care visits for their underlying *** analysis of COVID-19 infection among cancer patients is crucial to aid in the optimal management of these *** To identify contributors of worse outcomes in patients with malignancy and COVID-19 and to describe the role of critical *** In this review,we summarized the information from seminal articles on the presentation and management of patients with COVID-19 and malignancy that were published before December 10,*** searched the Pub Med and Medline database for“COVID-19”and“Cancer”,“Malignancy”.Studies published in English,including adults with malignancy and COVID-19 infection,were eligible to be included in this *** on patients that provided details on malignancy,clinical presentation,management,and outcome were *** details of malignancy that were included are the site of cancer,histopathological type,stage,chemotherapy,and *** of COVID-19 infection that were obtained are clinical presentation,the modality of testing,imaging,management,and *** care details that were obtained were the type of the organ dysfunction and the requirement of organ support measures,requirement of noninvasive,invasive ventilation,management of vasopressor support,and *** that did not have patient details,opinions,letters,and articles not published in English were *** articles were reviewed by 2 independent *** were screened for the above terminologies by independent clinician

关键词： COVID-19 Cancer Critical care Mortality Pandemic

Cocaine-induced methemoglobinemia

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World Journal of Emergency Medicine 2021年第1期12卷 81-82页

作者： Kamal Kant Sahu Ajay Kumar Mishra amos lal Ahmad Daniyal Siddiqui Susan VGeorge MD Medicine Saint Vincent HospitalWorcester 10608USA MD Medicine Mayo ClinicRochester 55905USA

Dear editor,We congratulate Chowdhury et al[1] for their excellentreport and successful management of a young ladysuffering from cocaine-induced *** this letter, we aim to address some additionalconcerns, which would ... 详细信息

关键词： editor letter caine

Update on retroperitoneal hematoma in children

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World Journal of Emergency Medicine 2020年第1期11卷 64-64页

作者： Kamal Kant Sahu Ajay Kumar Mishra amos lal Department of Internal Medicine Saint Vincent HospitalWorcester

Dear editor,We read with great interest the recent article by Badheka et al[1]published in your esteemed *** we would like to address few additional points related to childhood retroperitoneal hematoma(RPH).RPH can be broadly divided into two categories,trauma/procedure related or spontaneous ***,there may be one or more predisposing factors contributing for RPH:chronic liver disease,chronic kidney disease,bleeding disorders,blood thinner,interventions and so on.

关键词： hematoma bleeding RPH

Association between COVID-19 and anxiety during social isolation:A systematic review

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World Journal of Clinical Cases 2021年第25期9卷 7433-7444页

作者： Erlene Roberta Ribeiro dos Santos Jose Lucas Silva de Paula Felipe Maia Tardieux Vânia NazaréCosta-e-Silva amos lal Antonio Flaudiano Bem Leite Department of Neuropsychiatry and Behavioral Science-Neurosciences Research Circle on TechnologiesStrategies and Instruments Applied to Collective HealthVitória de Santo Antão 55608680Brazil Department of Collective Health Research Circle on TechnologiesStrategies and Instruments Applied to Collective HealthVitória de Santo Antão 55608680Brazil State Audit Component of the Unified Health System State Health SecretariatRecife 50751530Brazil Department of Medicine Division of Pulmonary and Critical Care MedicineMayo ClinicRochesterMN 55905United States Department of Epidemiological Surveillance Henrique de HolandaMunicipal Health SecretariatVitória de Santo Antão 55608680Brazil

BACKGROUND The uncertainties about coronavirus disease 2019(COVID-19),the change in routine,lifestyles and the reduction of physical contact can cause stress,anxiety,emotional overload,poor sleep and even physical health *** To evaluate the scientific publications available on the relationship between COVID-19 and anxiety experienced in the general population,during the period of social isolation,adopted by governmental organizations and public health policymakers as a measure to contain the spread of *** A literature search was performed systematically exploring the PubMed and Medline databases using the following terms classified as MeSH descriptors:(“anxiety”AND“pandemic”AND“COVID-19”).For the search,in the Biblioteca Virtual em Saúde–BVS,***,Web of Science and National Library plat forms, the following keywords were used: ("anxiety" AND "coronavirus" AND"social isolation"). Thirty-seven peer-reviewed articles were found. PRISMA andthe Downs & Black checklist were used for qualitative *** applying the inclusion criteria, seven (n = 7) original scientific articles wereselected. The collated evidence demonstrated increased levels of symptoms ofanxiety and depression during the period of social isolation. The populationbetween 21 to 40 years was most affected. The risk of severe depression was twiceas high at the epicenter of the pandemic. Sleep quality was significantly *** about politics, religion, and consumption of products from China werefound to generate fear and anticipate probable changes in the pattern of postpandemicconsumption. Social isolation exacerbated feelings of extreme hopelessness,sadness, loneliness and suicidal *** conclude that there is a potential relationship between social isolation duringthe COVID-19 pandemic and symptoms of anxiety. It is important to note that thedirect and indirect costs of not identifying the detrimental effects of thisphenomenon and ne

关键词： Pandemic COVID-19 Anxiety Social isolation Mental health Public health

Artificial intelligence and computer simulation models in critical illness

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World Journal of Critical Care Medicine 2020年第2期9卷 13-19页

作者： amos lal Yuliya Pinevich Ognjen Gajic Vitaly Herasevich Brian Pickering Department of Medicine Division of Pulmonary and Critical Care MedicineRochesterMayo ClinicMN 55905United States Multidisciplinary Epidemiology and Translational Research in Intensive Care Group Mayo ClinicRochesterMN 55905United States Department of Anesthesiology and Perioperative Medicine Division of Critical CareMayo ClinicRochesterMN 55905United States

Widespread implementation of electronic health records has led to the increased use of artificial intelligence(AI)and computer modeling in clinical *** early recognition and treatment of critical illness are central to good outcomes but are made difficult by,among other things,the complexity of the environment and the often non-specific nature of the clinical ***,AI applications are being proposed as decision supports for busy or distracted clinicians,to address this *** driven“associative”AI models are built from retrospective data registries with missing data and imprecise *** AI models lack transparency,often ignore causal mechanisms,and,while potentially useful in improved prognostication,have thus far had limited clinical *** be clinically useful,AI tools need to provide bedside clinicians with actionable *** addressing causal mechanisms not only increases validity and replicability of the model,but also adds transparency and helps gain trust from the bedside clinicians for real world use of AI models in teaching and patient care.

关键词： Artificial intelligence Digital twin Critical illness Predictive enrichment Causation Simulation models

Presentation and outcome of myocardial infarction with nonobstructive coronary arteries in coronavirus disease 2019

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World Journal of Critical Care Medicine 2022年第3期11卷 129-138页

作者： Kevin John amos lal Nitish Sharma Amr ElMeligy Ajay K Mishra Department of Critical Care Believers Church Medical College HospitalThiruvalla 689103KeralaIndia Division of Pulmonary&Critical Care Medicine Mayo ClinicRochesterMN 55905United States Division of Cardiology Saint Vincent HospitalWorcesterMA 01608United States Division of Interventional Cardiology Saint Vincent HospitalWorcesterMA 01608United States Department of Cardiovascular Medicine Saint Vincent HospitalWorcesterMA 01608United States

Among the cardiac complications of coronavirus disease 2019(COVID-19),one increasingly reported in the literature is myocardial infarction with nonobstructive coronaries(MINOCA).We reviewed all reported cases of MINOCA in COVID-19 patients to summarize its clinical features,evaluation,and *** performed a literature search in Pubmed using the search terms‘COVID-19’and‘MINOCA’or‘non-obstructive coronaries’.Among the reported cases,the mean age was 61.5 years(SD±13.4),and 50%were *** pain was the presenting symptom in five patients(62.5%),and hypertension was the most common comorbidity(62.5%).ST-elevation was seen in most patients(87.5%),and the overall mortality rate was 37.5%.MINOCA in COVID-19 is an entity with a broad differential ***,a uniform algorithm is needed in its evaluation to ensure timely diagnosis and management.

关键词： COVID-19 Myocardial infarction with non-obstructive coronary arteries Outcome

Utility of cardiac bioenzymes in predicting cardiovascular outcomes in SARS-CoV-2

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World Journal of Virology 2022年第5期11卷 375-390页

作者： Anjani Muthyala Sandeep Sasidharan Kevin John John amos lal Ajay K Mishra Department of Internal Medicine Saint Vincent HospitalWorcesterMA 01608United States Department of Critical Care Belivers Church Medical College HospitalThiruvalla 689103KerelaIndia Department of Medicine Division of Pulmonary and Critical Care MedicineMayo ClinicRochesterMN 55905United States Department of Cardiology Saint Vincent HospitalWorcesterMA 01608United States

BACKGROUND Cardiovascular complications have been increasingly recognized in the severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)associated coronavirus disease 2019(COVID-19).Cardiac biomarkers are released because of this ongoing cardiovascular injury and can act as surrogate markers to assess the disease *** To review the variation and utility of these biomarkers in COVID-19 to ascertain their role in diagnosis,prognosis and clinical outcomes of the *** We performed a literature search in PubMed,Medline and the Reference Citation Analysis(RCA),using the search terms“COVID-19”and“cardiac bioenzymes”or“cardiac biomarkers”.Additionally,we also used the latest reference citation analysis tool to identify more *** Cardiac troponin has been consistently elevated in patients with COVID-19 associated myocarditis,and strongly correlated with adverse *** peptides including brain natriuretic peptide(BNP)and pro-BNP is elevated in patients with COVID-19 associated cardiac injury,irrespective of their prior heart failure status,and independently correlated with worst *** these traditional biomarkers,novel cardiac bioenzymes including presepsin,soluble ST2 and copeptin,are also increasingly recognized as markers of cardiovascular injury in COVID-19 and can be associated with poor *** Assessment of cardiac bioenzymes at admission and their serial monitoring can help assess the severity of disease and predict mortality in patients with SARS-CoV-2 *** studies are needed to elude the critical importance of novel biomarkers.

关键词： SARS-CoV-2 Troponin Brain natriuretic peptide Prognosis Outcomes Heart failure

Predictive modeling in neurocritical care using causal artificial intelligence

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World Journal of Critical Care Medicine 2021年第4期10卷 112-119页

作者： Johnny Dang amos lal Laure Flurin Amy James Ognjen Gajic Alejandro A Rabinstein Mayo Clinic Alix School of Medicine Mayo ClinicRochesterMN 55905United States Department of Medicine Division of Pulmonary and Critical Care MedicineMultidisciplinary Epidemiology and Translational Research in Intensive CareMayo ClinicRochesterMN 55905United States Division of Clinical Microbiology Mayo ClinicRochesterMN 55905United States Department of Medicine Mayo ClinicRochesterMN 55905United States Department of Medicine Department of NeurologyMayo Clinic College of MedicineRochesterMN 55905United States

Artificial intelligence(AI)and digital twin models of various systems have long been used in industry to test products quickly and *** of digital twins in clinical medicine caught attention with the development of Archimedes,an AI model of diabetes,in *** recently,AI models have been applied to the fields of cardiology,endocrinology,and undergraduate medical *** use of digital twins and AI thus far has focused mainly on chronic disease management,their application in the field of critical care medicine remains much less *** neurocritical care,current AI technology focuses on interpreting electroencephalography,monitoring intracranial pressure,and prognosticating *** models have been developed to interpret electroencephalograms by helping to annotate the tracings,detecting seizures,and identifying brain activation in unresponsive *** this mini-review we describe the challenges and opportunities in building an actionable AI model pertinent to neurocritical care that can be used to educate the newer generation of clinicians and augment clinical decision making.

关键词： Artificial intelligence Digital twin Critical care Neurology Causal artificial intelligence Predictive modeling

Heart failure in COVID-19 patients:Critical care experience

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World Journal of Virology 2022年第1期11卷 1-19页

作者： Kevin John John Ajay K Mishra Chidambaram Ramasamy Anu A George Vijairam Selvaraj amos lal Department of Critical Care Believers Church Medical College HospitalThiruvalla 689103India Department of Internal Medicine Division of Cardiovascular MedicineSaint Vincent HospitalWorcesterMA 01608United States Division of Medicine The Miriam Hospital and Warren Alpert Medical School of Brown UniversityProvidenceRI 02906United States Department of Medicine Division of Pulmonary and Critical Care medicineMayo ClinicRochesterMN 55902United States

Patients with heart failure(HF)may be at a higher risk of coronavirus disease 2019(COVID-19)infection and may have a worse outcome due to their comorbid conditions and advanced *** this narrative review,we aim to study the interaction between COVID-19 and HF from a critical care *** performed a systematic search for studies that reported HF and critical carerelated outcomes in COVID-19 patients in the PubMed and Medline *** a total of 1050 papers,we identified 26 that satisfied the eligibility criteria for our *** such as patient demographics,HF,intensive care unit(ICU)admission,management,and outcome were extracted from these studies and *** reported outcomes in heart-transplant patients with COVID-19 *** hospitalized patients with COVID-19,the prevalence of HF varied between 4%and 21%.The requirement for ICU admission was between 8%and 33%.HF patients with COVID-19 had an overall mortality rate between 20%and 40%.We identified that HF is an independent predictor of mortality in hospitalized COVID-19 patients,and patients with HF were more likely to require ventilation,ICU admission and develop *** with HF with reduced ejection fraction did worse than those with HF with midrange ejection fraction,and HF with preserved ejection ***-19 patients with HF should be identified early and managed aggressively in an attempt to improve outcomes in this cohort of patients.

关键词： Heart failure COVID-19 Critical care Intensive care Mortality