RevDate: 2025-12-17
CmpDate: 2020-07-01

Chieffo A, Stefanini GG, Price S, et al (2020)

EAPCI Position Statement on Invasive Management of Acute Coronary Syndromes during the COVID-19 pandemic.

EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology, 16(3):233-246.

The coronavirus disease 2019 (COVID-19) pandemic poses an unprecedented challenge to healthcare worldwide. The infection can be life threatening and require intensive care treatment. The transmission of the disease poses a risk to both patients and healthcare workers. The number of patients requiring hospital admission and intensive care may overwhelm health systems and negatively affect standard care for patients presenting with conditions needing emergency interventions. This position statements aims to assist cardiologists in the invasive management of acute coronary syndrome (ACS) patients in the context of the COVID-19 pandemic. To that end, we assembled a panel of interventional cardiologists and acute cardiac care specialists appointed by the European Association of Percutaneous Cardiovascular Interventions (EAPCI) and from the Acute Cardiovascular Care Association (ACVC) and included the experience from the first and worst affected areas in Europe. Modified diagnostic and treatment algorithms are proposed to adapt evidence-based protocols for this unprecedented challenge. Various clinical scenarios, as well as management algorithms for patients with a diagnosed or suspected COVID-19 infection, presenting with ST- and non-ST-segment elevation ACS are described. In addition, we address the need for re-organization of ACS networks, with redistribution of hub and spoke hospitals, as well as for in-hospital reorganization of emergency rooms and cardiac units, with examples coming from multiple European countries. Furthermore, we provide a guidance to reorganization of catheterization laboratories and, importantly, measures for protection of healthcare providers involved with invasive procedures.

RevDate: 2025-12-17
CmpDate: 2020-07-02

Klein JD, Koletzko B, El-Shabrawi MH, et al (2020)

Promoting and supporting children's health and healthcare during COVID-19 - International Paediatric Association Position Statement.

Archives of disease in childhood, 105(7):620-624.

RevDate: 2025-12-17
CmpDate: 2020-07-02

Farrell TW, Ferrante LE, Brown T, et al (2020)

AGS Position Statement: Resource Allocation Strategies and Age-Related Considerations in the COVID-19 Era and Beyond.

Journal of the American Geriatrics Society, 68(6):1136-1142.

Coronavirus disease 2019 (COVID-19) continues to impact older adults disproportionately, from severe illness and hospitalization to increased mortality risk. Concurrently, concerns about potential shortages of healthcare professionals and health supplies to address these needs have focused attention on how resources are ultimately allocated and used. Some strategies misguidedly use age as an arbitrary criterion, inappropriately disfavoring older adults. This statement represents the official policy position of the American Geriatrics Society (AGS). It is intended to inform stakeholders including hospitals, health systems, and policymakers about ethical considerations to consider when developing strategies for allocating scarce resources during an emergency involving older adults. Members of the AGS Ethics Committee collaborated with interprofessional experts in ethics, law, nursing, and medicine (including geriatrics, palliative care, emergency medicine, and pulmonology/critical care) to conduct a structured literature review and examine relevant reports. The resulting recommendations defend a particular view of distributive justice that maximizes relevant clinical factors and deemphasizes or eliminates factors placing arbitrary, disproportionate weight on advanced age. The AGS positions include (1) avoiding age per se as a means for excluding anyone from care; (2) assessing comorbidities and considering the disparate impact of social determinants of health; (3) encouraging decision makers to focus primarily on potential short-term (not long-term) outcomes; (4) avoiding ancillary criteria such as "life-years saved" and "long-term predicted life expectancy" that might disadvantage older people; (5) forming and staffing triage committees tasked with allocating scarce resources; (6) developing institutional resource allocation strategies that are transparent and applied uniformly; and (7) facilitating appropriate advance care planning. The statement includes recommendations that should be immediately implemented to address resource allocation strategies during COVID-19, aligning with AGS positions. The statement also includes recommendations for post-pandemic review. Such review would support revised strategies to ensure that governments and institutions have equitable emergency resource allocation strategies, avoid future discriminatory language and practice, and have appropriate guidance to develop national frameworks for emergent resource allocation decisions. J Am Geriatr Soc 68:1136-1142, 2020.

RevDate: 2025-12-17
CmpDate: 2020-06-11

Lavinsky J, Kosugi EM, Baptistella E, et al (2020)

An update on COVID-19 for the otorhinolaryngologist - a Brazilian Association of Otolaryngology and Cervicofacial Surgery (ABORL-CCF) Position Statement.

Brazilian journal of otorhinolaryngology, 86(3):273-280.

INTRODUCTION: We are facing a pandemic with a great impact worldwide, as a result of the rapid spread of the novel coronavirus (COVID-19). The medical community is still getting to know behavior of this virus and the consequences from a population point of view. All this knowledge is extremely dynamic, so some behaviors are still not well established. Otorhinolaryngologists have a central role in the management of this situation, in which they must assess the patient, avoid contamination to and by health professionals and other patients. Thus, the recommendations of the Brazilian Association of Otorhinolaryngology and Cervical-Facial Surgery (ABORL-CCF) have the main objective of reducing the spread of the new coronavirus during otorhinolaryngological care and assisting in the management of these patients.

METHODS: Review of the main recommendations of national and international scientific societies, decisions by government agencies and class councils. The topics will be related to the general aspects of COVID-19, personal protective equipment, care in patient assistance, endoscopic exam routines and the management of sinonasal, otological and pediatric evaluations related to COVID-19.

RESULTS: The use of personal protective equipment is considered crucial in routine ENT care. We recommend postponing appointments, exams and elective surgeries to reduce the spread of COVID-19. Similarly, we recommend changing routines in several areas of otolaryngology. Additionally, guidance is provided on the use of telemedicine resources during the pandemic period.

CONCLUSIONS: We are still at the beginning of the COVID-19 pandemic and scientific evidence is still scarce and incomplete, so these ABORL-CCF recommendations for otorhinolaryngologists may be updated based on new knowledge and the pattern of the new coronavirus spread.

RevDate: 2025-12-17
CmpDate: 2020-06-23

Pfeifer M, Ewig S, Voshaar T, et al (2020)

[Position Paper for the State of the Art Application of Respiratory Support in Patients with COVID-19 - German Respiratory Society].

Pneumologie (Stuttgart, Germany), 74(6):337-357.

Against the background of the pandemic caused by infection with the SARS-CoV-2, the German Society for Pneumology and Respiratory Medicine (DGP e.V.), in cooperation with other associations, has designated a team of experts in order to answer the currently pressing questions about therapy strategies in dealing with COVID-19 patients suffering from acute respiratory insufficiency (ARI).The position paper is based on the current knowledge that is evolving daily. Many of the published and cited studies require further review, also because many of them did not undergo standard review processes.Therefore, this position paper is also subject to a continuous review process and will be further developed in cooperation with the other professional societies.This position paper is structured into the following five topics:1. Pathophysiology of acute respiratory insufficiency in patients without immunity infected with SARS-CoV-22. Temporal course and prognosis of acute respiratory insufficiency during the course of the disease3. Oxygen insufflation, high-flow oxygen, non-invasive ventilation and invasive ventilation with special consideration of infectious aerosol formation4. Non-invasive ventilation in ARI5. Supply continuum for the treatment of ARIKey points have been highlighted as core statements and significant observations. Regarding the pathophysiological aspects of acute respiratory insufficiency (ARI), the pulmonary infection with SARS-CoV-2 COVID-19 runs through three phases: early infection, pulmonary manifestation and severe hyperinflammatory phase.There are differences between advanced COVID-19-induced lung damage and those changes seen in Acute Respiratory Distress Syndromes (ARDS) as defined by the Berlin criteria. In a pathophysiologically plausible - but currently not yet histopathologically substantiated - model, two types (L-type and H-type) are distinguished, which correspond to an early and late phase. This distinction can be taken into consideration in the differential instrumentation in the therapy of ARI.The assessment of the extent of ARI should be carried out by an arterial or capillary blood gas analysis under room air conditions and must include the calculation of the oxygen supply (measured from the variables of oxygen saturation, the Hb value, the corrected values of the Hüfner number and the cardiac output). In principle, aerosols can cause transmission of infectious viral particles. Open systems or leakage systems (so-called vented masks) can prevent the release of respirable particles. Procedures in which the invasive ventilation system must be opened, and endotracheal intubation must be carried out are associated with an increased risk of infection.The protection of personnel with personal protective equipment should have very high priority because fear of contagion must not be a primary reason for intubation. If the specifications for protective equipment (eye protection, FFP2 or FFP-3 mask, gown) are adhered to, inhalation therapy, nasal high-flow (NHF) therapy, CPAP therapy or NIV can be carried out according to the current state of knowledge without increased risk of infection to the staff. A significant proportion of patients with respiratory failure presents with relevant hypoxemia, often also caused by a high inspiratory oxygen fraction (FiO2) including NHF, and this hypoxemia cannot be not completely corrected. In this situation, CPAP/NIV therapy can be administered under use of a mouth and nose mask or a respiratory helmet as therapy escalation, as long as the criteria for endotracheal intubation are not fulfilled.In acute hypoxemic respiratory insufficiency, NIV should be performed in an intensive care unit or in a comparable unit by personnel with appropriate expertise. Under CPAP/NIV, a patient can deteriorate rapidly. For this reason, continuous monitoring with readiness to carry out intubation must be ensured at all times. If CPAP/NIV leads to further progression of ARI, intubation and subsequent invasive ventilation should be carried out without delay if no DNI order is in place.In the case of patients in whom invasive ventilation, after exhausting all guideline-based measures, is not sufficient, extracorporeal membrane oxygenation procedure (ECMO) should be considered to ensure sufficient oxygen supply and to remove CO2.

RevDate: 2025-12-17
CmpDate: 2021-03-03

Sadeghipour P, Talasaz AH, Eslami V, et al (2021)

Management of ST-segment-elevation myocardial infarction during the coronavirus disease 2019 (COVID-19) outbreak: Iranian"247" National Committee's position paper on primary percutaneous coronary intervention.

Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions, 97(3):E346-E351.

World Health Organization has designated coronavirus disease 2019 (COVID-19) as a pandemic. During the past several weeks, a considerable burden has been imposed on the Iranian's healthcare system. The present document reviewed the latest evidence and expert opinion regarding the management of ST-segment-elevation myocardial infarction during the outbreak of COVID-19 and outlines a practical algorithm for it.

RevDate: 2025-12-17
CmpDate: 2020-09-10

Maillard JY, Bloomfield SF, Courvalin P, et al (2020)

Reducing antibiotic prescribing and addressing the global problem of antibiotic resistance by targeted hygiene in the home and everyday life settings: A position paper.

American journal of infection control, 48(9):1090-1099.

Antimicrobial resistance (AMR) continues to threaten global health. Although global and national AMR action plans are in place, infection prevention and control is primarily discussed in the context of health care facilities with home and everyday life settings barely addressed. As seen with the recent global SARS-CoV-2 pandemic, everyday hygiene measures can play an important role in containing the threat from infectious microorganisms. This position paper has been developed following a meeting of global experts in London, 2019. It presents evidence that home and community settings are important for infection transmission and also the acquisition and spread of AMR. It also demonstrates that the targeted hygiene approach offers a framework for maximizing protection against colonization and infections, thereby reducing antibiotic prescribing and minimizing selection pressure for the development of antibiotic resistance. If combined with the provision of clean water and sanitation, targeted hygiene can reduce the circulation of resistant bacteria in homes and communities, regardless of a country's Human Development Index (overall social and economic development). Achieving a reduction of AMR strains in health care settings requires a mirrored reduction in the community. The authors call upon national and international policy makers, health agencies, and health care professionals to further recognize the importance of targeted hygiene in the home and everyday life settings for preventing and controlling infection, in a unified quest to tackle AMR.

RevDate: 2025-12-17
CmpDate: 2020-05-04

Garcia-Castrillo L, Petrino R, Leach R, et al (2020)

European Society For Emergency Medicine position paper on emergency medical systems' response to COVID-19.

European journal of emergency medicine : official journal of the European Society for Emergency Medicine, 27(3):174-177.

The 2019 novel coronavirus acute respiratory epidemic is creating a stressed situation in all the health systems of the affected countries. Emergency medical systems and specifically the emergency departments as the front line of the health systems are suffering from overload and severe working conditions, the risk of contagion and transmission of the health professionals adds a substantial burden to their daily work. Under the perspective of European Society For Emergency Medicine, the recommendations provided by the health authorities are reviewed focus on the emergency department's activity.

RevDate: 2025-12-17
CmpDate: 2020-10-30

Tarantini G, Fraccaro C, Chieffo A, et al (2020)

Italian Society of Interventional Cardiology (GISE) position paper for Cath lab-specific preparedness recommendations for healthcare providers in case of suspected, probable or confirmed cases of COVID-19.

Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions, 96(4):839-843.

COVID-19 pandemic raised the issue to guarantee the proper level of care to patients with acute cardiovascular diseases and concomitant suspected or confirmed COVID-19 and, in the meantime safety and protection of healthcare providers. The aim of this position paper is to provide standards to healthcare facilities and healthcare providers on infection prevention and control measures during the management of suspected and confirmed cases of 2019-nCoV infection accessing in cath-lab. The document represents the view of the Italian Society of Interventional Cardiology (GISE), and it is based on recommendations from the main World and European Health Organizations (WHO, and ECDC) as well as from the Italian Society of Anesthesia, Analgesia, Resuscitation and Intensive Care (SIAARTI).

RevDate: 2025-12-17
CmpDate: 2020-05-06

Poon LC, Abramowicz JS, Dall'Asta A, et al (2020)

ISUOG Safety Committee Position Statement on safe performance of obstetric and gynecological scans and equipment cleaning in context of COVID-19.

Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology, 55(5):709-712.

RevDate: 2025-12-16

Blanco J, Ferreras M, O Cosido (2025)

Predictive modeling of hospital emergency department demand using artificial intelligence: A systematic review.

International journal of medical informatics, 207:106215 pii:S1386-5056(25)00432-0 [Epub ahead of print].

BACKGROUND: Accurately forecasting patient arrivals in hospital emergency departments (EDs) is critical for hospital capacity and planning and clinical decision-making. Artificial intelligence (AI), particularly machine learning (ML) and deep learning (DL), has shown promising performance over traditional time series approaches. However, the extent to which these models are validated and generalizable remains uncertain.

OBJECTIVE: To systematically review the literature on predictive models for hospital ED demand forecasting, focusing on algorithms used, internal and external variables, validation strategies and limitations pre- and post-pandemic developments.

METHODS: A systematic literature review (SLR) was conducted following PRISMA guidelines. Five databases (PubMed, IEEE, Springer, ScienceDirect, ACM) were searched for peer-reviewed articles published between January 2019 and July 2025. Eligible studies applied predictive algorithms - excluding those focused on COVID-19 - to forecast ED visits. Extracted data included modeling approaches, feature types, evaluation metrics, and validation methods.

RESULTS: Eleven studies met the inclusion criteria. Classical models such as ARIMA and SARIMA remain in use, but ML (e.g., XGBoost, Random Forest) and DL (e.g., LSTM, CNN) showed higher predictive accuracy, especially with high-dimensional, nonlinear data. Incorporating external variables-such as weather (temperature, humidity, wind), air quality, and calendar events-consistently improved performance. Common metrics included Mean Absolute Error (MAE), Root Mean Squared Error (RMSE), and Mean Absolute Percentage Error (MAPE), with MAPE ranging from 3 % to 18 %. Few studies performed external validation, and only a minority employed explainable AI methods (e.g., SHAP) to address interpretability.

CONCLUSIONS: AI-based models offer strong potential for ED demand forecasting, particularly when integrating environmental and temporal features. However, limited external validation and lack of interpretability remain significant barriers to clinical adoption. Future research should prioritize multicenter validation, standardized evaluation, and explainable AI to support reliable, transparent, and scalable use in hospital emergency departments.

RevDate: 2025-12-16
CmpDate: 2025-12-16

Miranda Quintero J, Celis-Amórtegui M, Arturo Rojas MC, et al (2025)

[Consenso de expertos en torno a la vacunación como estrategia de prevención primaria para la mujer que se encuentra en edad reproductiva, gestando o en la edad adulta].

Revista colombiana de obstetricia y ginecologia, 76(2):.

OBJETIVO: generar recomendaciones para la vacunación de la mujer, en las diferentes etapas de su vida, a fin de disminuir la posible variabilidad de su uso actual en Colombia. Materiales y métodos: el grupo desarrollador estuvo conformado por profesionales pertenecientes al área de la salud. Todos los participantes declararon por escrito sus conflictos de interés. Se formularon preguntas clínicas contestables, se hizo la graduación de los desenlaces y la pesquisa de la información se realizó en Medline/PubMed, Embase y Lilacs. La búsqueda también abarcó fuentes de literatura gris y se actualizó el 14 de mayo de 2024 sin restricciones por fecha o idioma. Se implementó la metodología GRADE (Grading of Recommendations Assessment, Development and Evaluation) para establecer la calidad de la evidencia y la fuerza de la recomendación. En virtud de las limitaciones de los estudios recuperados, y especialmente cuando se trató de limitaciones en la aplicabilidad de la evidencia, se acudió a la opinión de expertos. Se realizó consenso formal acorde con la metodología RAND/UCLA (RAND Corporation/Universidad de California en Los Ángeles). Previo a la publicación, el documento fue objeto de revisión por pares.

RESULTADOS: se desarrollaron las siguientes recomendaciones: • El grupo desarrollador sugiere que las mujeres no inmunes a las paperas, sarampión o rubeola (p. ej., IgG negativo) sean vacunadas durante el periodo preconcepcional. Calidad de la evidencia: baja ⨁⨁◯◯ • El grupo desarrollador sugiere que todas las mujeres en periodo preconcepcional se vacunen contra la varicela si no tienen inmunidad natural confirmada (p. ej., anticuerpos IgG negativo para el virus varicela zóster). Calidad de la evidencia: muy baja ⨁◯◯◯ • El grupo desarrollador sugiere que las mujeres que viven en regiones endémicas para fiebre amarilla se vacunen durante el periodo preconcepcional si no han sido previamente inmunizadas. Calidad de la evidencia: muy baja ⨁◯◯◯ • El grupo desarrollador sugiere vacunar adolescentes y adultas jóvenes con la vacuna para el virus del papiloma humano (VPH), de 3 dosis (0,2 y 6 meses) con el fin de reducir la incidencia y mortalidad por cáncer cervical. Calidad de evidencia: moderada ⨁⨁⨁◯ • El grupo desarrollador sugiere que las mujeres gestantes sean inmunizadas contra el tétano, la difteria y la tos ferina durante la gestación, con el objetivo de reducir el riesgo de infección en la madre y el neonato. Calidad de la evidencia: baja ⨁⨁◯◯ • El grupo desarrollador sugiere la vacunación contra la influenza a cualquier edad gestacional, con el objetivo de reducir el riesgo de infección en la madre y el neonato hasta los seis meses de edad. Calidad de la evidencia: muy baja ⨁◯◯◯ • El grupo desarrollador sugiere la vacunación materna frente al COVID-19 a cualquier edad gestacional, con el objetivo de reducir el riesgo de hospitalización y muerte de la madre y el neonato durante los primeros cuatro meses de vida. Calidad de la evidencia: muy baja ⨁◯◯◯ • El grupo desarrollador sugiere la vacunación contra el virus sincitial respiratorio (VSR) en mujeres gestantes, con el objetivo de reducir el riesgo de hospitalización en el neonato. Calidad de la evidencia: muy baja ⨁◯◯◯ • El grupo desarrollador sugiere que la mujer adulta mayor se vacune contra el herpes zóster, con el fin de reducir la morbilidad asociada a esta condición. Calidad de la evidencia: moderada ⨁⨁⨁◯ • El grupo desarrollador sugiere que la mujer adulta mayor se vacune contra la influenza a fin de reducir la incidencia de infección respiratoria aguda (IRA). Calidad de la evidencia: moderada ⨁⨁⨁◯ • El grupo desarrollador sugiere que la mujer adulta mayor se vacune contra el neumococo a fin de reducir la incidencia de neumonía y enfermedad neumocócica invasora. Calidad de la evidencia: baja ⨁⨁◯◯ • El grupo desarrollador sugiere que la mujer adulta mayor se vacune contra el VSR a fin de reducir la incidencia de infección respiratoria aguda e infección respiratoria del tracto inferior. Calidad de la evidencia: baja ⨁⨁◯◯ • El grupo desarrollador sugiere que la mujer adulta mayor que vive en regiones endémicas para fiebre amarilla se vacune si no ha sido previamente inmunizada. Calidad de la evidencia: muy baja ⨁◯◯◯ Conclusiones: se recomienda la vacunación como estrategia de prevención primaria a lo largo de las diferentes etapas de la vida en la mujer. Dada la calidad de la evidencia y las serias limitaciones en la aplicabilidad de algunos estudios, especialmente en mujeres gestantes, se requieren más investigaciones que evalúen la seguridad y la efectividad de esta intervención en esta etapa de la vida.

RevDate: 2025-12-16
CmpDate: 2025-12-16

Gabor M, Schlosserova A, OO Korchynska (2025)

Vaccination in pregnancy: a systematic review of current evidence.

Wiadomosci lekarskie (Warsaw, Poland : 1960), 78(10):2142-2146.

OBJECTIVE: Aim: To summarize current recommendations and the state of knowledge on vaccination of pregnant women against influenza, pertussis, and Covid-19, and to highlight evidence on the efficacy and safety of vaccination during pregnancy.

PATIENTS AND METHODS: Materials and Methods: A systematic literature review of studies published between 2014 and 2024 in the PubMed, Science Direct, Google Scholar, and NCBI databases was conducted. Of the total number of 31 studies found, 10 that met our required conditions were included. The inclusion criteria were peer-reviewed articles dealing with vaccination during pregnancy. Data selection and extraction were performed in accordance with PRISMA recommendations.

CONCLUSION: Conclusions: Vaccination of pregnant women appears to be a safe and effective way to protect mothers and their offspring. Emphasis should be placed on raising awareness and education in clinical practice.

RevDate: 2025-12-16
CmpDate: 2025-12-16

Fedorchenko Y, O Zimba (2025)

Ethical Use of Artificial Intelligence for Processing Medical Images.

Journal of Korean medical science, 40(48):e341 pii:40.e341.

Artificial intelligence (AI) tools employ prompts and algorithms to perform tasks that typically require human expertise, hypothesis formulation, and critical evaluation. AI enables rapid analysis of complex imaging data, automates segmentation and lesion detection, and supports real-time image-guided interventions. Deep learning architectures (CNNs, RNNs, U-Net, and transformer-based models) facilitate advanced image classification, reconstruction, and interpretation, achieving clinical accuracies above 90% in multiple domains, including coronavirus disease 2019, oncology, and rheumatology. Generative AI platforms (MedGAN, StyleGAN, CycleGAN, SinGAN-Seg) further support synthetic image creation and dataset augmentation, mitigating data scarcity while preserving patient privacy. However, the integration of AI in healthcare presents significant ethical challenges. Key concerns include algorithmic bias, patient privacy, transparency, accountability, and equitable access. Biases-such as annotation, automation, confirmation, demographic, and feedback-loop bias-can compromise diagnostic reliability and patient outcomes. Ethical deployment requires rigorous data governance, informed consent, anonymization, standardized validation frameworks, human oversight, and regulatory compliance. Maintaining interpretability and transparency of AI outputs is essential for clinical decision-making, while professional training and AI literacy are critical to mitigate overreliance and ensure patient safety.

RevDate: 2025-12-16
CmpDate: 2025-12-16

Manarte R, MR Henriques (2025)

From exceptionalism to universal testing: an historical review of HIV testing in Portugal.

BMC public health, 25(1):4251.

INTRODUCTION: Portugal has made significant progress over the last 40 years in the response against the Human Immunodeficiency Virus (HIV) infection and the Acquired Immunodeficiency Syndrome (AIDS). However, as of 2021, it remained one of the three Western European countries with the highest rates of new HIV infections and AIDS cases. Initially shaped by HIV exceptionalism, Portugal began transitioning to a universal testing strategy in 2011. This study provides a historical and policy review of the evolution of HIV testing in Portugal, focusing on alignment with international guidelines and national implementation outcomes.

METHODS: We conducted a narrative policy review covering the period from 1998 to 2024. Our analysis drew on scientific literature, national health plans, surveillance reports, and international guidelines. Documents were selected through structured searches in multiple academic databases and government repositories using relevant Portuguese and English search terms. Thematically coded findings were mapped chronologically and assessed against evolving WHO and CDC recommendations.

RESULTS: Portugal gradually moved from a targeted testing approach to a more comprehensive, universal strategy. Key policy shifts occurred in 2011 and 2017, accompanied by an expansion of testing modalities, including self-testing and community-based testing. Despite these developments, implementation has been uneven. The lack of standardized protocols, limited integration into primary healthcare, and regional disparities tied to a contract-based health system have contributed to inconsistent service delivery. Additionally, testing uptake among older adults, migrants, and other key populations remains suboptimal. The COVID-19 pandemic temporarily disrupted testing services but also accelerated the use of self-testing strategies.

DISCUSSION: Portugal's experience illustrates the challenges of operationalizing universal HIV testing within a hybrid public-private healthcare system. Although policies increasingly reflect international best practices, structural barriers continue to hinder equitable implementation.

CONCLUSION: To close existing testing gaps, Portugal must strengthen implementation by standardizing procedures, improve disaggregated data collection in monitoring systems, and ensure greater integration of HIV testing in primary healthcare. Enhanced outreach to underserved populations will be critical to achieving national and international HIV prevention targets. This paper offers a historical and policy perspective to inform more equitable and effective national testing strategies.

RevDate: 2025-12-16
CmpDate: 2025-12-16

Maleki F, Hosseinpour M, Pashaei MR, et al (2025)

Body mass index in children with newly diagnosed celiac disease: A systematic review and meta-analysis.

European journal of pediatrics, 185(1):18.

UNLABELLED: Clinical manifestations of celiac disease (CeD) in children are often associated with malabsorption, malnutrition, and underweight. Recent evidence suggests an increased prevalence in normal-weight and obese children. Under-recognition of patients with normal or high BMI can lead to delayed diagnosis and serious complications. The present study aimed to determine the BMI status of children with CeD at diagnosis and before gluten-free diet (GFD). A systematic review and meta-analysis was conducted following the PRISMA and MOOSE guidelines and after PROSPERO registration (CRD42023390243). The information sources, including PubMed, Scopus, and Web of Science, were systematically searched through 30 September 2025 to identify relevant articles. The study's eligibility criteria included observational studies, such as retrospective, cross-sectional, and prospective designs, with participants whose CeD diagnosis was confirmed by a gastroenterologist and who reported BMI data at the time of diagnosis. Heterogeneity among studies was assessed using the I[2] statistic. Funnel plots and Egger's test were also used to examine publication bias. The risk of bias of studies was assessed using the Newcastle-Ottawa (NOS) scale. The Grading of Recommendations, Assessment, Development and Evaluation (GRADE) framework was used to determine the certainty of the evidence. Overall, 32 studies including 14,169 children with CeD were investigated. The pooled prevalence of underweight and overweight/obesity at diagnosis was 15.3% (10.8-20.4%) and 10.5% (5.7-16.4%), respectively. Subgroup analysis by WHO region revealed a marked heterogeneity (I[2] > 90%), with the highest prevalence of underweight observed in the Eastern Mediterranean Region (EMRO) (31.9%). On the other hand, the highest prevalence of overweight/obesity was observed in the European Region (EURO) (12.0%) and the Western Pacific Region (WPRO) (21.4%). A key finding was a significant difference across World Bank income groups; underweight prevalence was nearly four times higher in low- and middle-income countries (LMICs), 35.48 (24.29, 47.51), compared with high-income countries, 9.58 (6.88, 12.63). The certainty of the evidence for all pooled prevalence estimates was rated as very low due to serious inconsistency and imprecision.

CONCLUSIONS:  The prevalence of normal weight and overweight/obesity in children with celiac disease at diagnosis was higher than that of underweight, mainly in high-income countries. This finding challenges the traditional belief about the CeD and emphasizes its diagnosis in children with suspicious symptoms, regardless of their BMI status. This approach will lead to earlier diagnosis, improving clinical outcomes and quality of life for patients in the long term.

WHAT IS KNOWN: • The clinical presentation of celiac disease is evolving, and its association with underweight is inconsistent. • The structural effects of COVID-19 on the developing brain remain poorly understood due to limited pediatric imaging studies.

WHAT IS NEW: • This is the first meta-analysis focused exclusively on children, revealing that the majority (70.2%) present with a normal BMI at diagnosis. • The clinical inconsistency in BMI presentation is strongly linked to income levels; underweight prevalence is nearly four times higher in LMICs (35.5%) than in high-income countries (9.6%).

RevDate: 2025-12-15

Chen P, Prosser M, Phillips B, et al (2025)

Accuracy and Reliability of Remote Shoulder Motion Capturing Methods: A Systematic Review and Meta-Analysis.

Journal of shoulder and elbow surgery pii:S1058-2746(25)00849-3 [Epub ahead of print].

BACKGROUND: The COVID-19 pandemic accelerated the demand for remote assessment tools in rehabilitation, especially the need for accurate and reliable technologies to measure shoulder range of motion (ROM) outside of clinical environments. Emerging tools such as smartphone apps, wearable sensors, and markerless motion capture systems are increasingly being adopted, yet their accuracy and reliability compared to reference standards remains unclear.

OBJECTIVE: To systematically evaluate the accuracy and reliability of existing remote shoulder ROM measurement technologies, quantify measurement bias, and assess their agreement with reference standards.

METHODS: A systematic review and meta-analysis was conducted on 26 studies evaluating remote ROM measurement tools. Pooled mean bias (in degrees) was calculated as the primary effect size for agreement, with reliability assessed using intraclass correlation coefficients (ICCs). Subgroup analyses were performed by motion type, technology category, population health status, and data acquisition method. Risk of bias was assessed using the QUADAS-2 tool.

RESULTS: Remote measurement methods showed a small but consistent overestimation of ROM compared to reference standards (pooled mean bias = 2.63°, 95% CI: 1.52°, 3.74°), particularly in flexion, internal rotation, and external rotation. No significant bias was observed in abduction or extension. Both IMU and non-IMU technologies demonstrated comparable levels of overestimation. Pathological populations exhibited greater variability (bias = 4.33° vs. 2.37° in healthy subjects). Self-measurements showed lower and non-significant bias compared to assessor-guided methods. Reliability was generally high, especially for test-retest assessments (ICCs > 0.90), though more variable in inter-rater and pathological settings.

CONCLUSION: Remote shoulder ROM measurement technologies tend to slightly overestimate joint angles but remain within clinically acceptable limits. These tools are reliable for tracking ROM trends and suitable for remote monitoring in clinical and research settings. However, increased variability in pathological populations warrants caution. Broader validation in diverse patient cohorts is needed to strengthen clinical implementation.

RevDate: 2025-12-15

Cho AH, Cho SY, Kim S, et al (2025)

Targeting emerging viruses with phage display-driven engineered antibodies: Bridging molecular design and clinical application.

Molecular aspects of medicine, 107:101441 pii:S0098-2997(25)00105-0 [Epub ahead of print].

Phage display (PD) is a powerful platform that accelerates the discovery and engineering of therapeutic antibodies across diverse diseases, including emerging and re-emerging viral infections. The COVID-19 pandemic highlighted the urgency for rapid and adaptable antibody development against highly mutable pathogens, including severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). PD technology enables the rapid and high-throughput identification, optimization, and efficient reformatting of virus-neutralizing antibodies, yielding fully PD-derived antibodies and reformatted derivatives from PD fragments without requiring convalescent samples or animal immunization. This approach supports a proactive and scalable strategy for pandemic preparedness. This review provides a comprehensive overview of PD-derived therapeutic antibodies targeting infectious diseases, focusing on approved agents and candidates in clinical or preclinical development for SARS-CoV-2. We highlight recent case studies, including our own, showing the successful application of PD in generating potent neutralizing and multispecific antibody formats. These offer functional advantages such as enhanced breadth and affinity while also serving as versatile molecular tools for elucidating viral pathogenesis and immune evasion mechanisms. Despite PD's technological strengths, the clinical advancement of PD-derived candidates has been influenced by external circumstances associated with the evolving pandemic landscape, highlighting the need to strategically leverage PD's strengths to accelerate translational outcomes in future outbreaks. This review offers a well-rounded viewpoint on PD, outlining its applications, addressing its challenges, and incorporating emerging innovations into PD workflows. These advances position PD-derived candidates as a strategic, versatile, and rapid-response platform that bridges molecular insights with clinical translation, offering a robust framework for addressing current and future infectious disease challenges.

RevDate: 2025-12-16
CmpDate: 2021-05-03

Beck ALS, Barberato SH, Almeida ALC, et al (2021)

Position Statement on Indications and the Safe Reintroduction of Cardiovascular Imaging Methods in the COVID-19 Scenario - 2021.

Arquivos brasileiros de cardiologia, 116(3):659-678.

RevDate: 2025-12-16
CmpDate: 2020-07-23

Ganau M, Netuka D, Broekman M, et al (2020)

Neurosurgeons and the fight with COVID-19: a position statement from the EANS Individual Membership Committee.

Acta neurochirurgica, 162(8):1777-1782.

RevDate: 2025-12-16
CmpDate: 2020-09-03

Lavoué V, Akladios C, Gladieff L, et al (2020)

Onco-gynecologic surgery in the COVID-19 era: Risks and precautions-A position paper from FRANCOGYN, SCGP, SFCO, and SFOG.

Journal of gynecology obstetrics and human reproduction, 49(7):101787.

RevDate: 2025-12-15
CmpDate: 2025-12-15

Padilla-Blanco M, García-García T, Grigas J, et al (2025)

Hidden players of COVID-19: the evolving roles of SARS-CoV-2 accessory proteins.

Frontiers in immunology, 16:1726698.

SARS-CoV-2 accessory proteins (APs), particularly ORF3a and ORF9b, have emerged as key modulators of host-pathogen interaction and potential contributors to long COVID. Of the 13 predicted APs, only nine are expressed during infection - termed Infection-related APs - while the remaining are classified as Putative APs. Despite this distinction, extensive gene overlap among APs underscores the remarkable adaptability of SARS-CoV-2 viral genome. This review delves into the diverse roles of the original Wuhan APs and their Omicron counterparts in shaping host immunity, with an emphasis on their ability to suppress type I interferon (IFN-I) signalling, modulate cellular metabolism, and trigger inflammatory/apoptotic pathways. By integrating immunopathological insights with evolutionary dynamics and structural perspectives, this review provides a comprehensive understanding of the mechanism underlying Omicron's reduced pathogenicity and highlights promising, yet unexplored, therapeutic targets within the SARS-CoV-2 accessory proteome.

RevDate: 2025-12-15
CmpDate: 2025-12-15

Gabig-Cimińska M (2025)

Dysregulated TFEB-autophagy-lysosome pathway links acute COVID-19 immunopathology to Long COVID sequelae.

Frontiers in immunology, 16:1708364.

SARS-CoV-2 disrupts cellular homeostasis, including the autophagy-lysosome pathway (ALP), a critical component of innate immunity and viral clearance. By subverting autophagy, SARS-CoV-2 proteins such as ORF3a, ORF7a, and NSP6 inhibit autophagosome-lysosome (APG-L) fusion, generating "incomplete autophagy" that permits viral persistence and drives hyperinflammation. Transcription factor EB (TFEB), a master regulator of lysosomal biogenesis and autophagy, has emerged as a central player in the host response to coronavirus infection. TFEB orchestrates the expression of genes required for lysosomal function and autophagic flux while also shaping immune processes, including cytokine production, interferon-stimulated gene expression, and inflammasome clearance. This mini review synthesizes current knowledge on the TFEB-ALP axis in COVID-19 pathogenesis, highlighting its influence on acute immunopathology and its potential contribution to post-acute sequelae (Long COVID). Restoring TFEB activity and autophagic flux may counteract SARS-CoV-2 evasion strategies and restrain aberrant inflammatory responses. Harnessing the TFEB-autophagy pathway as a host-directed therapeutic strategy could help rebalance immune homeostasis, limit tissue damage during acute infection, and mitigate persistent inflammatory sequelae in Long COVID.

RevDate: 2025-12-15
CmpDate: 2025-12-15

Pandey V, Sen D, Rathee S, et al (2025)

Unlocking Toll-Like Receptors: Targeting Therapeutics for Respiratory Tract Infections and Inflammatory Disorders.

Recent advances in inflammation & allergy drug discovery, 19(3):303-315.

The Toll-like Receptors (TLRs) family has significantly enhanced the understanding of innate immune responses by identifying and responding to various microbes or host-derived organisms. TLRs contribute to these responses by increasing the levels of cytokines, interleukins, and other inflammatory mediators through multiple pathways. Located both intracellularly and on the surface of various cells and tissues, including vascular smooth muscles (VSMs) and myocardium cells, TLRs play distinct roles in innate immune activation, such as recognizing pathogen-associated molecular patterns (PAMPs) and activating downstream signaling pathways. In the context of COVID-19, TLRs are critically involved in the pathophysiology by mediating excessive inflammatory responses that exacerbate disease severity, influencing both the acute phase and long-term outcomes. It has been observed that inflammatory diseases such as atherosclerosis, viral myocarditis, and other comorbidities associated with the spread of COVID-19 have increased, although the exact mechanisms remain not fully understood. Nonetheless, there is evidence of TLR-mediated increased pro-inflammatory signaling by different mechanisms in these diseases. This review explains the role of TLRs in various inflammatory diseases related to COVID-19, including viral myocarditis, acute lung infections, and atherosclerosis. Furthermore, the review discusses various herbal drugs, such as Platycodon grandiflorum, Acanthopanax senticosus, Scutellaria baicalensis Georgi, and Engelhardia roxburghiana, and their mechanisms of action on TLRs, including NF-κB, MyD88-dependent, MyD88-independent pathways, and Plasmacytoid DCs. Enhanced clarity on TLRs' specific contributions to COVID-19 pathophysiology and stronger evidence supporting herbal interventions targeting TLRs could improve the impact and applicability of these findings in clinical settings.

RevDate: 2025-12-15

de Bruin O, Maisonneuve E, Hurley E, et al (2025)

Adverse outcomes among pregnant women with COVID-19 according to hospitalization status: A prospective individual participant data meta-analysis in Europe and North America.

International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics [Epub ahead of print].

BACKGROUND: Understanding the varied impact of COVID-19 severity on pregnancy outcomes is crucial for informed clinical management and targeted interventions.

OBJECTIVE: To evaluate the impact of COVID-19 on pregnancy outcomes, distinguishing between pregnant women managed in primary care and those requiring hospitalization.

SEARCH STRATEGY: Regulatory authorities actively promoted global cooperation on COVID-19's impact during pregnancy. Data were obtained through these regulatory bodies and direct researcher communication rather than through systematic searches.

SELECTION CRITERIA: Data sources required secondary population-based data to identify pregnancies with COVID-19, along with hospitalization, diagnostic and medication codes. Eligibility for the meta-analysis was determined through protocol evaluation and researcher consultations.

DATA COLLECTION AND ANALYSIS: PRISMA-IPD and Cochrane guidelines for prospective meta-analysis were followed. Protocols and definitions were standardized across sources, and a common R script was developed. Initially, crude and adjusted relative risks (aRR) with 95% confidence intervals (CI) were calculated to assess adverse outcomes in pregnant women with and without COVID-19 in each data source. Estimates were stratified by trimester at infection and hospitalization status. Subsequently, data were pooled using a random-effects meta-analysis.

MAIN RESULTS: Data from 10 sources across seven countries contributed to the meta-analysis, including 86 210 pregnant women diagnosed with COVID-19, of whom 4.4% were hospitalized. Non-hospitalized pregnant women with COVID-19 had no increased risks of adverse outcomes compared to pregnant women without COVID-19. However, hospitalized women with COVID-19 in each trimester had higher risks of cesarean section, preterm birth, and LBW compared to pregnant women without COVID-19. Hospitalization due to COVID-19 in the third trimester was associated with increased risk of stillbirth (aRR 5.90, 95% CI: 2.22-15.71, I[2] = 0%). First-trimester hospitalizations due to COVID-19 did not show heightened risks of GDM (aRR 2.08, 95% CI: 0.93-4.64, I[2] = 65%), pre-eclampsia (aRR 1.79, 95% CI: 0.48-6.66, I[2] = 71%), or major congenital anomalies (aRR 1.30, 95% CI: 0.55-3.06, I[2] = 0%).

CONCLUSIONS AND RELEVANCE: COVID-19 requiring hospitalization is associated with adverse pregnancy outcomes, emphasizing the need to prevent severe illness during pregnancy. This study also highlights the importance of international collaboration for gathering pregnancy data and shows that building global research networks is essential for responding to future health crises.

RevDate: 2025-12-15

Celano R, Urso F, Bartoli A, et al (2025)

COVID-19 and vascular access: Evidence and lessons for improving the standard of care, a scoping review.

The journal of vascular access [Epub ahead of print].

The Coronavirus Disease 2019 (COVID-19) pandemic has significantly impacted intravenous therapy practices, particularly in critically ill patients. Vascular access strategies were adapted to evolving clinical needs, infection control priorities, and resource limitations, with a focus on safety, efficacy, and technological advancements. This scoping review aimed to explore how the COVID-19 pandemic affected vascular access practices and catheter-related complications, with the objective of mapping innovations, identifying emerging trends, and summarizing preventive and therapeutic strategies. The review followed PRISMA-ScR guidelines and was registered in PROSPERO (CRD420251027530). A systematic search was conducted in PubMed[®], EMBASE[®], EBSCO-CINAHL[®], and CENTRAL for English-language studies published between January 2020 and May 2025 addressing catheter-related complications in COVID-19 patients, including catheter-related bloodstream infections (CRBSI), central line-associated bloodstream infections (CLABSI), catheter-related thrombosis (CRT), and accidental catheter removal. Among 521 screened articles, 58 met the inclusion criteria. Most studies reported higher rates of CRBSI, CLABSI, CRT, and accidental removal in COVID-19 patients, especially in critical care settings. Arterial catheters were also associated with elevated risks of thrombosis and infection during the pandemic. Mid-thigh femoral access sites emerged as practical alternatives to reduce central line use and healthcare personnel exposure. Technological advances, including power-injectable catheters, ultrasound-guided insertion, intracavitary ECG for tip confirmation, and securement tools such as cyanoacrylate glue and subcutaneous anchor systems, improved safety and reduced mechanical and infectious complications. Chlorhexidine-based antisepsis, antimicrobial-impregnated devices, and disinfectant caps effectively decreased CRBSI and CLABSI rates. In older, comorbid patients-now representing the majority of COVID-19 hospitalizations-nutritional and anticoagulant therapy must be carefully balanced to minimize bleeding and thrombotic risks. In conclusion, the pandemic catalyzed significant innovation and adaptation in vascular access practices. Integrating portable technologies, infection prevention strategies, and alternative access routes has enhanced patient care and established new standards for managing intravenous therapy in high-risk, resource-constrained settings.

RevDate: 2025-12-14

Rutter H, Wabnitz K, Nambiar D, et al (2025)

The Lancet Commission on improving population health post-COVID-19.

Lancet (London, England) pii:S0140-6736(25)02061-6 [Epub ahead of print].

RevDate: 2025-12-13

Waqqas HM, Pan J, Xia N, et al (2025)

mRNA based vaccines and therapeutics for parasitic infections: a comprehensive review.

Journal of nanobiotechnology pii:10.1186/s12951-025-03787-z [Epub ahead of print].

The success of mRNA vaccines during the COVID-19 pandemic has revealed a revolutionary platform for addressing neglected parasite zoonosis, which represent a continual and significant threat to world health, especially in resource-constrained settings. The current review consolidates recent progress in the development of mRNA-based treatments, vaccines, and diagnostic ways for these pathogens. We elucidate how customized delivery platforms, particularly lipid nanoparticles, augment the stability and immunogenicity of parasite-derived mRNA cargo by safeguarding it from degradation and promoting uptake by antigen-presenting cells. Our findings suggest that mRNA technology provides a particularly adaptable strategy to targeting complicated parasite life cycles and efficiently modulating host immune responses. However, important challenges, such as cold-chain logistics, scalability, clinical trial design for diverse populations, and managing public opinion, must be solved beforehand. Future initiatives must priorities the creation of thermostable formulations and effective community participation strategies. Finally, this review emphasizes that mRNA-based interventions represent a promising, albeit challenging, frontier in the fight against parasitic diseases, urging a collaborative cross-disciplinary effort to translate this potential into tangible health breakthroughs for the world's most vulnerable populations.

RevDate: 2025-12-15
CmpDate: 2025-12-15

Kattner AA (2025)

Sticks and stones - mending bones.

Biomedical journal, 48(6):100931.

A novel biomaterial demonstrates enhanced bone regeneration in critical defects, offering potential improvements in orthopedic repair. In immunology, a second booster dose of mRNA COVID-19 vaccine is shown to elicit robust responses in older adults in Taiwan. Hepatology research explores new therapeutic strategies for managing hepatitis B in kidney transplant recipients. Biomarker discovery advances with a new assay enabling the use of miRNAs for non-invasive diagnosis and staging of metabolic dysfunction-associated steatotic liver disease (MASLD). Finally, an optimized elastase assay improves FISH-based detection of ALK gene rearrangements, enhancing diagnostic accuracy in non-small cell lung cancer (NSCLC).

RevDate: 2025-12-15
CmpDate: 2025-12-15

Bernstein WK, Pearl RG, Huang J, et al (2026)

Enhancing Anesthetic Preoptimization: Promising Opportunities for Innovation in Economically Diverse Regions.

Anesthesia and analgesia, 142(1):76-84.

The escalating costs of perioperative care are unsustainable, necessitating the identification of high-impact investment opportunities to enhance both quality and cost-effectiveness of perioperative processes. In both rural and urban areas with less access to health care resources, a sustainable health care system must focus on delivering value-based care and prioritizing population health, promoting efficiency, preventing complications, and optimizing outcomes. Given the shortage of primary care physicians, and the lessons learned from the COVID-19 pandemic, which emphasized the importance of a systems-based approach, as well as the evolving roles in the perioperative surgical home and ERAS pathways, anesthesiologists are in a prime position to contribute to these essential value-based objectives. They can achieve this by playing a more active role in the preoperative evaluation and optimization of patients.This paper presents a comprehensive review of pertinent perioperative medical conditions (obstructive sleep apnea, hypertension, anemia, food insecurity and nutrition, diabetes, cognitive and brain health) that can be optimized before surgery. It highlights the latest research and innovations in preoperative management that can significantly alter intraoperative anesthetic management of these conditions leading to reduced morbidity and mortality among surgical patients. Furthermore, this paper highlights existing gaps in preoperative management, particularly in the optimization of comorbid medical conditions.

RevDate: 2025-12-14
CmpDate: 2025-12-12

Kanno H, Liu Z, Sato R, et al (2025)

Single-pixel imaging flow cytometry for biomedical research.

Inflammation and regeneration, 45(1):36.

High-throughput single-cell analysis and screening have become essential tools in life science research. Imaging flow cytometry, in particular, enables large-scale image-based profiling of heterogeneous cell populations, allowing statistical analysis of cellular morphology, subcellular features, and functional responses. However, its analytical capability is often limited by the use of conventional two-dimensional (2D) image sensors. In this review, we highlight recent advances in single-pixel imaging flow cytometry, which replaces 2D image sensors with single-pixel photodetectors. This approach offers advantages in sensitivity, flexibility, and speed in imaging system design and has been implemented in various optical configurations to achieve high-throughput single-cell imaging. We first introduce its key techniques, then outline representative biomedical applications, including cancer and COVID-19 research, and finally discuss current limitations and prospects for future developments. Single-pixel imaging flow cytometry is expected to serve as a versatile platform supporting both basic and translational studies in diverse biomedical applications.

RevDate: 2025-12-12

Chen H, Zhang J, Huang J, et al (2025)

Convergence of mRNA technology and chimeric antigen receptor therapy: targeted technology optimizing targeted therapy.

Journal of translational medicine, 23(1):1393.

Engineering cells to express chimeric antigen receptors (CARs) represents a novel approach in cancer immunotherapy, demonstrating remarkable efficacy in the treatment of hematologic malignancies while also encountering numerous challenges. Against the backdrop of the widespread application of COVID-19 mRNA vaccines, the integration of mRNA technology to produce CAR cells and enhance CAR therapies marks the cutting edge of cancer treatment innovation, offering potential solutions to the challenges faced by traditional CAR therapies. This convergence offers distinct advantages. It enables the generation of CAR cells both in vitro and in vivo without transgene integration, thereby achieving transient expression that reduces the risk of various side effects. Meanwhile, this approach entails lower production costs. This method may therefore serve as a novel and promising alternative to existing therapies in the future. In this article, we review the latest advancements and clinical applications of mRNA-based CAR therapies, which utilize mRNA technology to generate CAR-T cells. Additionally, we explore the diverse therapies enabled by mRNA technology, such as gene editing and vaccines, and their combination with CAR therapies. By analyzing their challenges and prospects, we aim to provide new insights into comprehensively improving the therapeutic efficacy of CAR therapies and expanding their clinical application.

RevDate: 2025-12-14
CmpDate: 2025-12-14

Barton MJ, Okada M, M Todorovic (2025)

Podcasts in health education-Insights from a scoping review and survey.

Anatomical sciences education, 18(12):1388-1405.

Podcasts have rapidly emerged as a powerful tool for health communication, especially since the COVID-19 pandemic. While evidence shows that podcasts can enhance student knowledge, confidence, and flexibility in learning, their educational impact is primarily studied within formal academic contexts. Despite their popularity and potential, little is known about how bioscience-focused health podcasts engage broader audiences beyond structured health education programs. Limited research examines who listens, why they choose podcasts, and how this format influences their learning or behavior. To address this, we used a mixed-methods approach comprising a scoping review and an exploratory online survey. The scoping review, following PRISMA guidelines, identified 14 eligible studies published between 2008 and 2024. The survey, distributed via social media and Dr. Matt & Dr. Mike's Medical Education Podcast, captured responses from 226 participants-predominantly aged 25-34 and mostly from the USA-with two-thirds enrolled in health programs. Participants cited access to expert insights, enjoyment, and the ability to multitask as key reasons for podcast use. Content relevance and presenter expertise were rated the most important factors when selecting a health podcast. The preferred episode length was 30-60 min. On average, participants rated the impact of podcasts on their health knowledge at 4.22 out of 5, with 58% reporting changes in health-related behaviors. These findings suggest that podcasts offer a flexible, engaging way to communicate bioscience-focused health content and support learning across diverse audiences. Educators should consider listener motivations and preferences when integrating podcasts into educational practice.

RevDate: 2025-12-12
CmpDate: 2025-12-12

Bhalla A, Tummalapalli SL, J Silberzweig (2025)

Quality Metrics in Dialysis: It Takes a Village.

Advances in kidney disease and health, 32(5):451-459.

Dialysis is a specialized therapy rendered by a team of interdisciplinary professionals. Federal regulations mandate that dialysis facility staff, at minimum, include a registered nurse, physician, social worker, and dietitian. To ensure that patients on dialysis receive high-quality care, the Centers for Medicare and Medicaid Services introduced the first federally mandated pay for performance program in January 2012: the ESRD Quality Incentive Program. Quality metrics in the ESRD Quality Incentive Program have continuously evolved, necessitating greater involvement from the dialysis interdisciplinary team. In this article, we discuss the interdisciplinary nature of dialysis facility staffing and highlight the critical role of all care team members in attaining high performance on dialysis quality metrics. In the context of the coronavirus disease 2019 pandemic, we highlight recent staffing challenges and propose strategies to alleviate workforce shortages. Finally, we review 2 major trends: (1) an increased emphasis on home dialysis and (2) calls to address social determinants of health, which will require the interdisciplinary team to assume an even larger role in achieving high-quality care.

RevDate: 2025-12-13
CmpDate: 2025-12-13

Welc N, Anioła A, Ważniewicz S, et al (2025)

Syphilis incidence during the COVID-19 pandemic: systematic review and meta-analysis.

Clinics in dermatology, 43(6):836-849.

The COVID-19 pandemic created a public health crisis that affected mental and physical health. Research examined its effect on sexually transmitted infections, particularly syphilis. Asymptomatic stages and inadequate screening likely delayed detection and increased transmission after restrictions eased. Limited health care access and lockdowns reduced social interactions. Studying syphilis reveals how changes in health care access influenced transmission, showcasing the pandemic as a natural experiment for sexually transmitted infection epidemiology. We used the PubMed database, selecting studies from 2019 to August 2024. The meta-analysis evaluated incidence rate ratios from 2019 to 2020 to assess the pandemic's global impact on syphilis rates. Published papers were categorized by region for subgroup analysis. Of the 233 studies, 21 were selected for further analysis. A common-effects model was used to calculate the incidence rate ratio with a 95% CI. We assessed publication bias using funnel plot asymmetry and Egger test, examining heterogeneity with the I[2] statistic. We found a 14% decrease in syphilis incidence in various regions (incidence rate ratio: 1.14; 95% CI: 1.06-1.24, P = .006). Analysis by country and city was inconclusive. This indicates that the impact of the epidemic on syphilis transmission and diagnosis may be multifactorial. Syphilis incidence fell during the pandemic, illustrating that reduced health care access and social restrictions affected transmission. National analyses were inconclusive, suggesting the pandemic's effects on syphilis may vary by location. These findings emphasize the need for further research on the pandemic's long-term impact on syphilis trends and the importance of improving sexually transmitted infection surveillance and health care access during recovery.

RevDate: 2025-12-12

Hamel LP (2025)

Nicotiana benthamiana's Responses to Agroinfiltration, a Treasure Grove of New Avenues to Improve Protein Yields in Plant Molecular Farming.

Plant biotechnology journal [Epub ahead of print].

Transient expression of recombinant proteins in leaves of Nicotiana benthamiana is routinely employed for both basic research and manufacturing of biopharmaceutical products in plants. Relying on disarmed strains of the bacterial plant pathogen Agrobacterium tumefaciens as a transgene vector, this safe, cost-effective and easily scalable 'plant molecular farming' approach offers a reliable alternative to classical protein expression platforms. Commonly referred to as agroinfiltration, scaled-up versions of this manufacturing process have now become helpful in the fight against global health issues, such as those rapidly evolving virus strains causing influenza or coronavirus disease 2019. In the past decades, considerable efforts have been deployed to improve the efficacy of Agrobacterium-mediated expression, including through the development of new binary vectors, the design of strong promoters, and the deployment of approaches to increase levels and stability of transgene mRNAs. By comparison, much less attention has been given to understanding the effects that agroinfiltration unavoidably has on host plants, including the infiltration process itself, the perception of Agrobacterium and the subsequent accumulation of recombinant products throughout the expression phase. Using the upregulation profiles of plant receptor genes during the heterologous expression of virus-like particles in N. benthamiana leaves, I here describe how some of these host responses interact with each other to form an intricate signalling interplay at the molecular level. I also review host plant's responses to agroinfiltration and highlight strategies that have emerged to improve the efficacy of plant cell biofactories based on the better understanding of this transient expression system.

RevDate: 2025-12-12
CmpDate: 2025-12-12

Takkar A, Mahesh KV, Shree R, et al (2025)

Neuro-ophthalmology of Infectious Diseases.

Journal of neuro-ophthalmology : the official journal of the North American Neuro-Ophthalmology Society, 45(3):362-377.

BACKGROUND: According to the World Health Organization, infections, particularly sepsis, are linked to over 20% mortality worldwide and are leading cause of morbidity. A variety of infections have neuro-ophthalmic manifestations. The profile of infectious agents, clinical manifestations, severity, and prognosis of these diseases are highly heterogeneous, and it is therefore difficult to make generalized statements about management.

EVIDENCE ACQUISITION: Available literature with regard to individual infectious agents and their neuroophthalmic manifestations or complications was searched using electronic databases such as PubMed, MEDLINE, Scopus, ProQuest, and Embase. The current study is a review of the literature along with the authors' personal experience in this field.

RESULTS: In this review, we describe the key neuro-ophthalmic manifestations of common bacterial, fungal, viral (except HIV, opportunistic infections, and COVID-19 virus), parasitic, and protozoal infections using illustrative examples.

CONCLUSIONS: Infections may involve the afferent and efferent visual pathways, as well as higher order visual processing functions. They can directly invade the eye and the brain or may cause damage due to inflammation, necrosis, vascular compromise, and postinfective demyelination. With the shifting geographic boundaries and widespread international migration, the spectrum of infectious neuro-ophthalmic diseases is expanding. Clinical details, dedicated imaging, biochemical, serological, and at times histopathological confirmation aids in making prompt diagnosis.

RevDate: 2025-12-12
CmpDate: 2025-12-12

Yang Y, Sun Y, Kang X, et al (2025)

mRNA vaccine platforms and novel delivery systems: From mechanistic principles to clinical translation.

Human vaccines & immunotherapeutics, 21(1):2597629.

Messenger RNA (mRNA) vaccines have revolutionized the field of vaccinology, offering rapid design flexibility, scalable manufacturing, and strong immunogenicity. The unprecedented success of COVID-19 mRNA vaccines has accelerated research into novel delivery platforms and expanded therapeutic applications beyond infectious diseases to cancer immunotherapy and immune-mediated disorders. This review provides a comprehensive overview of the mechanistic principles underlying mRNA vaccine design, including mRNA engineering strategies, delivery innovations such as lipid nanoparticles (LNPs), polymeric nanoparticles (PNPs), and virus-like particles (VLPs), as well as emerging needle-free administration technologies. We further highlight recent advances in therapeutic areas spanning infectious diseases (e.g. HIV, tuberculosis, respiratory syncytial virus), oncology, and non-traditional indications such as autoimmune disorders. Despite remarkable progress, critical challenges persist in vaccine stability, delivery efficiency, large-scale manufacturing, and global accessibility. Finally, we discuss future research directions integrating artificial intelligence, nanotechnology, and systems immunology to accelerate next-generation mRNA vaccine development and clinical translation.

RevDate: 2025-12-12
CmpDate: 2025-12-12

Bessalah S, Sinha D, Yuan X, et al (2025)

[Long COVID: therapeutic challenges and opportunities in the face of persistent sequelae].

Medecine sciences : M/S, 41(11):869-876.

The COVID-19 pandemic, caused by SARS-CoV-2, has not only led to a global health and economic crisis but also renewed attention to a clinical phenomenon of persistent symptoms after viral infection. This phenomenon is defined as long COVID or post-COVID-19 syndrome. Approximately one in eight patients experience persistent symptoms of varying intensity after the acute phase of the infection. This phenomenon, combined with the virus's high transmissibility and rapid mutation rate, poses a major public health challenge. This review examines various therapeutic approaches currently under consideration for treating long COVID, and explores future prospects in this field.

RevDate: 2025-12-12
CmpDate: 2025-12-12

Van Houtte P, Lamarche F, S Every-Palmer (2025)

Effects of face coverings on people and interactions in mental health settings: scoping review.

BJPsych open, 12(1):e11 pii:S2056472425109174.

BACKGROUND: Early in the SARS-CoV-2 pandemic, most jurisdictions implemented mandatory face covering policies across healthcare settings. This intervention, which lasted multiple years, was unprecedented in psychiatry. Masks may affect the delivery of mental healthcare, given its reliance on nuanced communication and establishing a therapeutic alliance.

AIMS: This scoping review aimed to provide an overview of the current literature concerning the impact of face masks in mental health settings beyond infection control and identify research gaps to guide future research and policy.

METHOD: Systematic searches were completed in the MEDLINE, Embase, PsycINFO, Scopus and CINAHL databases on 14 August 2024. Articles were eligible if they described peer-reviewed empirical studies involving people with mental disorders or mental health clinicians that reported on impacts of face coverings.

RESULTS: Twenty-eight studies were selected for inclusion, involving 5385 participants. There was considerable heterogeneity among studies. Negative effects of face masks were reported in 26 studies in at least one domain. Themes from the survey-based literature included face masks negatively affecting communication, the therapeutic relationship and overall assessment quality. Experimental studies using emotion recognition tasks showed that people with mental disorders were disadvantaged by masks when interpreting emotions from facial expressions. The most commonly studied population was people with autism spectrum disorder. Children and people with severe or acute mental illness were underrepresented. Only two studies expressly recruited psychiatrists.

CONCLUSIONS: Policy makers should be aware of adverse impacts of mask-wearing in mental health settings and consider these in evolving risk-benefit analyses. Further research is needed to establish the extent of impacts on population subgroups.

RevDate: 2025-12-12
CmpDate: 2025-12-12

Trulik KG, Kumar VA, Wu W, et al (2025)

Exploring Stress, Fatigue, Burnout, and Resilience Among Healthcare Personnel in Southern and South-Eastern Asia: A Scoping Review.

Public health reviews, 46:1608603.

OBJECTIVES: This study aims to compare methods used to measure burnout, fatigue, stress, and resilience, as well as resilience-building interventions among healthcare personnel (HCP) in Southern and South-eastern Asia. Even before COVID-19, HCP faced high levels of burnout and stress, exacerbated by the pandemic. Identifying effective resilience-building strategies is essential to supporting a healthier workforce.

METHODS: Studies published from January 2016 to December 2021 focusing on burnout, stress, fatigue, and resilience were included. COVIDENCE software was used for screening.

RESULTS: A total of 55 studies were included in the review. Of these 55 studies, 51 measured burnout, stress, fatigue, or resilience, using 77 different instruments. The MBI-HSS, PSS-10, BRS, Brief-COPE, and CD-RISC were the most common tools to assess burnout, stress, and individual resilience. Four studies evaluated resilience interventions, using mindfulness training, meditation, progressive muscle relaxation, and yoga.

CONCLUSION: There are many studies assessing burnout, stress, and resilience among HCP in Southern and South-eastern Asia, yet gaps remain in identifying effective resilience-building interventions. Further research is needed to assess the impact of individual resilience on health systems resilience.

RevDate: 2025-12-12
CmpDate: 2025-12-12

Manivannan SN, Diaz Arenas C, Grubaugh ND, et al (2025)

The importance of epistasis in the evolution of viral pathogens.

Virus evolution, 11(1):veaf091.

Understanding the genetic and genomic underpinnings of infectious disease outbreaks has emerged as a frontier of epidemiology. Here, we argue that epistasis-where the phenotypic effects of mutations or gene variants are dictated by the presence of other mutations or genes-should become a focus of genomic epidemiology. To demonstrate this, we present the results of a systematic review of the literature on epistasis in viruses, focusing on three major human viral systems: (i) influenza, (ii) SARS-CoV-2, and (iii) human immunodeficiency virus, as well as two other bodies of the literature mainly focusing on nonhuman viruses: (iv) tobacco etch virus and (v) experimental evolution of viruses. Our systematic review of these five bodies of the literature highlights that epistasis is prevalent in host-virus systems of various kinds, manifesting within and between different loci, with effects of different magnitudes and directions, and shaping various phenotypic traits of epidemiological interest. At the same time, our systematic review demonstrates that our ability to draw general conclusions about the direction and magnitude of epistasis in viral evolution is constrained by several factors: the idiosyncrasies of virus-host systems, biases in the underlying data collection exercises, and the limitations of existing methods. Moving forward, we encourage collaborations between genomic epidemiologists and evolutionary biologists to identify and measure epistasis in studying the evolution of viral pathogens.

RevDate: 2025-12-12
CmpDate: 2025-12-12

Xu T, Zhang J, Hou X, et al (2025)

MIS-C pathogenesis: immune dysregulation & viral triggers.

Frontiers in immunology, 16:1624963.

Multisystem Inflammatory Syndrome in Children (MIS-C) is a serious condition emerging during the COVID-19 pandemic, strongly associated with prior SARS-CoV-2 infection. Characterized by systemic inflammation affecting multiple organs, MIS-C presents a complex clinical picture including fever, gastrointestinal distress, cardiac dysfunction, and neurological manifestations. Although its exact pathogenesis remains incompletely understood, immune dysregulation is recognized as a central mechanism. This review examines current understanding of MIS-C pathogenesis, focusing on immune dysfunction and viral triggers, particularly SARS-CoV-2. We analyze both innate and adaptive immune responses, cytokine storm dynamics, molecular mimicry, and virus-induced inflammatory cascades. Additionally, we discuss potential immunomodulatory therapeutic strategies and identify future research directions to improve MIS-C management and treatment outcomes.

RevDate: 2025-12-12
CmpDate: 2025-12-12

Okon MB, Ugwu OP, Ugwu CN, et al (2025)

From pandemics to preparedness: harnessing AI, CRISPR, and synthetic biology to counter biosecurity threats.

Frontiers in public health, 13:1711344.

Biosecurity threats, which include natural outbreaks, laboratory accidents, and intentional bioterrorism, are a major issue for global health security. The impact of poor preparedness on the health, social, and economic effects of the 1918 influenza pandemic, the 2001 anthrax attacks, and the COVID-19 crisis is devastating. Standard methods, such as quarantine and serology, as well as traditional inoculations, offered basic defences but were often reactive, slow, and unfair. The recent scientific and technological progress has altered the concept of biosecurity preparedness by providing new instruments of early detection, quick reaction, and fair health solutions. Artificial intelligence-based epidemic prediction, next-generation sequencing, CRISPR-based diagnostics, and digital epidemiology are emerging technologies that enable near-real-time surveillance. New therapeutic agents and vaccines, such as mRNA and DNA platforms, monoclonal antibodies, and nanobody therapies, have enhanced response capabilities. Containment measures based on robotics, biosensors, nanotechnology-based PPE, and portable biocontainment units have simultaneously improved frontline safety. Sensitive health information and enhanced coordination are today secured with the help of digital and cyber-biosecurity tools. Nonetheless, the innovations have ethical, legal, and equity issues, which point to the need to govern responsibly and make them accessible to all. This review brings forth the incorporation of emerging technologies with international cooperation, fair systems, and responsive policies as the keys to developing resilient and future-orientated systems that could help alleviate natural, accidental, and intentional biosecurity threats.

RevDate: 2025-12-11

Ballout S, Darwish SA, Kelly PJ, et al (2025)

The use of storytelling in COVID-19 vaccine promotion: A scoping review of interventions and campaigns.

Vaccine, 72:128098 pii:S0264-410X(25)01396-9 [Epub ahead of print].

BACKGROUND: The development of the COVID-19 vaccine, a groundbreaking scientific advancement, also fueled vaccine hesitancy mainly due to vaccine misinformation and the limited public understanding of the new technology and its rapid pace of development and deployment. A variety of public health communication strategies have been used that include engaging the community in identifying and developing messages, using culturally appropriate communication methods, applying behavioral health principles, and storytelling. The purpose of this scoping review was to assess the most relevant evidence from the research literature on storytelling interventions to mitigate COVID vaccine hesitancy during the pandemic.

METHODS: A scoping review was conducted using the PICOS framework and PRISMA-ScR guidelines, examining studies across 16 databases published between 2020 and October 2025.

RESULTS: Twelve studies met inclusion criteria. Studies involved diverse populations and four implementation themes (cultural relevance, emotional engagement, participant involvement and reach) were identified. The experimental and quasi-experimental studies consistently found that narratives elicited greater emotional engagement, heightened perceived credibility, and stronger identification with the messenger.

CONCLUSION: Storytelling is recognized as a critical component of public health campaigns in its ability to leverage the power of community influencers, such as religious leaders, educators, and local advocates who echo community values. Long-term cohort studies, community-based social marketing campaigns, and qualitative studies are needed to assess specific impacts on vaccination behaviors. Storytelling, when tailored to audience, culture, and context, can contribute to promotion of vaccination, particularly in improving trust, empathy, and misinformation.

RevDate: 2025-12-11

Sorotos M, Firmani G, Mareş T, et al (2025)

Epidemiology of Breast Implant-Associated Anaplastic Large Cell Lymphoma - A systematic review of literature.

Journal of plastic, reconstructive & aesthetic surgery : JPRAS, 113:399-410 pii:S1748-6815(25)00695-3 [Epub ahead of print].

INTRODUCTION: Breast Implant Associated - Anaplastic Large Cell Lymphoma (BIA-ALCL) cases are steadily increasing worldwide. When considering only the patients with textured implant as the active population, prevalence appears higher than previously reported, and uncertainty regarding incidence rate (IR) trends. We aimed to provide comprehensive estimates by identifying epidemiologic studies reporting prevalence, risk, and IR.

METHODS: A systematic review was conducted up to November 2024 across PubMed, Google Scholar, and Web of Science. Epidemiological data were extracted from the "Patient Registry and Outcomes for Breast Implants and Anaplastic Large Cell Lymphoma Etiology and Epidemiology" (PROFILE) registry (US-specific), Food and Drug Administration (FDA)-Medical Device Reporting (MDR) (US/global), and BIA-ALCL Global Network (worldwide), providing granular data for 2019-2024, enabling yearly IR analysis. All findings were normalized using textured implants patients as the denominator. Interrupted time-series analysis was used to determine the impact of the COVID-19 pandemic on BIA-ALCL reporting.

RESULTS: Among the 1949 studies, 23 were analyzed.

PREVALENCE: 1.0-397.9/100,000 persons; risk: 1:250-1:99,992; and IR 0.021-124/100.000 persons/year. Nationally (US), PROFILE and FDA-MDR data showed IR peaking in 2020 (16.4 and 25.7/100,000) and then declining. Globally, FDA-MDR estimates peaked in 2021 (0.95/100,000) and plummeted in 2022 (0.14/100,000). Global Network data peaked in 2018 (0.68/100,000), dropped in 2020 (0.18/100,000), but rose again in 2024 (0.73/100,000). Significant IR declines (p = 0.02), were identified during the COVID-19 pandemic (2020-2022). Global data suggest transient underreporting and diagnostic delays.

CONCLUSION: BIA-ALCL IR decreased in 2022, then rose globally in 2023-2024, but not in the US, where it continued declining. IR trends were increasing but were influenced by COVID-19, with differences in absolute values likely reflecting smooth vs. textured implant market share variations. Contextualizing epidemiology by surface type and geography remains fundamental.

RevDate: 2025-12-11

Salamh P, Dilibe-Daramola F, Flannery A, et al (2025)

Incidence and characteristics among individuals developing frozen shoulder following COVID-19 vaccine administration: A systematic review.

Physiotherapy theory and practice [Epub ahead of print].

PURPOSE: Perform a systematic review to determine incidence and characteristics of vaccine administration of those developing frozen shoulder (FS) following COVID-19 vaccine administration.

METHODOLOGY: Systematic review of the literature (PROSPERO number CRD42024611140). Inclusion criteria; diagnosis of frozen shoulder, published or available in the English language and onset of frozen shoulder linked to COVID-19 vaccination. Studies were excluded if FS was linked to onset outside of vaccination and if data were not separated. Relevant studies were assessed for inclusion and selected studies were identified from PubMed, EMBASE, EBSCOhost, Cochrane Library, Web of Science and CINAHL databases. The search strategy was developed by a biomedical librarian run on August 4, 2025. Data were extracted from retained studies and underwent quality assessment using The Joanna Briggs Institute Critical Appraisal Checklist.

RESULTS: The search resulted in 1,506 studies and 9 retained for appraisal. A total of 140 individuals were identified among the retained studies with past medical history being reported in 6 of these studies identifying diabetes and hypothyroidism among the most common. Vaccine manufacturer and symptom manifestation data were reported in all retained studies. Incidence could not be determined based on available data.

CONCLUSION: In addition to known risk factors associated with vaccinations, those with comorbidities associated with the etiology of FS may also be predisposed to developing FS following COVID-19 vaccination administration. Clinicians evaluating those with suspected FS should be aware of the link between vaccinations and the development of FS. Additionally, clinicians administering COVID-19 vaccinations and boosters need to be aware of potential risk factors that may predispose individuals to developing FS following as well as possible signs and symptoms to be aware of post-vaccination.

RevDate: 2025-12-11
CmpDate: 2025-12-11

Nazarian E, Sinnige JS, Bos LDJ, et al (2025)

Advances in bedside imaging: lung ultrasound.

Intensive care medicine experimental, 13(1):126.

Lung ultrasound has become an indispensable tool in the management of acute respiratory failure, offering real-time, radiation-free bedside imaging. Its portability, repeatability, and high sensitivity for detecting pulmonary abnormalities have made it particularly valuable in critical care settings, especially during the Coronavirus disease 2019 pandemic. This narrative review explores the evolving role of lung ultrasound, examining both its established clinical applications and recent advances in artificial intelligence and imaging analysis. These developments emphasize the growing importance of lung ultrasound not only as a diagnostic tool but also as a platform for innovation, with artificial intelligence-driven approaches to further enhance its clinical utility.

RevDate: 2025-12-12
CmpDate: 2025-12-12

Worthington D (2025)

Integration of Virtual Care in the Audiology Service and Beyond.

American journal of audiology, 34(4):767-780.

PURPOSE: This clinical focus article examines the history and evolution of telehealth, emphasizing its technological advancements, integration into health care systems, and the transformative impact of the COVID-19 pandemic on telehealth utilization in the United States, within the private sector and the Veterans Health Administration (VHA). Particular attention is given to the integration of audiology within telehealth, highlighting how the growth and use of teleaudiology services within the VHA have expanded access to this specialized care for Veterans. It aims to clarify how telehealth, including teleaudiology, has been established as a critical modality for enhancing health care access and delivery to Veterans.

CONCLUSIONS: The historical context reveals that, while telehealth has roots tracing back to the American Civil War or earlier, the COVID-19 pandemic catalyzed an unprecedented surge in adoption and integration of telehealth services in both the private sector and the VHA. The data indicate a significant increase in telehealth encounters and patient satisfaction before, during, and after the COVID-19 pandemic, reinforcing its role as a complementary modality alongside traditional in-person care. Challenges such as regulatory barriers and digital access disparities continue to exist, yet ongoing efforts to embed telehealth training in health care education and to foster technological innovation signal a promising future for telehealth. As the health care landscape evolves, telehealth is poised to remain an integral component of patient-centered care.

RevDate: 2025-12-12
CmpDate: 2025-12-12

Ajulo HK, Alele FO, Emeto TI, et al (2025)

Spatial and spatiotemporal machine learning models for COVID-19 dynamics: a review of methodology and reporting practices.

Epidemiologic reviews, 47(1):.

COVID-19 has transitioned from a pandemic to an endemic state, but the emergence of novel variants continues to pose significant public health challenges. In this study, the application of spatial and spatiotemporal machine learning (ML) models in understanding the dynamics of COVID-19 was systematically reviewed, as were contextual local-level comprehensive socio-environmental drivers. A systematic search was conducted across the Scopus, Web of Science, PubMed, Emcare (via Ovid), and the World Health Organization COVID-19 databases, and gray literature, adhering to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Data extraction was conducted according to the Critical Appraisal and Data Extraction for Systematic Reviews of Prediction Modeling Studies checklist, and study quality was assessed using a validated scoring system. A total of 42 studies met the inclusion criteria. The review Findings indicate that global-scale spatial and spatiotemporal ML models dominate the field. Long-standing standalone factors in the demographic, environmental, and socioeconomic domains are frequently used as local-level drivers. However, the integration of composite indicators, aggregating multiple standalone factors into a single score, is notably lacking. Such composite indicators have the potential to reduce model complexity, improve interpretability, and enhance performance by capturing multidimensional aspects of vulnerability or risk in a more simplified form. This review highlights critical gaps in the current use of spatial and spatiotemporal ML models to understand the spatial epidemiology of COVID-19. Addressing these gaps could significantly enhance the understanding of COVID-19 dynamics and inform the development of effective public health strategies to mitigate future threats.

RevDate: 2025-12-12
CmpDate: 2025-10-17

Karakonstantis S, Lytras T, Keske S, et al (2025)

The Care Continuum of Patients With Influenza in the Post-COVID-19 Era: A Position Paper.

The Journal of infectious diseases, 232(Supplement_3):S333-S346.

This position paper addresses the evolving care continuum for patients with respiratory viral infections in the context of the post-coronavirus disease 2019 pandemic phase. We emphasize the need to place the patient at the center of attention from the first signs of influenza-like illness to recovery. Current practices have revealed several deficiencies, such as timely access to healthcare, fragmentation of care, and inadequate follow-up instructions. This article proposes means to address these deficiencies and discusses diagnostic and management considerations for patients with suspected influenza infection.

RevDate: 2025-12-12
CmpDate: 2025-12-12

Cruise C (2025)

Overview of Telehealth in the Department of Veterans Affairs.

American journal of audiology, 34(4):781-784.

BACKGROUND: Telehealth facilitates access to care via technology and broadband infrastructure, remotely connecting patients and their clinical care teams. This is particularly important for those in rural and medically underserved areas, where there may be a lack of specialty medical care, and terrain, weather, or transportation options may make travel to a health care facility difficult.

PURPOSE: The purpose of this clinical focus article is to provide an overview of the history, current state, and future direction of telehealth within the Department of Veterans Affairs.

CONCLUSIONS: A variety of tools and technology with which telehealth can be delivered exist. This enables health care organizations to leverage their clinical networks to match supply and demand across their enterprise and offer additional choices for how patients receive their care. The COVID-19 pandemic was an opportune time for expansion of telehealth. Postpandemic, in many health care systems, it has become a core part of clinical operations. To realize the full potential of telehealth and to ensure equity across populations, addressing gaps in broadband access and digital skills will be critical.

RevDate: 2025-12-12
CmpDate: 2025-05-09

Chen JG, Chen CY, Zhu K, et al (2025)

[Interpretation of the Position Paper on Olfactory Dysfunction 2023 (PPOD-23)].

Zhonghua er bi yan hou tou jing wai ke za zhi = Chinese journal of otorhinolaryngology head and neck surgery, 60(2):212-216.

RevDate: 2025-12-12
CmpDate: 2025-02-05

Pennestrì F, Cabitza F, Picerno N, et al (2025)

Sharing reliable information worldwide: healthcare strategies based on artificial intelligence need external validation. Position paper.

BMC medical informatics and decision making, 25(1):56.

Training machine learning models using data from severe COVID-19 patients admitted to a central hospital, where entire wards are specifically dedicated to COVID-19, may yield predictions that differ significantly from those generated using data collected from patients admitted to a high-volume specialized hospital for orthopedic surgery, where COVID-19 is only a secondary diagnosis. This disparity arises despite the two hospitals being geographically close (within20 kilometers). While machine learning can facilitate rapid public health responses, rigorous external validation and continuous monitoring are essential to ensure reliability and safety.

RevDate: 2025-12-12
CmpDate: 2024-11-29

Jacobsen FF, Glasdam S, Haukelien H, et al (2024)

Healthy ageing in long-term care? Lessons learned from the COVID-19 pandemic: a position paper.

Primary health care research & development, 25:e66.

AIM: This position paper focuses on healthy ageing for the frailest and institutionalized older adults in the context of the recent pandemic. The paper aims to identify and discuss hindering and promoting factors for healthy ageing in this context, taking both health safety and a meaningful social life into account, in a pandemic situation and beyond.

BACKGROUND: The recent COVID-19 pandemic has highlighted the vulnerability of frail older adults residing in long-term care institutions. This is a segment of the older population that does not seem to align well with the recent policy trend of healthy and active ageing. The need for healthy ageing in this population has been voiced by professionals and interest organizations alike, alluding to inadequate support systems during the pandemic, conditioned by both previous and newly emerging contextual factors. Supporting healthy ageing in older adults in nursing homes and other residential care settings calls for attending to meaningful social life as well as to disease control.

METHODS: Findings and early conclusions leading up to the position paper were presented with peer discussions involving healthcare professionals and researchers at two joint EFPC PRIMORE workshops 2021 and 2022, as well as other international research seminars on long-term care. The following aspects of long-term care and COVID-19 were systematically discussed in those events, with reference to relevant research literature: 1. Long-term care policies, 2. pre-COVID state of long-term care facilities and vulnerability to the pandemic, 3. factors influencing the extent of spread of infection in long-term care facilities, and 4. the challenge of balancing between strict measures for infection control and maintaining a meaningful social life for residents and their significant others.

FINDINGS: A policy shift towards ageing at home and supporting the healthiest of older adults seems to have had unwarranted effects both for frail older adults, their significant others, and professional care staff attending to their needs. Resulting insufficient investment in primary health care staff and in the built environment for frail older adults in nursing homes were detrimental both for the older adults living in nursing homes, their significant others, and staff. More investment in staff and in physical surroundings might improve the quality of care and the social life of older adults in nursing homes in a non-pandemic situation and be a resource for primary health care staff ensuring both protection from health hazards and a meaningful social life for frail older adults in a pandemic or epidemic situation. As for investing in the physical surroundings, smaller nursing homes are advantageous, with singular resident rooms and for developing out-and indoor spaces for socializing and for meeting with families and other visitors. Regarding investment in staff, there is a documented need for educated staff in full-time positions. Use of part-time or temporary staff should be limited.

RevDate: 2025-12-12
CmpDate: 2025-04-25

Vohra KP, Johnson KG, Dalal A, et al (2025)

Recommendations for permanent sleep telehealth: an American Academy of Sleep Medicine position statement.

Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine, 21(2):401-404.

UNLABELLED: Telehealth use greatly expanded under the Centers for Medicare and Medicaid Services waivers at the start of the COVID-19 pandemic; however, the uncertainty and limitations of continued coverage risks loss of this momentum. Permanent coverage with adequate reimbursement is essential for the long-term acceptance and expansion of telehealth services. Telehealth supports both the current and future need for sleep health management by expanding patient access, increasing clinician efficiency, improving patient safety, and addressing health care equity. Sleep medicine is an ideal field for telehealth due to limited provider access, safety concerns with sleepy patients, availability of remote patient monitoring for treatment management, and the minimal need for repeated physical examinations. Telehealth is noninferior for delivery of cognitive behavioral therapy for insomnia and can enhance obstructive sleep apnea treatment adherence. It is the position of the American Academy of Sleep Medicine that telehealth is an essential tool for the provision of high-quality, patient-centered care for patients with sleep disorders. We encourage all stakeholders including legislators, policymakers, clinicians, and patients to work together to address payment models, interstate care, technology access, prescribing practices, and ongoing research to ensure that sleep telehealth services are permanently available and accessible for all patients seeking sleep medicine care.

CITATION: Vohra KP, Johnson KG, Dalal A, et al. Recommendations for permanent sleep telehealth: an American Academy of Sleep Medicine position statement. J Clin Sleep Med. 2025;21(2):401-404.

RevDate: 2025-12-12
CmpDate: 2024-11-01

Assiri AM, Alshahrani AM, Sakkijha H, et al (2024)

Transforming respiratory tract infection diagnosis in the kingdom of saudi arabia through point-of-care testing: A white paper for policy makers.

Diagnostic microbiology and infectious disease, 110(4):116530.

With the evident increased prevalence of respiratory tract infections (RTIs) such as Respiratory Syncytial Virus (RSV), influenza, Group A Streptococcus (GAS), and COVID-19, the conventional diagnostic methods are considered sub-optimal in providing timely management to patients in the Kingdom of Saudi Arabia (KSA). Gaps in current diagnostics are magnified by the Kingdom's unique demographic composition, comprising 11.9 million foreign workers, and the annual influx of over 10 million pilgrims. Current gaps in timely diagnosis leads to delays in treatment, misuse of antibiotics, and protracted hospital stays, subsequently compromising patient care, and escalating healthcare costs. KSA healthcare stakeholders suggest that the integration of rapid molecular Point-of-Care Testing (POCT) into the Kingdom's healthcare infrastructure is an absolute necessity. This publication serves as an urgent call for action aimed at healthcare policymakers in Saudi Arabia, to review the existing diagnostic challenges and include rapid POCTs in the Saudi healthcare strategy for respiratory infections.

RevDate: 2025-12-12
CmpDate: 2024-09-16

Snyder Sulmasy L, Burnett JR, Carney JK, et al (2024)

Ethics and Academic Discourse, Scientific Integrity, Uncertainty, and Disinformation in Medicine: An American College of Physicians Position Paper.

Annals of internal medicine, 177(9):1244-1250.

Respect for the scientific process and a diversity of views; open discourse and debate based on principles of ethics, best available evidence, and scientific inquiry and integrity; and an understanding of evidence gaps and uncertainty and how to communicate about them are important values in the advancement of science and the practice of medicine. Physicians often must make decisions about their recommendations to patients in the face of scarce or conflicting data. Are these characteristics of medicine and science widely understood and effectively communicated among members of the profession and to patients and the public? Issues of scientific integrity are longstanding, but COVID-19 brought them to the forefront, in an environment that was sometimes characterized by communication missteps as guidance came and went-or changed-quickly. Today, is open debate flourishing? Have some debates shed more heat than light? Are people losing confidence in science and medicine? In health care institutions? The American College of Physicians explores these issues and offers guidance in this position paper.

RevDate: 2025-12-12
CmpDate: 2024-09-27

Hsu VP, Pergam SA, Shenoy ES, et al (2024)

SHEA position statement on pandemic preparedness for policymakers: emerging infectious threats.

Infection control and hospital epidemiology, 45(7):818-820.

RevDate: 2025-12-12
CmpDate: 2024-10-23

Freeman RJ, States LJ, Lewandowski SA, et al (2024)

ACPM Position Statement: Air Pollution and Environmental Justice.

American journal of preventive medicine, 67(5):792-800.

The American Lung Association's "State of the Air" 2023 report reveals almost 36% of Americans live with unhealthy levels of air pollution. Studies link air pollution with acute respiratory symptoms and exacerbation of respiratory and cardiovascular diseases. Differential air pollution exposures between white and nonwhite communities are significant components of environmental injustices. Even during the coronavirus disease 2019 (COVID-19) lockdown, when the United States experienced significant decreases in polluting activities, these differences persisted. The American College of Preventive Medicine's Science and Translation Committee conducted a nonsystematic literature review to explore initiatives addressing air pollution as a key component of environmental justice, the state of the science regarding health impacts, and evidence supporting mitigations to reduce those impacts. We recommend advocacy for cleaner energy sources and increasing green space; and increasing research, surveillance, and education and training on linkages between air pollutants and health. We recommend preventive medicine physicians raise awareness about increased risks of cardiovascular disease, cancer, asthma, and reduced lung function with air pollution exposure. Preventive medicine physicians may also educate patients and other practitioners about exposures, and how "conventional" disease prevention strategies may have unintended consequences; and influence healthcare leaders to improve efficiency and reduce emissions. We also recommend physicians utilize social determinants of health Z-Codes to capture environmental factors. Private payers should incorporate pollution exposure data into social determinants of health risk adjustments for Medicare Advantage programs. Medicaid agencies should develop provider recommendations for pediatric populations, and states should finance in-home interventions for asthma.

RevDate: 2025-12-12
CmpDate: 2024-09-27

Branch-Elliman W, Banach DB, Batshon LJ, et al (2024)

SHEA position statement on pandemic preparedness for policymakers: pandemic data collection, maintenance, and release.

Infection control and hospital epidemiology, 45(7):821-825.

The Society for Healthcare Epidemiology in America (SHEA) strongly supports modernization of data collection processes and the creation of publicly available data repositories that include a wide variety of data elements and mechanisms for securely storing both cleaned and uncleaned data sets that can be curated as clinical and research needs arise. These elements can be used for clinical research and quality monitoring and to evaluate the impacts of different policies on different outcomes. Achieving these goals will require dedicated, sustained and long-term funding to support data science teams and the creation of central data repositories that include data sets that can be "linked" via a variety of different mechanisms and also data sets that include institutional and state and local policies and procedures. A team-based approach to data science is strongly encouraged and supported to achieve the goal of a sustainable, adaptable national shared data resource.

RevDate: 2025-12-12
CmpDate: 2024-09-27

Weber DJ, Malani AN, Shenoy ES, et al (2024)

Society for Healthcare Epidemiology of America position statement on pandemic preparedness for policymakers: mitigating supply shortages.

Infection control and hospital epidemiology, 45(7):813-817.

The COVID-19 has had major direct (e.g., deaths) and indirect (e.g., social inequities) effects in the United States. While the public health response to the epidemic featured some important successes (e.g., universal masking ,and rapid development and approval of vaccines and therapeutics), there were systemic failures (e.g., inadequate public health infrastructure) that overshadowed these successes. Key deficiency in the U.S. response were shortages of personal protective equipment (PPE) and supply chain deficiencies. Recommendations are provided for mitigating supply shortages and supply chain failures in healthcare settings in future pandemics. Some key recommendations for preventing shortages of essential components of infection control and prevention include increasing the stockpile of PPE in the U.S. National Strategic Stockpile, increased transparency of the Stockpile, invoking the Defense Production Act at an early stage, and rapid review and authorization by FDA/EPA/OSHA of non-U.S. approved products. Recommendations are also provided for mitigating shortages of diagnostic testing, medications and medical equipment.

RevDate: 2025-12-12
CmpDate: 2024-09-27

Banach DB, Mathew TA, Batshon LJ, et al (2024)

SHEA position statement on pandemic preparedness for policymakers: building a strong and resilient healthcare workforce.

Infection control and hospital epidemiology, 45(7):804-807.

Throughout the COVID-19 pandemic, many areas in the United States experienced healthcare personnel (HCP) shortages tied to a variety of factors. Infection prevention programs, in particular, faced increasing workload demands with little opportunity to delegate tasks to others without specific infectious diseases or infection control expertise. Shortages of clinicians providing inpatient care to critically ill patients during the early phase of the pandemic were multifactorial, largely attributed to increasing demands on hospitals to provide care to patients hospitalized with COVID-19 and furloughs.[1] HCP shortages and challenges during later surges, including the Omicron variant-associated surges, were largely attributed to HCP infections and associated work restrictions during isolation periods and the need to care for family members, particularly children, with COVID-19. Additionally, the detrimental physical and mental health impact of COVID-19 on HCP has led to attrition, which further exacerbates shortages.[2] Demands increased in post-acute and long-term care (PALTC) settings, which already faced critical staffing challenges difficulty with recruitment, and high rates of turnover. Although individual healthcare organizations and state and federal governments have taken actions to mitigate recurring shortages, additional work and innovation are needed to develop longer-term solutions to improve healthcare workforce resiliency. The critical role of those with specialized training in infection prevention, including healthcare epidemiologists, was well-demonstrated in pandemic preparedness and response. The COVID-19 pandemic underscored the need to support growth in these fields.[3] This commentary outlines the need to develop the US healthcare workforce in preparation for future pandemics.

RevDate: 2025-12-12
CmpDate: 2024-09-27

Hsu VP, Haessler S, Banach DB, et al (2024)

SHEA position statement on pandemic preparedness for policymakers: introduction and overview.

Infection control and hospital epidemiology, 45(7):801-803.

Throughout history, pandemics and their aftereffects have spurred society to make substantial improvements in healthcare. After the Black Death in 14[th] century Europe, changes were made to elevate standards of care and nutrition that resulted in improved life expectancy.[1] The 1918 influenza pandemic spurred a movement that emphasized public health surveillance and detection of future outbreaks and eventually led to the creation of the World Health Organization Global Influenza Surveillance Network.[2] In the present, the COVID-19 pandemic exposed many of the pre-existing problems within the US healthcare system, which included (1) a lack of capacity to manage a large influx of contagious patients while simultaneously maintaining routine and emergency care to non-COVID patients; (2) a "just in time" supply network that led to shortages and competition among hospitals, nursing homes, and other care sites for essential supplies; and (3) longstanding inequities in the distribution of healthcare and the healthcare workforce. The decades-long shift from domestic manufacturing to a reliance on global supply chains has compounded ongoing gaps in preparedness for supplies such as personal protective equipment and ventilators. Inequities in racial and socioeconomic outcomes highlighted during the pandemic have accelerated the call to focus on diversity, equity, and inclusion (DEI) within our communities. The pandemic accelerated cooperation between government entities and the healthcare system, resulting in swift implementation of mitigation measures, new therapies and vaccinations at unprecedented speeds, despite our fragmented healthcare delivery system and political divisions. Still, widespread misinformation or disinformation and political divisions contributed to eroded trust in the public health system and prevented an even uptake of mitigation measures, vaccines and therapeutics, impeding our ability to contain the spread of the virus in this country.[3] Ultimately, the lessons of COVID-19 illustrate the need to better prepare for the next pandemic. Rising microbial resistance, emerging and re-emerging pathogens, increased globalization, an aging population, and climate change are all factors that increase the likelihood of another pandemic.[4].

RevDate: 2025-12-12
CmpDate: 2024-06-15

Suen LW, Incze M, Simon C, et al (2024)

Methadone's Resurgence in Bridging the Treatment Gap in the Overdose Crisis: Position Statement of AMERSA, Inc (Association for Multidisciplinary Education, Research, Substance Use, and Addiction).

Substance use & addiction journal, 45(3):337-345.

BACKGROUND: The United States is grappling with an unprecedented overdose crisis, exacerbated by the proliferation of potent synthetic opioids like illicitly manufactured fentanyl. Despite the efficacy of methadone treatment in managing opioid use disorder, regulatory barriers hinder its widespread utilization. This article examines the complex landscape of methadone regulation across federal, state, and local levels, highlighting disparities and opportunities for reform.

ISSUE: The COVID-19 public health emergency prompted temporary flexibility in methadone regulations, including expanded take-home doses and telehealth counseling, leading to improved treatment experiences and retention. Permanent revisions to federal guidelines have since been introduced by the Substance Abuse and Mental Health Services Administration, reflecting a progressive shift toward patient-centered care and streamlined access. State regulations, managed by Single State Agencies and State Opioid Treatment Authorities, vary widely, often imposing additional restrictions that impede access to methadone treatment. Local OTP clinics further exacerbate barriers through stringent policies, despite federal and state guidelines advocating for flexibility.

RECOMMENDATIONS: Coordinated efforts among policymakers, healthcare providers, and communities are needed to promote the development of accountability measures, incentives, and community involvement to ensure equitable access and quality of care. To truly meet the demand needed to end the existing overdose crisis and enhance accessibility and comprehensive healthcare services, methadone treatment expansion beyond traditional OTP settings into primary care offices and community pharmacies should take place.

RevDate: 2025-12-12
CmpDate: 2024-05-28

Tomasiewicz K, Woron J, Kobayashi A, et al (2024)

Post-COVID-19 syndrome in everyday clinical practice: interdisciplinary expert position statement endorsed by the Polish Society of Civilization Diseases.

Polish archives of internal medicine, 134(5):.

Post-COVID-19 syndrome, also known as long COVID-19 syndrome, is a complex set of symptoms that persist for weeks or months after recovery from an acute phase of COVID-19. These symptoms can affect various body systems, including the respiratory, nervous, cardiovascular, and digestive systems. The most common complaints are fatigue, shortness of breath, joint pain, taste and smell disorders, as well as problems with memory and concentration. Pathogenesis of post-COVID-19 syndrome is complicated and not fully understood, but it is likely related to an overactive immune system, disturbances in the intestinal microbiome, and cell and tissue damage caused by the virus. Incorporating a multidisciplinary approach to treating and rehabilitating patients and further research into this syndrome's underlying mechanisms and therapy are crucial for understanding and effectively treating this complex and multifaceted condition.

RevDate: 2025-12-12
CmpDate: 2024-01-26

Zuin M, Di Fusco SA, Zilio F, et al (2024)

[ANMCO Position paper - 2023 ANMCO States General: Towards a modern Cardiological Community Care].

Giornale italiano di cardiologia (2006), 25(2):121-125.

Over the last two decades, cardiovascular diseases have become the leading cause of chronic disease morbidity and mortality in Italy. Therefore, the chronic cardiovascular care landscape has evolved rapidly in an era of unprecedented demand. Furthermore, the COVID-19 pandemic has highlighted significant deficiencies in existing health and social care systems, especially in the management of chronic cardiovascular disease. In this scenario, the National Reform for Recovery and Resilience (PNRR) may represent a unique opportunity for the development of a new integrated care system between hospital and community. The Italian Association of Hospital Cardiologists (ANMCO) recognizes the need for a statement on the integrated cardiological community care to guide health professionals caring for people with chronic cardiovascular conditions. The aim of the present statement is to outline the evidence for a modern integrated cardiological community care identifying challenges and offering advice for a future transdisciplinary and multi-organizational approach to ensure best practice in the management of chronic cardiovascular disease.

RevDate: 2025-12-12
CmpDate: 2024-02-15

Campbell A, Teh B, Mulligan S, et al (2024)

Australia and New Zealand consensus position statement: use of COVID-19 therapeutics in patients with haematological malignancies.

Internal medicine journal, 54(2):328-336.

Despite widespread vaccination rates, we are living with high transmission rates of SARS-CoV-2. Although overall hospitalisation rates are falling, the risk of serious infection remains high for patients who are immunocompromised because of haematological malignancies. In light of the ongoing pandemic and the development of multiple agents for treatment, representatives from the Haematology Society of Australia and New Zealand and infectious diseases specialists have collaborated on this consensus position statement regarding COVID-19 management in patients with haematological disorders. It is our recommendation that both patients with haematological malignancies and treating specialists be educated regarding the preventive and treatment options available and that patients continue to receive adequate vaccinations, keeping in mind the suboptimal vaccine responses that occur in haematology patients, in particular, those with B-cell malignancies and on B-cell-targeting or depleting therapy. Patients with haematological malignancies should receive treatment for COVID-19 in accordance with the severity of their symptoms, but even mild infections should prompt early treatment with antiviral agents. The issue of de-isolation following COVID-19 infection and optimal time to treatment for haematological malignancies is discussed but remains an area with evolving data. This position statement is to be used in conjunction with advice from infectious disease, respiratory and intensive care specialists, and current guidelines from the National COVID-19 Clinical Evidence Taskforce and the New Zealand Ministry of Health and Cancer Agency Te Aho o Te Kahu COVID-19 Guidelines.

RevDate: 2025-12-12
CmpDate: 2024-03-01

Mayorga C, Çelik GE, Pascal M, et al (2024)

Flow-based basophil activation test in immediate drug hypersensitivity. An EAACI task force position paper.

Allergy, 79(3):580-600.

Diagnosing immediate drug hypersensitivity reactions (IDHRs) can pose a significant challenge and there is an urgent need for safe and reliable tests. Evidence has emerged that the basophil activation test (BAT), an in vitro assay that mirrors the in vivo response, can be a complementary test for many drugs. In this position paper, members of Task Force (TF) "Basophil activation test in the evaluation of Drug Hypersensitivity Reactions" from the European Academy of Allergy and Clinical Immunology (EAACI) present the data from a survey about the use and utility of BAT in IDHRs in Europe. The survey results indicate that there is a great interest for using BAT especially for diagnosing IDHRs. However, there are still main needs, mainly in the standardization of the protocols. Subsequently consensus-based recommendations were formulated for: (i) Technical aspects of BAT in IDHRs including type of sample, management of drugs, flow cytometry protocols, interpretation of the results; and (ii) Drug-specific aspects that should be taken into account when performing BAT in relation to betalactams, neuromuscular blocking agents, fluoroquinolones, chlorhexidine, opioids, radio contrast media, chemotherapeutics, biological agents, nonsteroidal anti-inflammatory drugs, COVID vaccine, and excipients. Moreover, aspects in the evaluation of pediatric population have also been considered. All this indicates that BAT offers the clinician and laboratory a complementary tool for a safe diagnostic for IDHRs, although its place in the diagnostic algorithm depends on the drug class and patient population (phenotype, geography, and age). The standardization of BAT is important for generalizing this method beyond the individual laboratory.

RevDate: 2025-12-12
CmpDate: 2024-04-01

Smolinska S, Popescu FD, Izquierdo E, et al (2024)

Telemedicine with special focus on allergic diseases and asthma-Status 2022: An EAACI position paper.

Allergy, 79(4):777-792.

Efficacious, effective and efficient communication between healthcare professionals (HCP) and patients is essential to achieve a successful therapeutic alliance. Telemedicine (TM) has been used for decades but during the COVID-19 pandemic its use has become widespread. This position paper aims to describe the terminology and most important forms of TM among HCP and patients and review the existing studies on the uses of TM for asthma and allergy. Besides, the advantages and risks of TM are discussed, concluding that TM application reduces costs and time for both, HCP and patients, but cannot completely replace face-to-face visits for physical examinations and certain tests that are critical in asthma and allergy. From an ethical point of view, it is important to identify those involved in the TM process, ensure confidentiality and use communication channels that fully guarantee the security of the information. Unmet needs and directions for the future regarding implementation, data protection, privacy regulations, methodology and efficacy are described.

RevDate: 2025-12-12
CmpDate: 2024-01-26

Chernyshov PV, Finlay AY, Tomas-Aragones L, et al (2024)

Quality of life measurement in teledermatology. Position statement of the European Academy of Dermatology and Venereology Task Forces on Quality of Life and Patient Oriented Outcomes and Teledermatology.

Journal of the European Academy of Dermatology and Venereology : JEADV, 38(2):254-264.

Many events, including the COVID-19 pandemic, have accelerated the implementation of teledermatology pathways within dermatology departments and across healthcare organizations. Quality of Life (QoL) assessment in dermatology is also a rapidly developing field with a gradual shift from theory to practice. The purpose of this paper organized jointly by the European Academy of Dermatology and Venereology (EADV) Task Force (TF) on QoL and patient-oriented outcomes and the EADV TF on teledermatology is to present current knowledge about QoL assessment during the use of teledermatology approaches, including data on health-related (HR) QoL instruments used in teledermatology, comparison of influence of different treatment methods on HRQoL after face-to-face and teledermatology consultations and to make practical recommendations concerning the assessment of QoL in teledermatology. The EADV TFs made the following position statements: HRQoL assessment may be an important part in most of teledermatology activities; HRQoL assessment may be easily and effectively performed during teledermatology consultations. It is especially important to monitor HRQoL of patients with chronic skin diseases during lockdowns or in areas where it is difficult to reach a hospital for face-to-face consultation; regular assessment of HRQoL of patients with skin diseases during teledermatology consultations may help to monitor therapy efficacy and visualize individual patient's needs; we recommend the use of the DLQI in teledermatology, including the use of the DLQI app which is available in seven languages; it is important to develop apps for dermatology-specific HRQoL instruments for use in children (for example the CDLQI and InToDermQoL) and for disease-specific instruments.

RevDate: 2025-12-12
CmpDate: 2024-03-22

Rhee C, Strich JR, Chiotos K, et al (2024)

Improving Sepsis Outcomes in the Era of Pay-for-Performance and Electronic Quality Measures: A Joint IDSA/ACEP/PIDS/SHEA/SHM/SIDP Position Paper.

Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 78(3):505-513.

The Centers for Medicare & Medicaid Services (CMS) introduced the Severe Sepsis/Septic Shock Management Bundle (SEP-1) as a pay-for-reporting measure in 2015 and is now planning to make it a pay-for-performance measure by incorporating it into the Hospital Value-Based Purchasing Program. This joint IDSA/ACEP/PIDS/SHEA/SHM/SIPD position paper highlights concerns with this change. Multiple studies indicate that SEP-1 implementation was associated with increased broad-spectrum antibiotic use, lactate measurements, and aggressive fluid resuscitation for patients with suspected sepsis but not with decreased mortality rates. Increased focus on SEP-1 risks further diverting attention and resources from more effective measures and comprehensive sepsis care. We recommend retiring SEP-1 rather than using it in a payment model and shifting instead to new sepsis metrics that focus on patient outcomes. CMS is developing a community-onset sepsis 30-day mortality electronic clinical quality measure (eCQM) that is an important step in this direction. The eCQM preliminarily identifies sepsis using systemic inflammatory response syndrome (SIRS) criteria, antibiotic administrations or diagnosis codes for infection or sepsis, and clinical indicators of acute organ dysfunction. We support the eCQM but recommend removing SIRS criteria and diagnosis codes to streamline implementation, decrease variability between hospitals, maintain vigilance for patients with sepsis but without SIRS, and avoid promoting antibiotic use in uninfected patients with SIRS. We further advocate for CMS to harmonize the eCQM with the Centers for Disease Control and Prevention's (CDC) Adult Sepsis Event surveillance metric to promote unity in federal measures, decrease reporting burden for hospitals, and facilitate shared prevention initiatives. These steps will result in a more robust measure that will encourage hospitals to pay more attention to the full breadth of sepsis care, stimulate new innovations in diagnosis and treatment, and ultimately bring us closer to our shared goal of improving outcomes for patients.

RevDate: 2025-12-12
CmpDate: 2023-09-20

Serchen J, Cline K, Mathew S, et al (2023)

Preparing for Future Pandemics and Public Health Emergencies: An American College of Physicians Policy Position Paper.

Annals of internal medicine, 176(9):1240-1244.

The onset of the COVID-19 pandemic revealed significant gaps in the United States' pandemic and public health emergency response system. At the federal level, government responses were undercut by a lack of centralized coordination, inadequately defined responsibilities, and an under-resourced national stockpile. Contradictory and unclear guidance throughout the early months of the pandemic, along with inconsistent funding to public health agencies, also created notable variance in state and local responses. The lack of a coordinated response added pressure to an already overwhelmed health care system, which was forced to resort to rationing care and personal protective equipment, creating moral distress and trauma for health care workers and their patients. Despite these severe shortcomings, the COVID-19 pandemic also highlighted successful policies and approaches, such as Operation Warp Speed, which led to the fastest development and distribution of a vaccine in history. In this position paper, the American College of Physicians (ACP) offers several policy recommendations for enhancing federal, state, and local preparedness for future pandemic and public health emergencies. This policy paper builds on various statements produced by ACP throughout the COVID-19 pandemic, including on the ethical distribution of vaccinations and resources, conditions to resume economic and social activity, and efforts to protect the health and well-being of medical professionals, among others.

RevDate: 2025-12-12
CmpDate: 2024-04-18

Whitcroft KL, Altundag A, Balungwe P, et al (2023)

Position paper on olfactory dysfunction: 2023.

Rhinology, 61(33):1-108.

BACKGROUND: Since publication of the original Position Paper on Olfactory Dysfunction in 2017 (PPOD-17), the personal and societal burden of olfactory disorders has come sharply into focus through the lens of the COVID-19 pandemic. Clinicians, scientists and the public are now more aware of the importance of olfaction, and the impact of its dysfunction on quality of life, nutrition, social relationships and mental health. Accordingly, new basic, translational and clinical research has resulted in significant progress since the PPOD-17. In this updated document, we present and discuss currently available evidence for the diagnosis and management of olfactory dysfunction. Major updates to the current version include, amongst others: new recommendations on olfactory related terminology; new imaging recommendations; new sections on qualitative OD and COVID-19 OD; updated management section. Recommendations were agreed by all co-authors using a modified Delphi process.

CONCLUSIONS: We have provided an overview of current evidence and expert-agreed recommendations for the definition, investigation, and management of OD. As for our original Position Paper, we hope that this updated document will encourage clinicians and researchers to adopt a common language, and in so doing, increase the methodological quality, consistency, and generalisability of work in this field.

RevDate: 2025-12-12
CmpDate: 2023-06-15

Brody S, Loree S, Sampson M, et al (2023)

Searching for evidence in public health emergencies: a white paper of best practices.

Journal of the Medical Library Association : JMLA, 111(1-2):566-578.

OBJECTIVES: Information professionals have supported medical providers, administrators and decision-makers, and guideline creators in the COVID-19 response. Searching COVID-19 literature presented new challenges, including the volume and heterogeneity of literature and the proliferation of new information sources, and exposed existing issues in metadata and publishing. An expert panel developed best practices, including recommendations, elaborations, and examples, for searching during public health emergencies.

METHODS: Project directors and advisors developed core elements from experience and literature. Experts, identified by affiliation with evidence synthesis groups, COVID-19 search experience, and nomination, responded to an online survey to reach consensus on core elements. Expert participants provided written responses to guiding questions. A synthesis of responses provided the foundation for focus group discussions. A writing group then drafted the best practices into a statement. Experts reviewed the statement prior to dissemination.

RESULTS: Twelve information professionals contributed to best practice recommendations on six elements: core resources, search strategies, publication types, transparency and reproducibility, collaboration, and conducting research. Underlying principles across recommendations include timeliness, openness, balance, preparedness, and responsiveness.

CONCLUSIONS: The authors and experts anticipate the recommendations for searching for evidence during public health emergencies will help information specialists, librarians, evidence synthesis groups, researchers, and decision-makers respond to future public health emergencies, including but not limited to disease outbreaks. The recommendations complement existing guidance by addressing concerns specific to emergency response. The statement is intended as a living document. Future revisions should solicit input from a broader community and reflect conclusions of meta-research on COVID-19 and health emergencies.

RevDate: 2025-12-12
CmpDate: 2023-05-17

Brunetti ND, Curcio A, Nodari S, et al (2023)

The Italian Society of Cardiology and Working Group on Telecardiology and Informatics 2023 updated position paper on telemedicine and artificial intelligence in cardiovascular disease.

Journal of cardiovascular medicine (Hagerstown, Md.), 24(Suppl 2):e168-e177.

In 2015, the Italian Society of Cardiology and its Working Group on Telemedicine and Informatics issued a position paper on Telecardiology, resuming the most eminent evidence supporting the use of information and communication technology in principal areas of cardiovascular care, ranked by level of evidence. More than 5 years later and after the global shock inflicted by the SARS-CoV-2 pandemic, an update on the topic is warranted. Recent evidence and studies on principal areas of cardiovascular disease will be therefore reported and discussed, with particular focus on telemedicine for cardiovascular care in the COVID-19 context. Novel perspectives and opportunities disclosed by artificial intelligence and its applications in cardiovascular disease will also be discussed. Finally, modalities by which machine learning have realized remote patient monitoring and long-term care in recent years, mainly filtering critical clinical data requiring selective hospital admission, will be provided.

RevDate: 2025-12-12
CmpDate: 2023-08-31

Chen A, Ayub MH, Mishuris RG, et al (2023)

Telehealth Policy, Practice, and Education: a Position Statement of the Society of General Internal Medicine.

Journal of general internal medicine, 38(11):2613-2620.

Telehealth services, specifically telemedicine audio-video and audio-only patient encounters, expanded dramatically during the COVID-19 pandemic through temporary waivers and flexibilities tied to the public health emergency. Early studies demonstrate significant potential to advance the quintuple aim (patient experience, health outcomes, cost, clinician well-being, and equity). Supported well, telemedicine can particularly improve patient satisfaction, health outcomes, and equity. Implemented poorly, telemedicine can facilitate unsafe care, worsen disparities, and waste resources. Without further action from lawmakers and agencies, payment will end for many telemedicine services currently used by millions of Americans at the end of 2024. Policymakers, health systems, clinicians, and educators must decide how to support, implement, and sustain telemedicine, and long-term studies and clinical practice guidelines are emerging to provide direction. In this position statement, we use clinical vignettes to review relevant literature and highlight where key actions are needed. These include areas where telemedicine must be expanded (e.g., to support chronic disease management) and where guidelines are needed (e.g., to prevent inequitable offering of telemedicine services and prevent unsafe or low-value care). We provide policy, clinical practice, and education recommendations for telemedicine on behalf of the Society of General Internal Medicine. Policy recommendations include ending geographic and site restrictions, expanding the definition of telemedicine to include audio-only services, establishing appropriate telemedicine service codes, and expanding broadband access to all Americans. Clinical practice recommendations include ensuring appropriate telemedicine use (for limited acute care situations or in conjunction with in-person services to extend longitudinal care relationships), that the choice of modality be done through patient-clinician shared decision-making, and that health systems design telemedicine services through community partnerships to ensure equitable implementation. Education recommendations include developing telemedicine-specific educational strategies for trainees that align with accreditation body competencies and providing educators with protected time and faculty development resources.

RevDate: 2025-12-12
CmpDate: 2023-05-17

Qaseem A, MacLean CH, Tierney S, et al (2023)

Performance Measures for Physicians Providing Clinical Care Using Telemedicine: A Position Paper From the American College of Physicians.

Annals of internal medicine, 176(5):694-698.

There has been an exponential growth in the use of telemedicine services to provide clinical care, accelerated by the COVID-19 pandemic. Clinical care delivered via telemedicine has become a major and accepted method of health care delivery for many patients. There is an urgent need to understand quality of care in the telemedicine environment. This American College of Physicians position paper presents 6 recommendations to ensure the appropriate use of performance measures to evaluate quality of clinical care provided in the telemedicine environment.

RevDate: 2025-12-12
CmpDate: 2023-04-25

Franciosi JP, Berg EA, Rosen JM, et al (2023)

North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition Position Statement for Telehealth.

Journal of pediatric gastroenterology and nutrition, 76(5):684-694.

Telehealth (TH) broadly encompasses remote activities of clinical care (telemedicine), provider and patient education, and general health services. The use of synchronous video for TH first occurred in 1964 and then catapulted to the forefront in 2020 during the coronavirus disease 2019 public health emergency. Due to the sudden need for increased TH utilization by nearly all health care providers at that time, TH became essential to clinical practice. However, its sustainable future is unclear in part given that best practices for TH in pediatric gastroenterology (GI), hepatology, and nutrition remain undefined and non-standardized. Key areas for review include historical perspective, general and subspeciality usage, health care disparities, quality of care and the provider-patient interaction, logistics and operations, licensure and liability, reimbursement and insurance coverage, research and quality improvement (QI) priorities, and future use of TH in pediatric GI with a call for advocacy. This position paper from the Telehealth Special Interest Group of North American Society of Gastroenterology, Hepatology and Nutrition provides recommendations for pediatric GI-focused TH best practices, reviews areas for research and QI growth, and presents advocacy opportunities.

RevDate: 2025-12-12
CmpDate: 2023-03-28

Ravi V, Kapil A, Biswas S, et al (2023)

Indian association of medical microbiologists (IAMM) position paper on guidelines for COVID and SARSCoV2 infections.

Indian journal of medical microbiology, 42:53-54.

RevDate: 2025-12-12
CmpDate: 2023-06-19

Dugdale LS, Esbensen KL, Sulmasy LS, et al (2023)

Ethical Guidance on Family Caregiving, Support, and Visitation in Hospitals and Residential Health Care Facilities, Including During Public Health Emergencies: an American College of Physicians Position Paper.

Journal of general internal medicine, 38(8):1986-1993.

Public health emergencies create challenges for the accommodation of visitors to hospitals and other care facilities. To mitigate the spread of COVID-19 early in the pandemic, health care institutions implemented severe visitor restrictions, many remaining in place more than 2 years, producing serious unintended harms. Visitor restrictions have been associated with social isolation and loneliness, worse physical and mental health outcomes, impaired or delayed decision-making, and dying alone. Patients with disabilities, communication challenges, and cognitive or psychiatric impairments are particularly vulnerable without caregiver presence. This paper critically examines the justifications for, and harms imposed by, visitor restrictions during the COVID-19 pandemic and offers ethical guidance on family caregiving, support, and visitation during public health emergencies. Visitation policies must be guided by ethical principles; incorporate the best available scientific evidence; recognize the invaluable roles of caregivers and loved ones; and involve relevant stakeholders, including physicians, who have an ethical duty to advocate for patients and families during public health crises. Visitor policies should be promptly revised as new evidence emerges regarding benefits and risks in order to prevent avoidable harms.

RevDate: 2025-12-12
CmpDate: 2023-03-16

Behr J, Berger M, Blum TG, et al (2023)

[SARS-CoV-2-Infection and Interstitial Lung Disease: Position paper of the German Respiratory Society].

Pneumologie (Stuttgart, Germany), 77(3):143-157.

The SARS-CoV-2 pandemic had a tremendous impact on diagnosis and treatment of interstitial lung diseases (ILD). Especially in the early phase of the pandemic, when the delta variant was prevailling, a huge number of viral pneumonias were observed, which worsened pre-existing, triggered de novo occurence or discovery of previously subclincal interstitial lung diseases. The effect of SARS-CoV-2 infection - without or with accompanying viral pneumonia - on the further development of pre-existing ILD as well of new pulmonary inflitrates and consolidiations is difficult to predict and poses a daily challenge to interdisciplinary ILD boards. This position paper of the German Respiratory Society (DGP e.V.) provides answers to the most pressing questions based on current knowledge.

RevDate: 2025-12-12
CmpDate: 2023-07-26

Akbulut AC, Arisz RA, Baaten CCFMJ, et al (2023)

Blood Coagulation and Beyond: Position Paper from the Fourth Maastricht Consensus Conference on Thrombosis.

Thrombosis and haemostasis, 123(8):808-839.

The Fourth Maastricht Consensus Conference on Thrombosis included the following themes. Theme 1: The "coagulome" as a critical driver of cardiovascular disease. Blood coagulation proteins also play divergent roles in biology and pathophysiology, related to specific organs, including brain, heart, bone marrow, and kidney. Four investigators shared their views on these organ-specific topics. Theme 2: Novel mechanisms of thrombosis. Mechanisms linking factor XII to fibrin, including their structural and physical properties, contribute to thrombosis, which is also affected by variation in microbiome status. Virus infection-associated coagulopathies perturb the hemostatic balance resulting in thrombosis and/or bleeding. Theme 3: How to limit bleeding risks: insights from translational studies. This theme included state-of-the-art methodology for exploring the contribution of genetic determinants of a bleeding diathesis; determination of polymorphisms in genes that control the rate of metabolism by the liver of P2Y12 inhibitors, to improve safety of antithrombotic therapy. Novel reversal agents for direct oral anticoagulants are discussed. Theme 4: Hemostasis in extracorporeal systems: the value and limitations of ex vivo models. Perfusion flow chamber and nanotechnology developments are developed for studying bleeding and thrombosis tendencies. Vascularized organoids are utilized for disease modeling and drug development studies. Strategies for tackling extracorporeal membrane oxygenation-associated coagulopathy are discussed. Theme 5: Clinical dilemmas in thrombosis and antithrombotic management. Plenary presentations addressed controversial areas, i.e., thrombophilia testing, thrombosis risk assessment in hemophilia, novel antiplatelet strategies, and clinically tested factor XI(a) inhibitors, both possibly with reduced bleeding risk. Finally, COVID-19-associated coagulopathy is revisited.

RevDate: 2025-12-12
CmpDate: 2023-03-28

de Sequera P, Quiroga B, Goicoechea M, et al (2022)

Update of the prevention and isolation measure recommendations against SARS-COV-2 in dialysis units of Spain: A position paper of the Spanish Society of Nephrology Council.

Nefrologia, 42(6):714-721.

SARS-CoV-2 pandemic has changed across the last two years. The development and approval of SARS-CoV-2 vaccines and the emergence of new variants has opened up a new scenario. On this regard, Spanish Society of Nephrology (S.E.N.) Council considers that an update of the previous recommendations should be performed. In the present statement, and taking into account the current epidemiological situation, are included updated recommendations of protection and isolation for patients on dialysis programs.

RevDate: 2025-12-12
CmpDate: 2023-01-30

Feleszko W, Okarska-Napierała M, Buddingh EP, et al (2023)

Pathogenesis, immunology, and immune-targeted management of the multisystem inflammatory syndrome in children (MIS-C) or pediatric inflammatory multisystem syndrome (PIMS): EAACI Position Paper.

Pediatric allergy and immunology : official publication of the European Society of Pediatric Allergy and Immunology, 34(1):e13900.

Multisystem inflammatory syndrome in children (MIS-C) is a rare, but severe complication of coronavirus disease 2019 (COVID-19). It develops approximately 4 weeks after severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and involves hyperinflammation with multisystem injury, commonly progressing to shock. The exact pathomechanism of MIS-C is not known, but immunological dysregulation leading to cytokine storm plays a central role. In response to the emergence of MIS-C, the European Academy of Allergy and Clinical Immunology (EAACI) established a task force (TF) within the Immunology Section in May 2021. With the use of an online Delphi process, TF formulated clinical statements regarding immunological background of MIS-C, diagnosis, treatment, follow-up, and the role of COVID-19 vaccinations. MIS-C case definition is broad, and diagnosis is made based on clinical presentation. The immunological mechanism leading to MIS-C is unclear and depends on activating multiple pathways leading to hyperinflammation. Current management of MIS-C relies on supportive care in combination with immunosuppressive and/or immunomodulatory agents. The most frequently used agents are systemic steroids and intravenous immunoglobulin. Despite good overall short-term outcome, MIS-C patients should be followed-up at regular intervals after discharge, focusing on cardiac disease, organ damage, and inflammatory activity. COVID-19 vaccination is a safe and effective measure to prevent MIS-C. In anticipation of further research, we propose a convenient and clinically practical algorithm for managing MIS-C developed by the Immunology Section of the EAACI.

RevDate: 2025-12-12
CmpDate: 2023-03-10

DiScala S, Uritsky TJ, Brown ME, et al (2023)

Society of Pain and Palliative Care Pharmacists White Paper on the Role of Opioid Stewardship Pharmacists.

Journal of pain & palliative care pharmacotherapy, 37(1):3-15.

Opioid stewardship is one essential function of pain and palliative care pharmacists and a critical need in the United States. In recent years, this country has been plagued by two public health emergencies: an opioid crisis and the COVID-19 pandemic, which has exacerbated the opioid epidemic through its economic and psychosocial toll. To develop an opioid stewardship program, a systematic approach is needed. This will be detailed in part here by the Opioid Stewardship Taskforce of the Society of Pain and Palliative Care Pharmacists (SPPCP), focusing on the role of the pharmacist. Many pain and palliative care pharmacists have made significant contributions to the development and daily operation of such programs while also completing other competing clinical tasks, including direct patient care. To ensure dedicated time and attention to critical opioid stewardship efforts, SPPCP recommends and endorses opioid stewardship models employing a full time, opioid stewardship pharmacist in both the inpatient and outpatient setting. Early research suggests that opioid stewardship pharmacists are pivotal to improving opioid metrics and pain care outcomes. However, further research and development in this area of practice is needed and encouraged.

RevDate: 2025-12-12
CmpDate: 2023-01-25

Vukoja M, Kopitovic I, Lazic Z, et al (2022)

Diagnosis and treatment of adult asthma patients in Serbia: a 2022 experts group position statement.

Expert review of respiratory medicine, 16(11-12):1133-1144.

INTRODUCTION: Asthma is the most common non-communicable chronic lung condition across all ages. Epidemiological data indicate that many asthma patients in Serbia remain undiagnosed and untreated. The implementation of recent global advances in asthma management is limited due to the lack of a systematic approach, drug availability and regulatory affairs. In addition, the global coronavirus disease pandemic has posed a significant challenge, particularly in resource-limited settings.

AREAS COVERED: In this paper, we propose an algorithm for treating adult asthma patients in Serbia. We performed PubMed database search on published asthma clinical trials and guidelines from 1 January 2015 to 10 March 2020. The consensus process incorporated a modified Delphi method that included two rounds of e-mail questionnaires and three rounds of national asthma expert meetings. We focus on 1) objective diagnosis of asthma, 2) the implementation of up-to-date therapeutic options, and 3) the identification and referral of severe asthma patients to newly established severe asthma centers.

EXPERT OPINION: Regional specificities and variations in healthcare systems require the adaptation of evidence-based knowledge. Practical, clinically oriented algorithms designed to overcome local barriers in healthcare delivery may facilitate timely and adequate asthma diagnosis and the local implementation of current advances in asthma management.

RevDate: 2025-12-12
CmpDate: 2023-01-16

Strengers P, O'Brien SF, Politis C, et al (2023)

White paper on pandemic preparedness in the blood supply.

Vox sanguinis, 118(1):8-15.

BACKGROUND AND OBJECTIVES: In March 2020, the WHO declared the SARS-CoV-2 corona virus a pandemic which caused a great disruption to global society and had a pronounced effect on the worldwide supply of blood.

MATERIALS AND METHODS: In 2022 an on-line meeting was organised with experts from Austria, Canada, Germany, Greece, Netherlands and United States to explore the opportunities for increasing preparedness within blood systems for a potential future pandemic with similar, or more devastating, consequences. The main themes included the value of preparedness, current risks to the blood supply, supply chain vulnerabilities, and the role of innovation in increasing resiliency and safety.

RESULTS: Seven key recommendations were formulated and including required actions at different levels.

CONCLUSION: Although SARS-CoV-2 might be seen as a unique event, global health risks are expected to increase and will affect blood transfusion medicine if no preparedness plans are developed.

RevDate: 2025-12-12
CmpDate: 2023-01-26

Perram J, Purtill D, Bajel A, et al (2023)

Australia and New Zealand Transplant and Cellular Therapies (ANZTCT) position statement: COVID-19 management in patients with haemopoietic stem cell transplant and chimeric antigen receptor T cell.

Internal medicine journal, 53(1):119-125.

Patients with post-haemopoietic stem cell transplant or chimeric antigen receptor T -cell (CAR-T) therapy face a significant risk of morbidity and mortality from coronavirus disease 2019 because of their immunosuppressed state. As case numbers in Australia and New Zealand continue to rise, guidance on management in this high-risk population is needed. Whilst we have learned much from international colleagues who faced high infection rates early in the pandemic, guidance relevant to local health system structures, medication availability and emerging therapies is essential to equip physicians to manage our patients optimally.

RevDate: 2025-12-12
CmpDate: 2023-02-07

Sacks-Zimmerman A, Bergquist TF, Farr EM, et al (2023)

Rehabilitation of Neuropsychiatric Symptoms in Patients With Long COVID: Position Statement.

Archives of physical medicine and rehabilitation, 104(2):350-354.

Long COVID, a term used to describe ongoing symptoms after COVID-19 infection, parallels the course of other postviral syndromes. Neuropsychiatric symptoms of long COVID can be persistent and interfere with quality of life and functioning. Within the biopsychosocial framework of chronic illness, rehabilitation professionals can address the neuropsychiatric sequelae of long COVID. However, current practice models are not designed to address concurrent psychiatric and cognitive symptoms in adults living with long COVID. Thus, we present a biopsychosocial framework for long COVID and provide treatment strategies based on evidence from current literature of postviral chronic illness. These recommendations will guide rehabilitation professionals in identifying common neuropsychiatric symptoms in long COVID that can be targeted for intervention and addressing these symptoms via integrative interventions taking into account the biopsychosocial presentation of long COVID symptoms.

RevDate: 2025-12-12
CmpDate: 2024-03-13

Castelletti S, Gervasi S, Ballardini E, et al (2024)

The athlete after COVID-19 infection: what the scientific evidence? What to do? A position statement.

Panminerva medica, 66(1):63-74.

The Coronavirus-19 disease (COVID-19) related pandemic have deeply impacted human health, economy, psychology and sociality. Possible serious cardiac involvement in the infection has been described, raising doubts about complete healing after the disease in many clinical settings. Moreover, there is the suspicion that the vaccines, especially those based on mRNA technology, can induce myopericarditis. Myocarditis or pericarditis related scars can represent the substrate for life-threatening arrhythmias, triggered by physical activity. A crucial point is how to evaluate an athlete after a COVID-19 infection ensuring a safe return to play without increasing the number of unnecessary disqualifications from sports competitions. The lack of conclusive scientific data significantly increases the difficulty to propose recommendations and guidelines on this topic. At the same time, the psychological and physical negative consequences of unnecessary sports restriction must be taken into account. The present document aims to provide an updated brief review of the current knowledge about the COVID-19 cardiac involvement and how to recognize it and to offer a roadmap for the management of the athletes after a COVID-19 infections, including subsequent impact on exercise recommendations. Our document exclusively refers to cardiovascular implications of the disease, but pulmonary consequences are also considered.

RevDate: 2025-12-12
CmpDate: 2022-10-06

Filipiak KJ, Babkowski MC, Cameli M, et al (2022)

TIMES TO ACT. Italian-Spanish-Polish-Uzbek Expert Forum Position Paper 2022. Dyslipidemia and arterial hypertension: The two most important and modifiable risk factors in clinical practice.

Cardiology journal, 29(5):730-738.

Hypertension and lipid disorders are two of the main cardiovascular risk factors. Both risk factors - if detected early enough - can be controlled and treated with modern, effective drugs, devoid of significant side effects, available in four countries as different as Italy, Spain, Poland, and Uzbekistan. The aim herein, was to develop this TIMES TO ACT consensus to raise the awareness of the available options of the modern and intensified dyslipidemia and arterial hypertension treatments. The subsequent paragraphs involves consensus and discussion of the deleterious effects of COVID-19 in the cardiovascular field, the high prevalence of hypertension and lipid disorders in our countries and the most important reasons for poor control of these two factors. Subsequently proposed, are currently the most efficient and safe therapeutic options in treating dyslipidemia and arterial hypertension, focusing on the benefits of single-pill combination (SPCs) in both conditions. An accelerated algorithm is proposed to start the treatment with a PCSK9 inhibitor, if the target low-density-lipoprotein values have not been reached. As most patients with hypertension and lipid disorders present with multiple comorbidities, discussed are the possibilities of using new SPCs, combining modern drugs from different therapeutic groups, which mode of action does not confirm the "class effect". We believe our consensus strongly advocates the need to search for patients with cardiovascular risk factors and intensify their lipid-lowering and antihypertensive treatment based on SPCs will improve the control of these two basic cardiovascular risk factors in Italy, Spain, Poland and Uzbekistan.

RevDate: 2025-12-12
CmpDate: 2022-09-01

Cheah FC, Thong MK, Zulkifli I, et al (2022)

COVID-19 vaccination for children in Malaysia - A position statement by the College of Paediatrics, Academy of Medicine of Malaysia.

The Malaysian journal of pathology, 44(2):177-185.

The availability of COVID-19 vaccines and mass vaccination programmes in adults have significantly reduced the case attack rates and disease burden. COVID-19 vaccination successfully decreases the population at risk of infection, allowing for the safer re-opening of economies and reducing the pandemic's crippling impact on healthcare systems. However, the rapidly mutating severe acute respiratory syndrome-coronavirus-2 poses challenges in diminishing vaccine-induced immunity and vaccinating a significant proportion of adults to achieve herd immunity. These challenges necessitated adolescent vaccination. With the recent emergence of the highly transmissible Omicron variant and the increasing COVID-19 hospitalisation rates of children below 12 years old, many countries opted to also vaccinate younger children. Phase II/III clinical trials and real-world experience demonstrate that COVID-19 vaccinations are effective and safe for younger children and adolescents. Before Malaysia introduced its national COVID-19 vaccination programme for children 5-11 years old (which ran between March and June 2022), an expert advisory statement was issued by the College of Paediatrics, Academy of Medicine of Malaysia, to highlight the benefits and importance of vaccinating children. The advisory statement included clarifications about vaccine-related side effects such as post-vaccination myocarditis and allergic reactions to encourage informed decision making by healthcare providers and parents. This paper, which was prepared based on the critical appraisal of the current evidence, evaluation of the international experiences and the positive impact of COVID-19 vaccination in children, collectively sums up the rationale to support and ensure the success of the nationwide vaccination programme for children. Hence, the College recommends COVID-19 vaccination for children in Malaysia.

RevDate: 2025-12-12
CmpDate: 2022-08-17

Feng LZ, Jiang HY, Yi J, et al (2022)

[Introduction and implications of WHO position paper: vaccines against influenza, May 2022].

Zhonghua yi xue za zhi, 102(30):2315-2318.

On May 13, 2022, World Health Organization(WHO) Position Paper on Influenza Vaccine (2022 edition) was published. This position paper updates information on influenza epidemiology, high risk population, the impact of immunization on disease, influenza vaccines and effectiveness and safety, and propose WHO's position and recommendation that all countries should consider implementing seasonal influenza vaccine immunization programmes to prepare for an influenza pandemic. In addition, it proposes that the influenza surveillance platform can be integrated with the surveillance of other respiratory viruses, such as SARS-CoV-2 and Respiratory Syncytial Virus. This position paper has some implications for the prevention and control of influenza and other respiratory infectious diseases in China: (1) Optimize influenza vaccine policies to facilitate the implementation of immunization services; (2) Influenza prevention and control should from the perspective of Population Medicine focus on the individual and community to integrate with "Promotion, Prevention, Diagnosis, Control, Treatment, Rehabilitation"; (3) Incorporate prevention and control of other respiratory infectious diseases such as influenza, COVID-19, respiratory syncytial virus and adenovirus, and intelligently monitor by integrating multi-channel data to achieve the goal of co-prevention and control of multiple diseases.

RevDate: 2025-12-12
CmpDate: 2022-08-30

Beretta GD, Casolino R, Corsi DC, et al (2022)

Position paper of the Italian Association of Medical Oncology on the impact of COVID-19 on Italian oncology and the path forward: the 2021 Matera statement.

ESMO open, 7(4):100538.

The coronavirus disease 2019 (COVID-19) pandemic has severely affected cancer care and research by disrupting the prevention and treatment paths as well as the preclinical, clinical, and translational research ecosystem. In Italy, this has been particularly significant given the severity of the pandemic's impact and the intrinsic vulnerabilities of the national health system. However, whilst detrimental, disruption can also be constructive and may stimulate innovation and progress. The Italian Association of Medical Oncology (AIOM) has recognized the impact of COVID-19 on cancer care continuum and research and proposes the '2021 Matera statement' which aims at providing pragmatic guidance for policymakers and health care institutions to mitigate the impact of the global health crisis on Italian oncology and design the recovery plan for the post-pandemic scenario. The interventions are addressed both to the pillars (prevention, diagnosis, treatment, follow-up, health care professionals) and foundations of cancer care (communication and care relationship, system organization, resources, research, networking). The priorities to be implemented can be summarized in the MATERA acronym: Multidisciplinarity; Access to cancer care; Telemedicine and Territoriality; Equity, ethics, education; Research and resources; Alliance between stakeholders and patients.

RevDate: 2025-12-12
CmpDate: 2022-09-20

Marjot T, Eberhardt CS, Boettler T, et al (2022)

Impact of COVID-19 on the liver and on the care of patients with chronic liver disease, hepatobiliary cancer, and liver transplantation: An updated EASL position paper.

Journal of hepatology, 77(4):1161-1197.

The COVID-19 pandemic has presented a serious challenge to the hepatology community, particularly healthcare professionals and patients. While the rapid development of safe and effective vaccines and treatments has improved the clinical landscape, the emergence of the omicron variant has presented new challenges. Thus, it is timely that the European Association for the Study of the Liver provides a summary of the latest data on the impact of COVID-19 on the liver and issues guidance on the care of patients with chronic liver disease, hepatobiliary cancer, and previous liver transplantation, as the world continues to deal with the consequences of the COVID-19 pandemic.

RevDate: 2025-12-12
CmpDate: 2022-08-17

Crowley R, Atiq O, Hilden D, et al (2022)

Long-Term Services and Supports for Older Adults: A Position Paper From the American College of Physicians.

Annals of internal medicine, 175(8):1172-1174.

The number of Americans aged 65 years or older is expected to increase in the coming decades. Because the risk for disability increases with age, more persons will need long-term services and supports (LTSS) to help with bathing, eating, dressing, and other everyday tasks. Long-term services and supports are delivered in nursing homes, assisted living facilities, the person's home, and other settings. However, the LTSS sector faces several challenges, including keeping patients and staff safe during the COVID-19 pandemic, workforce shortages, quality problems, and fragmented coverage options. In this position paper, the American College of Physicians offers policy recommendations on LTSS coverage, financing, workforce, safety and quality, and emergency preparedness and calls on policymakers and other stakeholders to reform and improve the LTSS sector so that care is high quality, accessible, equitable, and affordable.

RevDate: 2025-12-12
CmpDate: 2022-08-17

Serchen J, Atiq O, Hilden D, et al (2022)

Strengthening Food and Nutrition Security to Promote Public Health in the United States: A Position Paper From the American College of Physicians.

Annals of internal medicine, 175(8):1170-1171.

Food insecurity functions as a social driver of health, directly negatively impacting health status and outcomes, which can further negatively impact employment and income and increase medical expenditures-all of which exacerbates food insecurity. Progress in meaningfully reducing the food-insecurity rate has stalled in recent years. Although rates have decreased since their peak during the Great Recession, these gains have been reversed by the economic implications of the COVID-19 pandemic. As the federal government is the largest provider of food assistance, there is much potential in better leveraging nutrition assistance programs like the Supplemental Nutrition Assistance Program (SNAP) and the Child Nutrition Programs to increase access to healthful foods and improve public health. However, these programs face many funding challenges and internal shortcomings that create uncertainties and prevent maximal effect. Physicians and other medical professionals also have a role in improving nutritional health by screening for food insecurity and serving as connectors between patients, community organizations, and government services. Governments and payers must support these efforts by providing sufficient resources to practices to fulfill this role. In this position paper, the American College of Physicians (ACP) offers several policy recommendations to strengthen the federal food-insecurity response and empower physicians and other medical professionals to better address those social drivers of health occurring beyond the office doors.

RevDate: 2025-12-12
CmpDate: 2022-07-26

Kohan L, Pellis Z, Provenzano DA, et al (2022)

American Society of Regional Anesthesia and Pain Medicine contrast shortage position statement.

Regional anesthesia and pain medicine, 47(9):511-518.

The medical field has been experiencing numerous drug shortages in recent years. The most recent shortage to impact the field of interventional pain medicine is that of iodinated contrast medium. Pain physicians must adapt to these changes while maintaining quality of care. This position statement offers guidance on adapting to the shortage.

RevDate: 2025-12-12
CmpDate: 2022-06-14

Kaap-Fröhlich S, Ulrich G, Wershofen B, et al (2022)

Position paper of the GMA Committee Interprofessional Education in the Health Professions - current status and outlook.

GMS journal for medical education, 39(2):Doc17.

In the wake of local initiatives and developmental funding programs, interprofessionality is now included in national curricula in the German-speaking countries. Based on the 3P model (presage, process, product), this position paper presents the development of interprofessional education in recent years in Germany, Austria and Switzerland and places it in an international context. Core aspects as legal frameworks, including amendments to occupational regulations as well as the formation of networks and faculty development are basic requirements for interprofessional education. New topics and educational settings take shape in the process of interprofessional education: patient perspectives and teaching formats, such as online courses, become more important or are newly established. The influence of the COVID-19 pandemic on interprofessional education is explored as well. Among many new interprofessional courses, particularly the implementation of interprofessional training wards in Germany and Switzerland are positive examples of successful interprofessional education. The objective of interprofessional education continues to be the acquisition of interprofessional competencies. The main focus is now centered on evaluating this educational format and testing for the corresponding competencies. In the future, more capacities will be required for interprofessional continuing education and post-graduate education. Structured research programs are essential to ascertain the effects of interprofessional education in the German-speaking countries. In this position paper the GMA committee on interprofessional education encourages further advancement of this topic and expresses the aim to continue cooperating with other networks to strengthen and intensify interprofessional education and collaboration in healthcare.

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