Over the last few months several studies has shown conflicting efficacy and safety of Hydroxychloroquine (HCQ) alone or in association with azithromycin or Doxycycline. Most recent data now published in International Journal of Infectious Diseases showing mortality benefit of HCQ alone or in association with Azithromycin in the treatment of COVID-19. In this observational study [...]
Yale Ad-Hoc COVID-19 Treatment Team algorithms and protocols - multiple algorithms are assembled into a series of color-coded guidance sheets for hospitalist and internist to use. This algorithm is last updated on 4/27/20 and as such still include Hydroxychloroquine in treatment pathway, which is not a standard of care currently. However, rest of the treatment [...]
It was the arrival of the second man in his early 20s gasping for air that alarmed Dixie Harris, MD. Young patients rarely get so sick, so fast, with a severe lung illness, and this was her second case in a matter of days. Then she saw three more patients at her Utah telehealth clinic [...]
For the past several years, the trend has been to use inhaled corticosteroid(ICS) early and often for patients with asthma. And now the 2019 Global Initiative for Asthma (GINA) guidelines recommend using ICS as first-line therapy (step 1) as needed).[1] This change is sure to increase ICS use even more. The logic behind using ICS [...]
PURPOSE: Orofacial myofunctional therapy (OMT) is a modality of treatment for children and adults with obstructive sleep apnea (OSA) to promote changes in the musculature of the upper airways. This review summarizes and discusses the effects of OMT on OSA, the therapeutic programs employed, and their possible mechanisms of action. METHODS: We conducted an online [...]
Patients who have risk factors for obstructive sleep apnea (OSA) or who report symptoms of OSA should be screened for it, first with a complete sleep history and standardized questionnaire, and then by objective testing if indicated. The gold standard test for OSA is polysomnography performed overnight in a sleep laboratory. Home testing is an [...]
Aminophylline suppositories, cocaine nasal packs, and potassium iodide were commonly prescribed for asthma in 1963 when Claude A. Frazier, MD, wrote a thoughtful essay on the do’s and don’ts in treating allergic asthma in Consultant.1 How times have changed! Dr Frazier left us with several clinical observations that are prophetic. He was correct in asserting [...]
The lungs are responsible for the exchange of oxygen and carbon dioxide that keep the brain, heart, and other parts of the body healthy. Age, smoking, inhaling pollutants, and other factors can affect lung function. People cannot necessarily change their lung capacity in terms of how much oxygen their lungs can hold. However, they can [...]
Physicians are at increased pressure to reduce readmissions for certain chronic diseases. A recent study found that implementation of the 30-day readmission rules has been associated with increased 30-day post-discharge mortality for those hospitalized for heart failure and pneumonia. Post-discharge deaths have increased by 0.25% for patients hospitalized with heart failure and by 0.40% for [...]
Corticosteroids were both beneficial and cost-effective for hospitalized adults with severe CAP. Hospitalized people with non-severe CAP may also benefit from corticosteroid therapy, but with no survival advantage In 2015, results of two randomized trials showed that systemic corticosteroids were beneficial for some hospitalized patients with community-acquired pneumonia (CAP; NEJM JW Gen Med Mar 15 [...]
