Radiology

Study details initial CT findings in COVID-19 pneumonia

Researchers reviewed the initial thin-section CT scans of 51 patients with lab-confirmed COVID-19 who were admitted to a single hospital in Shanghai. CT images showed the following:

–Pure ground-glass opacities (GGOs) were present in 77%

–GGOs with reticular and/or interlobular septal thickening were present in 75%

–GGOs with consolidation were present in 59%

–Pure consolidation was present in 55%

–86% of patients had bilateral lung involvement

Consolidated lung lesions were more frequently seen in patients 5 or more days from symptom onset vs. 4 days or fewer, as well as in patients older than 50.


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FDA

FDA warns of possible EpiPen autoinjector malfunction

Emergency administration of epinephrine using EpiPen and EpiPen Jr autoinjectors (as well as authorized generics) may be prevented or delayed due to device failure, difficulty removing the device from the carrier tube, and user error, according to an FDA drug safety communication. A letter to health care professionals describes how the devices may activate prematurely if the blue safety release is removed using a sideways force or if the safety release is raised. Also, some devices may not slide out of the carrier tube easily, or at all, due to a slight deformation of the tube’s rim.

In addition, the letter identifies user errors that can hinder administration: leaving the safety release in place, not ensuring the needle is in contact with the outer thigh before and during activation, and not ensuring the device is held in place for at least 3 seconds after activation.

FDA urges health care providers, patients, and caregivers to periodically review the instructions, practice using the EpiPen trainer, and inspect autoinjectors before they’re needed. Pharmacists are also advised to inspect the products before dispensing them, and to not distribute any device that doesn’t slide easily out of the carrier tube or that has a raised safety release.


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FDA

FDA to allow use of convalescent plasma to treat critically ill COVID-19 patients

While clinical trials are being conducted, FDA is facilitating access to COVID-19 convalescent plasma for use in patients with serious or immediately life-threatening COVID-19 infections. Use of plasma from recovered donors has been studied in other outbreaks such as H1N1 influenza, MERS, and SARS. Although promising, such use hasn’t been shown to be effective in every disease studied. Considerations for donor eligibility include:

–Prior diagnosis of lab-confirmed COVID-19

–Complete symptom resolution at least 14 days prior to donation

–Female donors negative for HLA antibodies, or male donors

–Negative results for COVID-19 either from nasopharyngeal swab or molecular diagnostic test from blood

–Defined SARS-CoV-2 neutralizing antibody titers, if available


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Chest

Beware community-acquired pneumonia patients without fever

Patients with bacteremic community-acquired pneumonia who were afebrile had a higher mortality rate than those with febrile bacteremia or nonbacteremic pneumonia, in a cohort study involving 4,349 patients. The results suggest that current guidelines, which discourage blood cultures in the absence of fever, may need reconsideration.


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