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Anesthesia Services In The Time Of Covid, James Chen, Daisy Sangroula, Katelyn Williams, Sydney Pham, Ozan Akca, Jiapeng Huang, Sean Clifford 2020 Department of Anesthesiology & Perioperative Medicine, University of Louisville

Anesthesia Services In The Time Of Covid, James Chen, Daisy Sangroula, Katelyn Williams, Sydney Pham, Ozan Akca, Jiapeng Huang, Sean Clifford

The University of Louisville Journal of Respiratory Infections

Our hospital is a 400-bed Level-1 trauma center with 78 ICU beds serving the greater Louisville metropolitan area. The COVID-19 pandemic forced our hospital to re-evaluate our core business operations and to develop a coherent response to a fluid situation. Between March 15 and May 15, 2020, the University of Louisville Hospital admitted more than 100 COVID-19 inpatients, approximately 30 were admitted to the intensive care unit (ICU) and most required endotracheal intubation. The following review describes our Department of Anesthesiology & Perioperative Medicine foci, actions and rationale during the COVID-19 pandemic. While we hope not to experience another pandemic in ...


Severe Covid-19, Arpan H. Chawala, Shivam Gulati, Bettina Sinanova, Jose Bordon 2020 Division of Infectious Diseases, Department of Medicine, University of Louisville School of Medicine, Louisville, KY, USA

Severe Covid-19, Arpan H. Chawala, Shivam Gulati, Bettina Sinanova, Jose Bordon

The University of Louisville Journal of Respiratory Infections

Introduction: There are substantial variabilities of the clinical characteristics and outcomes of severe coronavirus disease (COVID-19) creating difficulty to do an optimal assessment of this condition. We reviewed the current English literature to quantify the findings of baselines characteristics and health outcomes of patients with severe COVID-19 primarily with acute respiratory distress syndrome (ARDS).

Methods: We examined only studies that assessed patients with proven COVID-19 by RT-PCR by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) with at least one of the following severity criteria: severe COVID-19, treated in the ICUs, ARDS and/or invasive mechanical ventilation (IMV) treatment. We assessed the ...


Is Sars-Cov-2 A Neurotropic Virus And A Potential Facilitator Of Cns Infection For Other Pathogens?, Jose Bordon 2020 Washington Health Institute, Washington, D.C.

Is Sars-Cov-2 A Neurotropic Virus And A Potential Facilitator Of Cns Infection For Other Pathogens?, Jose Bordon

The University of Louisville Journal of Respiratory Infections

No abstract provided.


The Importance Of Cycle Threshold Values In The Evaluation Of Patients With Persistent Positive Pcr For Sars-Cov-2: Case Study And Brief Review, Jose Bordon, Donghoon Chung, Priya Krishnan, Ruth Carrico, Julio A. Ramirez 2020 Division of Infectious Diseases, Department of Medicine, University of Louisville School of Medicine, Louisville, KY, USA and Washington Health Institute, Washington, D.C., USA

The Importance Of Cycle Threshold Values In The Evaluation Of Patients With Persistent Positive Pcr For Sars-Cov-2: Case Study And Brief Review, Jose Bordon, Donghoon Chung, Priya Krishnan, Ruth Carrico, Julio A. Ramirez

The University of Louisville Journal of Respiratory Infections

Some patients recovered from COVID-19 but the reverse transcription polymerase chain reaction (RT-PCR) for SARS-CoV-2 remains persistently positive. In the evaluation of these patients it is important to define the cycle threshold (Ct) value of the RT-PCR test. This article will present a case study, address relevant findings and interpretation of the RT-PCR test, and define the use of Ct values in defining when a healthcare working may return to work. Our current approach is to allow to return to work healthcare workers with persistently positive RT-PCR if the Ct values are greater than 35.


An Overview Of Current Clinical Trials Of Agents For The Treatment And Prevention Of Covid-19 In The United States, Kenneth Schot Hannan, William P. McKinney 2020 University of Louisville

An Overview Of Current Clinical Trials Of Agents For The Treatment And Prevention Of Covid-19 In The United States, Kenneth Schot Hannan, William P. Mckinney

The University of Louisville Journal of Respiratory Infections

Introduction: Given the rapid worldwide spread of SARS-CoV-2 and the attendant risks for severe complications and mortality, numerous clinical trials for its treatment and prevention have been generated in a short period. This report focuses on the categories of the wide spectrum of agents being studied in the United States and the intensity of effort involved with each so that clinicians may consider whether suggesting enrollment may be appropriate for their patients.

Methods: A search was completed of the ClinicalTrials.gov database on May 28, 2020 for all such trials underway as of that date in the US. A total ...


Why Every Hospital Needs A Covid-19 Clinical Case Review Team, Ashley M. Wilde, Paul Schulz, Brian C. Bohn, Sarah E. Moore, Matthew Song, Clayton J. Patross, Bryan Denham, Jim Frazier, Steve T. Hester, Julio A. Ramirez 2020 Norton Healthcare Pharmacy Services

Why Every Hospital Needs A Covid-19 Clinical Case Review Team, Ashley M. Wilde, Paul Schulz, Brian C. Bohn, Sarah E. Moore, Matthew Song, Clayton J. Patross, Bryan Denham, Jim Frazier, Steve T. Hester, Julio A. Ramirez

The University of Louisville Journal of Respiratory Infections

A hospital’s response to a global pandemic requires a coordinated effort to provide consistent guidance as information rapidly changes. In the early months of the COVID-19 pandemic, diagnosis and subsequent containment was challenging due to unfamiliarity with disease presentation, unknown reverse transcription-polymerase chain reaction sensitivity and inconsistent access to testing supplies. A centralized COVID-19 clinical case review team can provide guidance on test interpretation, isolation, resource coordination and more.


The Nurse Practitioner In The Time Of Covid, Julie Marfell, Lynn Kelso 2020 University of Kentucky

The Nurse Practitioner In The Time Of Covid, Julie Marfell, Lynn Kelso

The University of Louisville Journal of Respiratory Infections

No abstract provided.


Covid-19 Surveillance Testing Of Healthcare Personnel Drives Universal Masking Practice, Paul S. Schulz, Ashley M. Wilde, Steve T. Hester, Jim Frazier, Julio A. Ramirez 2020 Infectious Diseases, Norton Healthcare

Covid-19 Surveillance Testing Of Healthcare Personnel Drives Universal Masking Practice, Paul S. Schulz, Ashley M. Wilde, Steve T. Hester, Jim Frazier, Julio A. Ramirez

The University of Louisville Journal of Respiratory Infections

Health Care Professionals (HCP) are at increased risk of COVID-19 infection due to the unpredictable clinical presentation of COVID-19 disease, limited SARS-CoV-2 testing, personal protective equipment (PPE) shortages, and the inherent inability to distance from patients. Infected HCP may infect others including coworkers leading to a simultaneous increase of number of infections and decreased availability of HCP in a community. [1] Due to PPE shortages, many healthcare systems have faced difficult decisions regarding utilization of PPE to protect HCP and patients and the communities they serve. We describe Norton Healthcare’s success utilizing surveillance COVID-19 testing of HCP to inform ...


Vaccine-Preventable Diseases In The Time Of Covid, Thaddeus Zajdowicz, Margan Zajdowicz 2020 United States Navy Medical Corps (Retired)

Vaccine-Preventable Diseases In The Time Of Covid, Thaddeus Zajdowicz, Margan Zajdowicz

The University of Louisville Journal of Respiratory Infections

Prevention of other vaccine preventable diseases (VPD) must not be ignored during the COVID-19 pandemic.


The Strengths, Weaknesses, Opportunities And Threats (Swot) Analysis Of The Severe Acute Respiratory Syndrome Coronavirus 2 Of Covid-19, Michael Oluyemi Babalola Ph.D 2020 Infectious Diseases Epidemiology, Molecular Virology and Special Pathogens Research, Department of Microbiology, Adekunle Ajasin University, PMB 001, Akungba Akoko, Ondo state, Nigeria.

The Strengths, Weaknesses, Opportunities And Threats (Swot) Analysis Of The Severe Acute Respiratory Syndrome Coronavirus 2 Of Covid-19, Michael Oluyemi Babalola Ph.D

The University of Louisville Journal of Respiratory Infections

Introduction: SARS-CoV-2 is the etiologic agent of Coronavirus Disease 2019 (COVID-19), a highly contagious, emergent, acute, viral pneumonia that emanated sporadically in Wuhan, China in December 2019. COVID-19 became pandemic in February 2020 leading to 4,942,687 confirmed cases, over 321,987 deaths and grounded several economies around the world as of May 2020. Although global researchers, epidemiologists and medical professionals rose steadily to contain the disease, indepth knowledge and concerted efforts are still evolving on the virus. This research sought to elucidate the biological Strengths, the Weaknesses, Opportunities, and Threats to SARS-CoV-2, with a view to understanding and ...


Concomitant Invasive Pneumococcal Disease In A Patient With Covid-19 – A Case Report From The Louisville Epidemiology Study, Clayton J. Patross, Brian C. Bohn PharmD, Sarah E. Moore PharmD, Paul Schulz, Matthew Song PharmD, BCIDP, Ashley M. Wilde, Julio A. Ramirez 2020 Department of Pharmacy, Norton Healthcare Brownsboro Hospital

Concomitant Invasive Pneumococcal Disease In A Patient With Covid-19 – A Case Report From The Louisville Epidemiology Study, Clayton J. Patross, Brian C. Bohn Pharmd, Sarah E. Moore Pharmd, Paul Schulz, Matthew Song Pharmd, Bcidp, Ashley M. Wilde, Julio A. Ramirez

The University of Louisville Journal of Respiratory Infections

A 60-year-old male presented to the Emergency Department (ED) with a one-two day history of confusion, headache, and subjective fever. Because he had met with a contact two days prior to admission who had recently traveled from the Bahamas, a COVID-19 nasopharyngeal (NP) and oropharyngeal (OP) polymerase chain reaction (PCR) test was ordered. He was diagnosed with bacterial meningitis based on presenting neurologic symptoms and the identification of Streptococcus pneumoniae from blood cultures. The COVID-19 NP and OP test returned positive, although he never developed shortness of breath, cough, other respiratory symptoms, diarrhea, abdominal pain, nausea, vomiting, or any change ...


Applying Knowledge Translation In Rehabilitation: An Exploration Of What It Means To Change Clinical Practice, Stacey D. Guy 2020 The University of Western Ontario

Applying Knowledge Translation In Rehabilitation: An Exploration Of What It Means To Change Clinical Practice, Stacey D. Guy

Electronic Thesis and Dissertation Repository

Health care providers are often required to implement evidence-based recommendations into the care they deliver. Resources that support health care providers’ efforts are a useful knowledge translation strategy. This thesis describes the development and usability evaluation of an evidence-informed clinical practice implementation toolkit to support implementation efforts. Two studies were undertaken to provide insight into what was needed to support health care providers, and to inform the development of the toolkit. A retrospective evaluation analyzed the performance of a team implementing a pressure ulcer risk assessment for patients with spinal cord injury. The rates of adherence to the risk assessment ...


A Comparison Efficacy Study Of Commercial Nasopharyngeal Swabs Versus A Novel 3d Printed Swab For The Detection Of Sars-Cov-2, Forest W. Arnold, Gerald Grant, Phillip F. Bressoud, Stephen P. Furmanek, Donghoon Chung, Nadine Sbaih, Dipan Karmali, Meredith Cahill, George Pantalos 2020 University of Louisville

A Comparison Efficacy Study Of Commercial Nasopharyngeal Swabs Versus A Novel 3d Printed Swab For The Detection Of Sars-Cov-2, Forest W. Arnold, Gerald Grant, Phillip F. Bressoud, Stephen P. Furmanek, Donghoon Chung, Nadine Sbaih, Dipan Karmali, Meredith Cahill, George Pantalos

The University of Louisville Journal of Respiratory Infections

The large volume of diagnostic tests required by the response to the pandemic of COVID-19 pandemic resulted in a shortage of commercial nasopharyngeal swabs. In an effort to alleviate the shortage, swabs created by 3D printing may be a solution. We designed and produced 3D printed swabs and sought to compare their ability to detect SARS-CoV-2 in patients admitted for COVID-19 or who were suspected of having COVID-19. A total of 30 patients were swabbed with a commercial and printed 3D swab. Results matched in 28 of 31 patients (90%). Two patients were discordant with a positive commercial swab and ...


False-Negative Sars-Cov-2 Reverse Transcriptase Polymerase Chain Reaction (Rt-Pcr) Is An Important Consideration For Patient Management And Infection Prevention: A Case Report From The Louisville Covid-19 Epidemiology Study, Matthew Song PharmD, BCIDP, Ashley M. Wilde, Sarah E. Moore PharmD, Brian C. Bohn PharmD, Clayton J. Patross, Bryan Denham, Paul Schulz, Julio A. Ramirez 2020 Norton Healthcare

False-Negative Sars-Cov-2 Reverse Transcriptase Polymerase Chain Reaction (Rt-Pcr) Is An Important Consideration For Patient Management And Infection Prevention: A Case Report From The Louisville Covid-19 Epidemiology Study, Matthew Song Pharmd, Bcidp, Ashley M. Wilde, Sarah E. Moore Pharmd, Brian C. Bohn Pharmd, Clayton J. Patross, Bryan Denham, Paul Schulz, Julio A. Ramirez

The University of Louisville Journal of Respiratory Infections

We report a case of false negative SARS-CoV-2 RT-PCR on nasopharyngeal swab. Treating clinicians and infection preventionists should maintain a high suspicion for COVID-19 in the appropriate clinical setting despite negative test results. Utilization of chest CT should be strongly considered in the diagnostic work-up for suspected COVID-19, particularly in areas with limited RT-PCR availability.


Treatment-Associated Improvements In Self-Regulation And Mood As Theory-Based Correlates Of Increased Self-Efficacy For Weight-Management Behaviors, James J. Annesi 2020 YMCA of Metropolitan Atlanta; University of Alabama at Birmingham

Treatment-Associated Improvements In Self-Regulation And Mood As Theory-Based Correlates Of Increased Self-Efficacy For Weight-Management Behaviors, James J. Annesi

Health Behavior Research

Expanded understanding of the psychosocial dynamics of weight-loss treatment processes is required to improve consistently poor results. Women with obesity of ages 40–59 years participated in self-regulation-based (n = 41) and information-based (n = 46) treatments. Improvements in self-regulation and self-efficacy related to exercise and eating, mood, exercise, intake of fruits/vegetables and sweets, and weight were significant, and generally greater in the self-regulation group. Exercise- and eating-behavior changes significantly mediated the prediction of self-efficacy changes by changes in self-regulation, with mood change significantly adding to the prediction strength. Findings suggested the value in supporting exercise for its psychosocial benefits within ...


Stroke Management In The Time Of Covid, Marwa Elnazeir, Siddharth Narayanan, Kerri Remmel 2020 Adult Neurology Resident, Department of Neurology, University of Louisville School of Medicine, Louisville, KY, USA

Stroke Management In The Time Of Covid, Marwa Elnazeir, Siddharth Narayanan, Kerri Remmel

The University of Louisville Journal of Respiratory Infections

No abstract provided.


Covid-19 Radiological Library, Forest W. Arnold, Tracy VanMeter, Lachlan Smith, Danny McGrath, Matthew Grassman, Nishant Patel, William Mattingly 2020 Division of Infectious Diseases, University of Louisville School of Medicine, Louisville, KY, USA

Covid-19 Radiological Library, Forest W. Arnold, Tracy Vanmeter, Lachlan Smith, Danny Mcgrath, Matthew Grassman, Nishant Patel, William Mattingly

The University of Louisville Journal of Respiratory Infections

No abstract provided.


Sars-Cov-2 And Bacterial Co-Infection, Rodrigo Cavallazzi 2020 University of Louisville

Sars-Cov-2 And Bacterial Co-Infection, Rodrigo Cavallazzi

The University of Louisville Journal of Respiratory Infections

No abstract provided.


A Patient With Escherichia Coli Bacteremia And Covid-19 Co-Infection: A Case Report For The Louisville Covid-19 Epidemiology Study, Sarah E. Moore PharmD, Ashley M. Wilde PharmD, BCPS-AQID, Matthew Song PharmD, BCIDP, Brian C. Bohn PharmD, Clayton J. Patross PharmD, BCPS, Bryan Denham MD, Paul Schulz, Julio A. Ramirez 2020 Norton Healthcare

A Patient With Escherichia Coli Bacteremia And Covid-19 Co-Infection: A Case Report For The Louisville Covid-19 Epidemiology Study, Sarah E. Moore Pharmd, Ashley M. Wilde Pharmd, Bcps-Aqid, Matthew Song Pharmd, Bcidp, Brian C. Bohn Pharmd, Clayton J. Patross Pharmd, Bcps, Bryan Denham Md, Paul Schulz, Julio A. Ramirez

The University of Louisville Journal of Respiratory Infections

Patients with COVID-19 may have co-infections with other microorganisms. Here we report a case of a patient with an E. coli bacteremia secondary to a urinary tract infection, who experienced fevers while on active antimicrobial therapy. The patient was eventually tested for COVID-19 and found to be positive. This case emphasizes the need to suspect COVID-19 even in patients with documented bacterial infection.


Life In The Time Of Covid, Julio A. Ramirez 2020 University of Louisville

Life In The Time Of Covid, Julio A. Ramirez

The University of Louisville Journal of Respiratory Infections

No abstract provided.


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