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Shortages Looming for Respirators, Masks, Gowns  - web md

Shortages Looming for Respirators, Masks, Gowns

Only about 12% of facilities have been able to get supplemental PPE from federal resources, compared with 25% that have drawn from local donations and 17% from do-it-yourself efforts to cobble together masks and gowns, results show. State and local governments have supplied PPE to 29% of facilities surveyed.
web md - 21 hours ago
How Three Countries Have Kept COVID-19 In Check  - web md

How Three Countries Have Kept COVID-19 In Check

Although the United States missed its chance to head off a COVID-19 epidemic, and is well on its way to becoming the pandemic's new epicenter, these lessons drawn from other countries could still be used to help manage infections in the months and years ahead, Adalja and Kullar said.
web md - 22 hours ago
U.S. Hospital Beds Were Maxed Out Before Pandemic  - web md

U.S. Hospital Beds Were Maxed Out Before Pandemic

At Elmhurst Hospital Center, a 545-bed public hospital, doctors and nurses have only a few dozen ventilators for their patients, some of whom have died while waiting for a bed. A refrigerated truck has been stationed outside the hospital to hold the dead, the newspaper reported.
web md - 1 day ago
COVID-19: Dramatic Changes to Telepsychiatry Rules and Regs  - web md

COVID-19: Dramatic Changes to Telepsychiatry Rules and Regs

In the wake of drastic rule changes governing telemental health services during the COVID-19 outbreak, experts give the most up-to-date information on how to best navigate this ever-changing landscape.
web md - 1 day ago
Keep Calm: Under 25s With Diabetes Not Hospitalized Due to COVID-19  - web md

Keep Calm: Under 25s With Diabetes Not Hospitalized Due to COVID-19

Reassuringly, COVID-19 in under 25s with diabetes doesn't seem to require hospitalization, early reports from global hotspots indicate. But the pandemic means new cases of type 1 diabetes are being missed.
web md - 1 day ago
Livestock, Poultry Safe From Coronavirus: Expert  - web md

Livestock, Poultry Safe From Coronavirus: Expert

The low level of risk to livestock and poultry is good news for U.S. livestock producers, meat packers and consumers, who could use some stability as uncertainty about the coronavirus restricts many normal daily activities, Roth noted.
web md - 1 day ago
Severe COVID-19 Might Injure the Heart  - web md

Severe COVID-19 Might Injure the Heart

Doctors in China have already warned that heart injuries appear common in COVID-19 patients, particularly those with existing heart disease or high blood pressure. A recent, smaller study found that 12% of hospitalized patients had the complication.
web md - 1 day ago
Social Distancing May Be Working, New Study Hints  - web md

Social Distancing May Be Working, New Study Hints

Data show that the number of people with fever that's an early indication of coronavirus infection started falling almost immediately after social distancing measures took effect in some areas, USA Today reported.
web md - 2 days ago
Critics Lead Gilead to Drop Coronavirus Drug Status  - web md

Critics Lead Gilead to Drop Coronavirus Drug Status

Gilead asked the U.S. Food and Drug Administration to designate remdesivir a so-called orphan drug, saying it qualified as a rare disease because fewer than 200,000 Americans are infected with the coronavirus.
web md - 2 days ago
Young People Far From Immune to Coronavirus

Young People Far From Immune to Coronavirus' Bite

The data from China showed that older people were more likely to die. But Americans may have misunderstood the data that initially came out of China: that older people were most affected and younger ones were safe.
web md - 2 days ago
Wuhan Study Shows Social Distancing Saves Lives  - web md

Wuhan Study Shows Social Distancing Saves Lives

The closures significantly delayed the peak of the epidemic in Wuhan -- the epicenter of the worldwide pandemic -- and gave the health system the time and opportunity to grow and respond to the crisis, according to the study authors.
web md - 2 days ago
Commentary: What If There Is a Virtual ACC and Nobody Cares?  - web md

Commentary: What If There Is a Virtual ACC and Nobody Cares?

It seems tone-deaf to discuss science-that-can-wait while colleagues across the world fight this challenge, writes John Mandrola, MD, of the upcoming virtual American College of Cardiology Scientific Sessions.
web md - 2 days ago
Expert: Coronavirus Isn

Expert: Coronavirus Isn't 'Alive,' But Still Harms

"A virus usually enters the cell through a protein our cells have on their surface. COVID-19 -- and SARS [severe acute respiratory syndrome] before that -- use a protein called ACE2, which is on the surface of the cells in our lung, throat and intestinal tract,"  Mendenhall said.
web md - 2 days ago
ICU Lessons on COVID-19 From Italian Front Line: Be Flexible  - web md

ICU Lessons on COVID-19 From Italian Front Line: Be Flexible

The rate of increase in patients needing ICU beds in areas badly affected by COVID-19 can double every 3 to 5 days for over a month, with patients staying an average of 15 days; flexibility is imperative.
web md - 2 days ago
Social Distancing May Need to Last Months: Study  - web md

Social Distancing May Need to Last Months: Study

As painful as the last 9 days of social distancing have been, disease modelers think Americans may need to be at home much longer to truly “flatten the curve” of the COVID-19 infection and avoid overwhelming the critical care capacity of U.S. hospitals, a new study says.
web md - 2 days ago
COVID-19 May Delay Some Cancer Treatments  - web md

COVID-19 May Delay Some Cancer Treatments

It's long been understood that cancer, as well as its therapies, have the unfortunate side effect of weakening a patient's immune system. That can leave a patient more vulnerable to infectious illness, including COVID-19.
web md - 2 days ago
Could Robots Be Deployed in Battle With COVID-19?  - web md

Could Robots Be Deployed in Battle With COVID-19?

"Opportunities lie in intelligent navigation and detection of high-risk, high-touch areas, combined with other preventative measures," the authors said in a university news release. "New generations of large, small, micro- and swarm robots that are able to continuously work and clean [i.e., not only removing dust but also truly sanitizing/sterilizing all surfaces] could be developed."
web md - 2 days ago
Are Vital Home Health Workers Now A Safety Threat?  - web md

Are Vital Home Health Workers Now A Safety Threat?

Hundreds of thousands of health care workers go into homes to provide important services for seniors and disabled people. But with the rising concerns about the danger of the coronavirus pandemic, especially for older people, these health workers could be endangering their patients and themselves.
web md - 2 days ago
Coronavirus (COVID-19)  - web md

Coronavirus (COVID-19)

The virus that causes COVID-19 is a new (novel) strain of coronavirus called SARS-CoV-2. It causes mild flu-like symptoms, but severe cases can be fatal. Learn how to spot symptoms, prevent spreading of the disease, and find out what to do if you think you have it.
web md - 3 days ago
What People With Parkinson

What People With Parkinson's Need to Know About COVID-19

"People living with Parkinson's disease are at high risk if they contract COVID-19, whether they are above age 50 or if they have young-onset Parkinson's disease, which occurs in people younger than 50," said Dr. Frederick Southwick, an infectious disease expert at the University of Florida in Gainesville.
web md - 3 days ago
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C. difficile (C. diff): An urgent threat

C. difficile (C. diff): An urgent threat

harvard - 1 month ago

Clostridioides (previously Clostridium) difficile (C. diff) is the most common cause of diarrhea among hospitalized patients and the most commonly reported bacteria causing infections in hospitals. In a 2019 report, the CDC referred to C. diff as an urgent threat.

Who is most at risk?

C. diff infection (CDI) occurs more commonly following antibiotic therapy or hospitalization, and among older adults or patients with weakened immune responses. In 2002, an epidemic strain of C. diff emerged, causing more severe disease with inflammation of the colon (colitis) and an increase in deaths. This strain adheres better to the intestine and produces more toxin, which is responsible for causing illness. Non-epidemic strains may cause less severe disease.

What makes C. diff so difficult to treat?

A high relapse rate poses challenges to treating people with CDI. Recurrence of diarrhea following initial treatment occurs in about 20% of cases. The risk of yet another relapse is even greater in the weeks following treatment for a recurrent CDI.

C. diff produces spores (dormant cells capable of surviving harsh conditions for prolonged periods) that can contaminate the environment. Spores are hearty and resistant to routine cleaning. But enhanced protective measures careful hand washing, isolation precautions for infected patients (private room, gown, and gloves), and cleaning with agents capable of killing C. diff spores are effective ways to prevent transmission and control CDI.

Antibiotics disrupt the healthy gut bacteria (microbiome), which then provides suitable conditions for ingested spores to flourish and result in CDI.

Hospitalized patients are at greater risk, although healthy individuals in the community who have not been treated with antibiotics can also become infected.

The World Society of Emergency Surgery released updated clinical practice guidelines in 2019, focusing on CDI in surgical patients. Surgery, particularly gastrointestinal surgery, is a known risk for CDI. (Ironically, surgery is also a potential treatment option for severe CDI.)

What is the difference between C. diff colonization and C. diff infection?

Up to 5% of people in the community, and an even greater percentage of people who are hospitalized, may be colonized with C. diff bacteria, but not experience any symptoms. The risk of progressing to disease varies, since not all C. diff strains produce toxin that makes you sick. People colonized with a non-toxin-producing strain of C. diff may actually be protected from CDI.

CDI is diagnosed based on symptoms, primarily watery diarrhea occurring at least three times a day, and stool that tests positive for C. diff. A positive test without symptoms represents colonization and does not require treatment. Patients colonized with toxin-producing strains are at risk for disease, particularly if exposed to antibiotics.

How is C. diff treated?

The most common antibiotics used to treat CDI are oral vancomycin or fidaxomicin. Extended regimens, lasting several weeks, have been used successfully to treat recurrences. Vancomycin enemas and intravenous metronidazole, another antibiotic, are also used in severe cases.

Fecal microbiota or stool transplant (FMT) from screened donors is an effective investigational treatment for those who do not respond to other treatment. However, it is not without risk. FMT capsules are effective and logistically easier.

Patients with severe CDI not responding to therapy may benefit from surgery, typically a colon resection or a colon-sparing procedure.

What can you do to prevent CDI?

Though there are no guarantees, there are many things you can do to help reduce your risk of CDI, particularly if you are scheduled for hospitalization or surgery.

If you are scheduled for surgery, discuss routine antibiotics to prevent infection with your surgeon. In most cases, according to the CDC, one dose of an antibiotic is sufficient. If you have an established (non-C. diff) bacterial infection, several recent studies show that shorter antibiotic courses are effective and may also reduce your risk of CDI. You should also ask your doctor about avoiding antibiotics that are more likely to result in CDI (clindamycin, fluoroquinolones, penicillins, and cephalosporins).

If you are hospitalized with CDI, you should use a designated bathroom and wash your hands frequently with soap and water, particularly after using the restroom. In the hospital, encourage staff to practice hand hygiene in your line of sight, and express appreciation to hospital staff for keeping your environment germ-free. If you are at high risk for a CDI recurrence (you are 65 or older, have a weakened immune response, or had a severe bout of CDI), discuss the potential value of bezlotoxumab with your provider. This monoclonal antibody can help to further reduce risk of recurrent CDI in those who are at high risk for recurrence.

There are other preventive measures that you can take whether or not you are hospitalized. Limit the use of antacids, particularly proton-pump inhibitors (PPIs). Dont ask your doctor for antibiotics to treat colds, bronchitis, or other viral infections. Request education about side effects of prescribed antibiotics from your doctor or dentist, and discuss the shortest effective treatment duration for your condition. Let your doctor know that you want to minimize your risk for CDI. Practice exceptional hand hygiene before eating, and especially before and after visiting healthcare facilities.

For more information, visit the Peggy Lillis Foundation and the Centers for Disease Control and Prevention.

Follow me on Twitter @idandipacdoc

The post C. difficile (C. diff): An urgent threat appeared first on Harvard Health Blog.

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