CasesMed Research Journal

Peripheral Inserted Central Catheter as Vascular Device of Choice in Covid-19 Patient: The Experience of a PICC Team in a Hospital in Southern Italy

Alfonso Papa1*, Dario Tammaro2, Gennaro Liguori2, Giuseppina Scicchitano2, Anna Maria Salzano1,2, Maria Teresa Di Dato1,2 and Giuseppe Fiorentino3

During the COVID-19 pandemic, the management of vascular access in the most critical patients was an emerging problem. Correct management of vascular access according to standards has contributed to improving the outcome especially in patients admitted to the sub-intensive units. The use of PICCs in these patients is certainly a standard of care. In this paper we report the experience in a COVID Hospital in southern Italy in April 2020.


The Possible Role of Vitamin D in Prevention and Treatment of COVID-19 Disease

Shraga Shany*

Preliminary studies suggest an inverse link, between serum vitamin D levels and the severity, and mortality in Covid-19 patients. Such patients are suffering from inflammation storm caused by the excess production of cytokines by the immune system. The present review provides indications for the anti-inflammatory activity of 1,25-Dihdroxyvitamin D3 . This vitamin D active metabolite, downregulates the expression of TNFα in human macrophages. TNFα is a major mediator of host response to pathogens, since it initiates a powerful pro-inflammatory cascade. However, excessive production of TNFα over-activates inflammation accompanied by a cytokines storm, as occurs in the Covid-19 disease. These findings provide a biological basis and possible mode of action by which vitamin D makes its impact on the Covid-19 disease, and emphasize the possible role of vitamin in preventing Covid-19, or at least moderates its severe symptoms. Hence, it is suggested to prevent vitamin D deficiency by vitamin D supplementation for the general population, with a special care for the elderly. In case of acute Covid-19 disease, It is suggested to treat patients with the active metabolite of vitamin D, 1,25(OH)2D3 , or with its less calcaemic synthetic analogs.


Treatment of Childhood Cancer during COVID-19 Times

R B Nerli1*, Shashank D Patil1, Shridhar C Ghagane2 and Neeraj S Dixit2

The coronavirus disease 2019 (COVID-19) first reported in Wuhan, China in December 2019, has rapidly spread all over the world. As of today 3rd June 2020, more than 6,474,559 persons have tested positive for the disease and 382,921 have succumbed to it. In India too 208,543 have tested positive and 5,834 persons have died due to COVID-19. Ludvigsson [1] systematically reviewed the literature and reported that children seemed to have a milder disease course, carried better prognosis than in adults, and deaths were extremely rare


COVID-19 in Tanguieta (BENIN)

Fr Florent Dr. Giambattista Priuli*

This part of Africa was probably privileged because COVID-19 has not done much damage as a pandemic viral infection. Indeed, from the first announcements of the risk of the pandemic in our region, we have invested a lot to carry out preventive measures and barriers. Of course in this, we have been helped in some ways by the closure of the borders around us, see Mali, Burkina-Faso, Niger, Togo, Nigeria.


COVID-19 Patient Presenting as Complete Heart Block - A Case Report

Chanakya Kishore and IV Siva Prasad*

COVID-19 is the clinical manifestation of infection with Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2), first reported from China in 2019 which has now affected more than 6 million individuals across the world with more than 0.4 million deaths. We present a mid aged female who arrived to the hospital after syncope with GTCS.


Listeria Monocytogenes Disease in a Patient Treated with Adalimumab

Marco Distefano, MD*

Listeria monocytogenes is an uncommon Gram-positive pathogen that causes self-limited febrile gastroenteritis in healthy hosts. Listeria is also a cause of invasive disease, including bacteremia and central nervous system infection in individuals at the extremes of age (neonates and older adults), immunosuppressed patients, and pregnant women. The mortality of invasive disease caused by Listeria monocytogenes is 20-40%. TNFα blockers are a new class of immunosuppressant drugs considered the most significant therapeutic advance in the care of IBD and rheumatologic disorders. Few cases of invasive listeriosis are reported after adalimumab (a monoclonal antibody anti-TNFα) therapy.


The Pandemic Need for Mindfulness

Audrey Tolouian1* and Melissa Wholeben2

In a trauma facility, it is important that there be training for the healthcare providers that gives them tools to manage their internal reactions to the day to day events, as well as create a safe space and encourage a sense of community. For healthcare workers in high trauma areas- such as the new COVID-19 units, post- traumatic stress syndrome (PTSD) has been on the rise, in 2011, 14% of nurses were diagnosed, in 2019 an estimated 40% of nurses suffer from the disorder. With the small amount of 18% of nurses feeling they are prepared with proficient self-care skills to manage the effects caused from day to day events of the work environment prior to the COVID-19 pandemic that number is expected to rise exponentially. In a perfect world, healthcare providers would be given mindfulness training as they enter their specified career coursework. Once the students graduate, the orientation at the facility could take these trainings and reinforce them throughout the orientation period to emphasize the importance of self-care.


The COVID-19 Syndrome: One, Two, Three, or a Hundred Diseases......

Giovanni C Actis*

We are now entering our 8th month of combat against the SARS-CoV-2, a previously unknown RNA coronavirus that allegedly causing a cluster of severe atypical pneumonias at the end of December 2019 in China, began to be identified and traced since then. After rapidly invading mainland China and a few other countries in sequence, this agent got the classification of pandemia, with the depending syndrome named COVID-19. This grading is now being supported by a toll of some 16 million infected, and 600,000 fatalities worldwide. One of the major problems is the lack of fully effective drugs, whereas several vaccine programs have still a long way to go. Peoples’ fear, and massive job loss, is threatening to ignite social collapse, as a second disease within the first one. We hereby try to effectively unwrap a few qualifying points, to favor the designing of novel strategies.


Pitfalls Encountered during Anesthetic Care of First Surgical Case of COVID-19 at a University Hospital

Chan Jung, Jason Cosman*, Ariana M Nelson

With the rapid surge of SARS-CoV-2 cases, institutions had to quickly adapt to address proper management of this novel virus. With many unknowns, interprofessional relationships in the hospital were strained. This case exemplifies nursing and physician staff concerns and how these were addressed during management of the first COVID+ patient requiring surgery at our institution: a 54-year-old male with insulin-dependent type 2 diabetes mellitus (IDDM), morbid obesity, COVID positive (COVID+) status with productive cough and oxygen requirement scheduled for extensive right lower extremity debridement under general anesthesia. We will emphasize learning points in communication between floor nursing staff, operating room (OR) nursing and physician staff, and the interdisciplinary challenges faced.