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Remdesivir Effective, Well-Tolerated in Final Trial Report

Editor’s note: Find the latest COVID-19 news and guidance in Medscape’s Coronavirus Resource Center.

A final report from the multinational placebo-controlled ACTT-1 trial confirms that remdesivir is effective and well tolerated for shortening the time to recovery from COVID-19 infection.

In May 2020, remdesivir received Food and Drug Administration approval for emergency treatment of severe COVID-19 on the basis of a preliminary report on this trial. In August 2020, the FDA expanded the indication to include all hospitalized adult and pediatric patients with suspected or laboratory-confirmed COVID-19 infection irrespective of severity.

“Our findings were consistent with the findings of the preliminary report: a 10-day course of remdesivir was superior to placebo in the treatment of hospitalized patients with COVID-19,” reported a team of investigators led by John H. Beigel, MD, of the Division of Microbiology and Infectious Diseases at the National Institute of Allergy and Infectious Diseases, in the New England Journal of Medicine.

The drug’s broadened indication was not based on the ACTT-1 trial, according to Dr. Beigel. “Other data have demonstrated that remdesivir shortens recovery in patients with lower acuity. In our study, evidence of pneumonia was an enrollment requirement,” he explained in an interview.

In the newly published final ACTT-1 data, the median time to recovery was 10 days for those on active therapy versus 15 days for those randomized to placebo. With a rate ratio of 1.29 (P less than .001), this translated to a recovery that was about one third faster.

In this final report, remdesivir’s significant advantage over placebo regarding the trial’s primary endpoint was reinforced by efficacy on multiple secondary endpoints.

This benefits on multiple secondary endpoints included a 50% greater odds ratio (OR, 1.5; 95% CI, 1.2-1.9) of significant clinical improvement by day 15 after adjustment for baseline severity, a shorter initial length of hospital stay (12 vs. 17 days) and fewer days on oxygen supplementation (13 vs. 21 days) for the subgroup of patients on oxygen at enrollment.

Although the numerically lower mortality in the remdesivir arm (6.75 vs. 11.9%) did not reach statistical significance, Dr. Beigel said, “mortality was moving in the same direction as the other key endpoints.”

According to the study investigators, the types of rates of adverse events on remdesivir, which inhibits viral replication, “were generally similar in the remdesivir and placebo groups.”

In ACTT-1, 1,062 patients were randomized to remdesivir (200 mg loading dose followed by 100 mg daily for up to 9 days) or placebo. Patients were enrolled at study sites in North America, Europe, and Asia.

The data of ACTT-1 confirm a benefit from remdesivir in hospitalized COVID-19 patients with severe disease, but Dr. Beigel said he agrees with the current FDA indication that supports treatment in any hospitalized COVID-19 patient.

“We saw bigger benefits in patients with more severe infections. The benefits are not as large in patients with mild disease, but I think remdesivir should be considered in any hospitalized patient,” Dr. Beigel said.

This point of view is shared.


An Easy No BS Guide To Creating A Simple But Effective Men’s Skincare Routine

We don’t quite know who started it, but it’s crazy to think that there are still men out there who believe that good skincare is a woman-only game.

But in case you’re one of them, news flash: it’s 2020, and the world is much different as we know it. Teenagers are steadily reshaping our future, Kim Kardashian has her own documentary about the criminal justice system, and Japan is building a real 1:1 scale Gundam, so we believe men putting a lot more effort into caring for their skin shouldn’t come as that big of a surprise.

man2 Skincare isn’t just for women, and it’s time you take care of yourself as well. Photo: Photo by Pixabay (CC0)

But it’s a good change nonetheless, especially when for the longest time, all men know about grooming comprises of shower gel and body spray gift sets, with the occasional borrowing of their girlfriend’s facial wash (not that there’s anything wrong with that). But enough is enough, everybody stands to gain from proper skincare, and that includes men.

There’s no need to tiptoe around beauty products either, as we’ve made a list of simple but effective techniques to buff up your glow. Check out these do’s and don’ts for long-lasting results:

1. Stay hydrated

The first step to having a good skin game is to start from the inside, and that means drinking lots of water throughout the day. For our recommendation, make sure you down at least eight glasses of that good ol’ H20 a day. Dehydration makes your skin more vulnerable to skin disorders and premature wrinkling.

man3 Drinking water is one of the primary ways in keeping yourself hydrated and your skin moisturized. Photo: Photo by Pixabay (CC0)

2. Don’t eat too much sugar

Sure, you can indulge every now and then, as long as you won’t drink those caramel lattes daily. Not only are they not healthy for your body, but sugar is also a huge fan of causing inflammation in your system, which results in, you guessed it: breakouts. As such, make sure you eat cookies, donuts, cakes and any carbonated drink as less as possible, and opt for healthier choices. Don’t get too comfy with supposed “healthy” snacks like cereal and yogurt, as they might also contain sugar without advertising them. With these foods, it’s always a good idea to check the label.

3. Always lather up  

In addition to waking you up, a good splash of cold water on the face primes your skin for the day ahead, so make sure you pair it with a facial cleanser that can energize your skin and remove any gunk from the night before. For our money, we recommend the Lumin No-Nonsense Charcoal Cleanser.

lumin cleanser Lumin’s facial cleanser will help you prime your skin for the day ahead, and keep it clean before you retire for the night. Photo:

Specially formulated for men and their tougher skin, this cleanser from the famous brand uses a charcoal formulation to help suction

Laughter May Be Effective Medicine for These Trying Times

Dr. Peter Viccellio, a professor of emergency medicine at Stony Brook University Hospital on Long Island, has seen many Covid-19 patients during his hours in the emergency room. A touch of playfulness and kindly humor, he said, has helped to ease an enormously painful situation for both his patients and members of the overburdened hospital staff.

“Genuine levity can make patients believe that they are not going to meet their doom today” Dr. Viccellio said, but he added that it needs to flow naturally. “If you are empathetic with the person, your humor tends to fit them, it’s not forced. If you are not emotionally connected to them and force a joke it can go very wrong.”

A case in point: “A colleague of mine once said casually to a patient whose medical history he did not know, ‘Don’t worry about it, at least it’s not cancer,’” Dr. Viccellio recalled. “The patient replied, ‘Actually, Doc, it is.’”

Other kinds of joking that are potentially destructive, he said, are the in-group humor that mocks patients or other members of the hospital staff, and the gallows humor that focuses on the darker sides of medicine. And one needs to be careful not to appear to be making light of somebody else’s pain.

Despite these potential pitfalls, some hospitals have initiated formal humor programs, making funny books and videos available and inviting clowns in to interact with their younger patients. Some caregivers are also innovating ways to bring humor into their own practice.

Mary Laskin, a nurse case-manager at Kaiser Permanente in San Diego, has been working with her chronic pain patients online, teaching them laughter exercises alongside practices designed to develop other positive mental states like gratitude and forgiveness.

“This pandemic is like a tiger creeping toward us, a huge slow-motion stressor that makes the experience of pain worse. Humor helps my patients relax and release their grip on pain,” she said.

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The Most cost-effective And Most Effective Manner To White Tooth

One of many greatest challenges most dental practices face everyday is scheduling overdue patients. 6. Orthodontics – are a type of dental remedy that may enhance the oral well being and smile of a person. In case you want to maintain your teeth into your old age, perhaps it is time for a brush up on some good dental habits. A Royal Oak dentist might help you with correct guidance and give you the best of medical treatment for your tooth and gum.

Obtaining a license to follow dentistry, in most states, requires that candidates attend and graduate from an accredited dental faculty. For those who undergo from infected gums choose a mouthwash with aloe vera or chamomile that produce calming effects. Of course, private dentists are paid extra, they spend more time with sufferers and they do better work.

Two, their sufferers normally must pay for the procedures outright, so they do not have to fret about insurance whittling away at their revenue margins. Dentists also discover different adjustments in your mouth and can be the first to notice developments of mouth most cancers and can therefore save your life.

My tooth required deep cleaning which could only be finished one half of the mouth at a time, and would also require irrigation with antibiotics afterwards to help my gums heal. Dentistry is a career that keeps on changing on the best way operations and procedures are carried out and it is therefore vital for each dentist to be effectively up to date on the latest ones.

Your native municipality has every proper to determine a “free” healthcare system and watch it wilt, simply so long as I can vote with my toes and get the hell out of there. They’d instantly suppose that you do not brush your tooth, you might have bad breath, and also you just do not care about oral well being.…

The Most cost-effective And Most Effective Way To White Teeth

Poor dental well being can always affect your self esteem. Why dentists take such a comparatively very long time in injecting you. Sometimes this third molar, or wisdom tooth, may by no means come out at all, and when it does come, it typically does not come all the way down to a level with the opposite teeth. 5. Oral Prophylaxis – the sort of dental service includes tooth polishing and scaling.

And in Massachussetts, healthcare is including to the state’s already crippling deficit. I imagine many in the US don’t need common healthcare because of what you talked about – they are benefiting from those lucrative salaries, bonuses and insurance profits.

You possibly can proceed this treatment every time you are taking the pain reliever for the best quantity of aid. The dentist will do an oral exam, take some x-rays, fill any cavities that need to be taken care of and possibly schedule you to get your tooth cleaned, assuming that you simply didn’t already get it executed in this go to.

Mercury is extremely poisonous and should have resulted in hearing harm in some sufferers, another doable reason behind the tooth radio fable. Less Ache – Cosmetic dentistry can eliminate the ache of braces by utterly changing the necessity for them. Whether or not the affected person receives dental implants or a dental bridge, the patient should continue a every day oral hygiene regimen along with regular dental checkups and cleanings.

Research that won USDA approval used an anhydrous ammonia remedy that raised the pH of the meat to as excessive as 10, “an alkalinity nicely past the vary of most foods.” The company’s 2003 examine cited the “potential points surrounding the palatability of a pH-9.5 product.” The pH scale works using powers of 10. An increase of pH 6 to 7 is ten times the difference.…