A scientific panel, assembled by the World Health Organization (WHO), has recommended guidelines for physicians conducting studies of patients with severe acute respiratory syndrome (SARS). The panel urged physicians to apply the guidelines in analyzing all the data about various therapies gathered in this year?s epidemic. A majority of that information has yet to be analyzed or published. Although WHO did not release the guidelines, officials said that they were flexible because no one knew where, when, and in what setting SARS would return.
During the epidemic earlier this year, various treatments as well as traditional Chinese medicine were used under emergency conditions, in different settings, and in several countries to patients suffering from various stages of the illness. Those conditions, generally without standardized measurements or controlled situations, have made it harder to interpret results.
Normal supportive therapy such as nursing?and in severe cases the use of mechanical respirators to help patients breath - is the basis of SARS care and helped many patients survive. Physicians, however, still do not know the best way to treat SARS patients with breathing difficulties, said Simon Mardel, MD, a WHO official who recently led the 2-day meeting. The current methods consist of invasive ventilation (in which a patient is connected to a ventilator) and blowing oxygen into the lungs through a mask. Both carry the risk of transmitting the virus to hospital employees. Because there was no proper analysis, the panel was unable to determine which treatment worked better or which caused more harm.
Also, the panel agreed on guidelines that would allow physicians to perform quick and safe clinical trials, a procedure that usually takes years to complete. Furthermore, the group suggested determining the amount of SARS virus in the blood, respiratory secretions, and other body fluids as a way of measuring response to antiviral and other drugs.
One study linked multiple pregnancies to an increased risk of developing atrial fibrillation later in life, and another investigated the association between premature delivery and cardiovascular disease.
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