Session 1:

After discussing COVID-19 emerging in LTC facilities and current news, are there any other treatments that have shown promise or are they theoretical so far?

The following article was discussed: https://jamanetwork.com/journals/jama/fullarticle/2764727#full-text-tab

According to the WHO’s website, the following drugs are treatments options under study:

• Remdesivir was previously tested as an Ebola treatment. It has generated promising results in animal studies for Middle East Respiratory Syndrome (MERS-CoV) and severe acute respiratory syndrome (SARS), which are also caused by coronaviruses, suggesting it may have some effect in patients with COVID-19.
• Lopinavir/Ritonavir is a licensed treatment for HIV. Evidence for COVID-19, MERS and SARS is yet to show it can improve clinical outcomes or prevent infection. This trial aims to identify and confirm any benefit for COVID-19 patients. While there are indications from laboratory experiments that this combination may be effective against COVID-19, studies done so far in COVID-19 patients have been inconclusive.
• Interferon beta-1a is used to treat multiple sclerosis.
• Chloroquine and hydroxychloroquine are very closely related and used to treat malaria and rheumatology conditions respectively. In China and France, small studies provided some indications of possible benefit of chloroquine phosphate against pneumonia caused by COVID-19 but need confirmation through randomized trials.

 

Session 2:

• Review the clinical significance of 200/20 and 100/20 on visual acuity – what would that mean functionally?  What is the minimum required for driving (without corrective lenses)?  What is the number at which someone is legally blind?
  • Having 20/200 vision means that a person’s eyesight is about 10 times worse than what’s considered standard for most people, which is 20/20 vision. In other words, a person with 20/200 vision would have to stand 20 feet from a sign in order to read it, when a person with normal vision could read it at 200 feet away.
  • For driving in NY, the test must show that you have visual acuity of at least 20/40 (based on the Snellen Visual Acuity Scale) in either or both eyes, with or without corrective lenses.
  • The US Social Security Administration defines legal blindness as either eyesight that’s no better than 20/200 or a visual field of 20 degrees or less.
• What does it mean clinically if someone has pain on active ROM, but decreased or no pain on passive ROM?
  • Pain/limitation on active ROM but not passive suggests a structural problem with muscles/tendons because they’re firing with active ROM but not passive ROM.
  • According to https://www.massagetherapyreference.com/range-of-motion/, pain with active ROM can result from a strain of the mover musculature, a sprain of the ligamentous/joint capsule complex of the joint, and/or a strain or spasm of the antagonist muscles of the motion. One or any combination of these conditions can exist.