We report the successful use of combination therapy with two direct acting antivirals for treatme... more We report the successful use of combination therapy with two direct acting antivirals for treatment of chronic COVID-19. An immunocompromised 60 year old male with persistent SARS-CoV-2 infection over 4 months had chronic, progressive COVID-19 requiring mechanical ventilation. After failing monotherapy with two antivirals and neutralising monoclonal antibodies, he was treated with a 10 day course of intravenous remdesivir and crushed nirmatrelvir/ritonavir (Paxlovid) administered through a nasogastric tube. Following treatment, SARS-CoV-2 RNA became undetectable, with resolution of supplemental oxygen requirement and acute inflammatory changes on computed tomography. This case demonstrates potential synergy between remdesivir and nirmatrelvir/ritonavir in treating persistent, symptomatic SARS-CoV-2 infection.
We describe 2 cases of infectious proctitis secondary to human monkeypox in patients presenting w... more We describe 2 cases of infectious proctitis secondary to human monkeypox in patients presenting with rectal pain. These cases highlight the importance of multidisciplinary management of monkeypox and in expanding case definitions and enabling clinical recognition in patients presenting without skin rash.
Objective To characterise the clinical features of monkeypox infection in humans. Design Descript... more Objective To characterise the clinical features of monkeypox infection in humans. Design Descriptive case series. Setting A regional high consequences infectious disease centre with associated primary and secondary care referrals, and affiliated sexual health centres in south London between May and July 2022. Participants 197 patients with polymerase chain reaction confirmed monkeypox infection. Results The median age of participants was 38 years. All 197 participants were men, and 196 identified as gay, bisexual, or other men who have sex with men. All presented with mucocutaneous lesions, most commonly on the genitals (n=111 participants, 56.3%) or in the perianal area (n=82, 41.6%). 170 (86.3%) participants reported systemic illness. The most common systemic symptoms were fever (n=122, 61.9%), lymphadenopathy (114, 57.9%), and myalgia (n=62, 31.5%). 102/166 (61.5%) developed systemic features before the onset of mucocutaneous manifestations and 64 (38.5%) after (n=4 unknown). 27 ...
The objective of this study was to evaluate the contribution of EEG theta and alpha reactivity on... more The objective of this study was to evaluate the contribution of EEG theta and alpha reactivity on opening the eyes, in the diagnosis of slight and moderate Alzheimer's disease (AD). Thirty four patients with AD and a control group of 30 individuals were studied, all being assessed using a neurological evaluation, CERAD neuropsychological battery (consortium to establish a registry for Alzheimer's disease), incorporating the Mini Mental State Examination (MMSE), Clinical Dementia Rating (CDR) and a qEEG analysis of the absolute band power at rest, with the eyes both open and closed. The theta and alpha reactivity indices were calculated on opening the eyes, defined from the relationship between the absolute powers in the respective bands in the periods with the eyes open and with them closed, the quotient of the relationship between the alpha and theta indices, the alpha/theta ratio, was also calculated. Multiple regression models were used to determine the accuracy in discri...
We report the successful use of combination therapy with two direct acting antivirals for treatme... more We report the successful use of combination therapy with two direct acting antivirals for treatment of chronic COVID-19. An immunocompromised 60 year old male with persistent SARS-CoV-2 infection over 4 months had chronic, progressive COVID-19 requiring mechanical ventilation. After failing monotherapy with two antivirals and neutralising monoclonal antibodies, he was treated with a 10 day course of intravenous remdesivir and crushed nirmatrelvir/ritonavir (Paxlovid) administered through a nasogastric tube. Following treatment, SARS-CoV-2 RNA became undetectable, with resolution of supplemental oxygen requirement and acute inflammatory changes on computed tomography. This case demonstrates potential synergy between remdesivir and nirmatrelvir/ritonavir in treating persistent, symptomatic SARS-CoV-2 infection.
We describe 2 cases of infectious proctitis secondary to human monkeypox in patients presenting w... more We describe 2 cases of infectious proctitis secondary to human monkeypox in patients presenting with rectal pain. These cases highlight the importance of multidisciplinary management of monkeypox and in expanding case definitions and enabling clinical recognition in patients presenting without skin rash.
Objective To characterise the clinical features of monkeypox infection in humans. Design Descript... more Objective To characterise the clinical features of monkeypox infection in humans. Design Descriptive case series. Setting A regional high consequences infectious disease centre with associated primary and secondary care referrals, and affiliated sexual health centres in south London between May and July 2022. Participants 197 patients with polymerase chain reaction confirmed monkeypox infection. Results The median age of participants was 38 years. All 197 participants were men, and 196 identified as gay, bisexual, or other men who have sex with men. All presented with mucocutaneous lesions, most commonly on the genitals (n=111 participants, 56.3%) or in the perianal area (n=82, 41.6%). 170 (86.3%) participants reported systemic illness. The most common systemic symptoms were fever (n=122, 61.9%), lymphadenopathy (114, 57.9%), and myalgia (n=62, 31.5%). 102/166 (61.5%) developed systemic features before the onset of mucocutaneous manifestations and 64 (38.5%) after (n=4 unknown). 27 ...
The objective of this study was to evaluate the contribution of EEG theta and alpha reactivity on... more The objective of this study was to evaluate the contribution of EEG theta and alpha reactivity on opening the eyes, in the diagnosis of slight and moderate Alzheimer's disease (AD). Thirty four patients with AD and a control group of 30 individuals were studied, all being assessed using a neurological evaluation, CERAD neuropsychological battery (consortium to establish a registry for Alzheimer's disease), incorporating the Mini Mental State Examination (MMSE), Clinical Dementia Rating (CDR) and a qEEG analysis of the absolute band power at rest, with the eyes both open and closed. The theta and alpha reactivity indices were calculated on opening the eyes, defined from the relationship between the absolute powers in the respective bands in the periods with the eyes open and with them closed, the quotient of the relationship between the alpha and theta indices, the alpha/theta ratio, was also calculated. Multiple regression models were used to determine the accuracy in discri...
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