Timothy M. Uyeki

Bio: Timothy M. Uyeki is an academic researcher from Centers for Disease Control and Prevention. The author has contributed to research in topics: Influenza A virus subtype H5N1 & Influenza A virus. The author has an hindex of 86, co-authored 309 publications receiving 42818 citations. Previous affiliations of Timothy M. Uyeki include National Center for Immunization and Respiratory Diseases & University of California, San Francisco.

Clinical experience with intravenous zanamivir under an emergency investigational new drug program in the United States.

Abstract: TO THE EDITOR—We read the article by Fraaij et al [1] and would like to summarize the available information on intravenous zanamivir from the Food and Drug Administration (FDA)'s Emergency Investigational New Drug (EIND) application process [2]. No intravenous an-tiviral agents for treatment of severe influenza are currently approved in the United States. Since the emergence of 2009 pandemic influenza A virus subtype H1N1 (A[H1N1]pdm09), intravenous zanamivir has been authorized through an EIND application to the FDA as an investigational treatment for patients with serious and life-threatening influenza. As part of the EIND process, treating physicians are encouraged to submit data to the FDA, but reporting of requested data is voluntary. We reviewed the FDA's EIND database on influenza patients who received intravenous zanamivir from April 2009 through April 2011. For the 200 patients identified, we performed a descriptive analysis of reported patient information on age, sex, pregnancy status, baseline comorbidities, virologic test results , antiviral resistance data, other antiviral treatments, clinical complications, supportive care modalities used, intravenous zanamivir treatment duration, adverse events (AEs), and outcomes (Table 1). At the time of intravenous zanamivir request, many patients were critically ill with underlying comorbidities and required intensive care unit admission for severe complications of influenza A virus infection (predominantly due to A[H1N1]pdm09), including respiratory failure and renal failure. Most patients

INSIGHT FLU005: An Anti–Influenza Virus Hyperimmune Intravenous Immunoglobulin Pilot Study

Abstract: UNLABELLED Hemagglutination inhibition (HAI) antibody responses to anti-influenza virus hyperimmune intravenous immunoglobulin (hIVIG) were characterized. Thirty-one patients with influenza during the 2013-2014 season were randomly assigned to receive 0.25 g/kg of hIVIG (n = 16) or placebo (n = 15). For hIVIG recipients, the ratio of geometric mean titers (1 hour after infusion/before infusion) was 4.00 (95% confidence interval [CI], 2.61-6.13) for 2009 pandemic influenza A(H1N1) and 1.76 (95% CI, 1.33-2.32) for influenza A(H3N2) and influenza B. Among patients with 2009 pandemic influenza A(H1N1), ratios for hIVIG (n = 9) versus placebo (n = 8) were higher 1 hour after infusion (3.9 [95% CI, 2.3-6.7]) and sustained through day 3 (2.0 [95% CI, 1.0-4.0]). hIVIG administration significantly increases HAI titer levels among patients with influenza, supporting the need to perform a clinical outcomes study. CLINICAL TRIALS REGISTRATION NCT02008578.

Antivirals for influenza: a summary of a systematic review and meta-analysis of observational studies.

Abstract: Despite the use of antivirals to treat patients with severe influenza, questions remain with respect to effects and safety. Although a recent systematic review has provided some indication of benefit, the analysis is limited by the quality of the available evidence from randomized controlled trials. To supplement the existing information, the authors conducted a systematic review of observational studies of antiviral treatment for influenza. This report summarises the findings of that review. Similar to the randomised trials, the confidence in the estimates of the effects for decision-making is low to very low primarily due to the risk of selection and publication bias in the observational studies. From these observational studies, the summary estimates suggest that oseltamivir may reduce mortality, hospitalisation and duration of symptoms compared with no treatment. Inhaled zanamivir may also reduce symptom duration and hospitalisations, but patients may experience more complications compared with no treatment. Earlier treatment with antivirals is generally associated with better outcomes than later treatment. Further high-quality evidence is needed to inform treatment guidelines because of the overall low to very low quality of evidence.

Critically Ill Patients With Influenza A(H1N1)pdm09 Virus Infection in 2014

Abstract: Since 2009, H1N1pdm09 virus has continued to circulate and cause critical illness worldwide, but it has not predominated in the United States until this season, with a corresponding resurgence of influenza-related hospitalizations, critical illness, severe ARDS, and deaths. This year more than 60% of laboratory-confirmed influenzaassociated hospitalizations and deaths reported in adults younger than 65 years to date have been attributed to H1N1. 3,4 No significant antigenic changes in circulating H1N1pdm09 virus strains compared with vaccine strains have been detected since 2009. The relative effect on young and middle-aged adults might be partially due to their low influenza vaccine coverage and crossreactive immunity to H1N1pdm09 virus that elderly individuals have acquired from past exposure to antigenically related viruses. Based on lessons learned from the 2009 H1N1 pandemic, we offer suggestions for the care and management of H1N1pdm09 patients at risk for critical illness during this influenza season.

Clinical Characteristics of Coronavirus Disease 2019 in China.

Abstract: Background Since December 2019, when coronavirus disease 2019 (Covid-19) emerged in Wuhan city and rapidly spread throughout China, data have been needed on the clinical characteristics of...

Standards of Medical Care in Diabetes

Abstract: XI. STRATEGIES FOR IMPROVING DIABETES CARE D iabetes is a chronic illness that requires continuing medical care and patient self-management education to prevent acute complications and to reduce the risk of long-term complications. Diabetes care is complex and requires that many issues, beyond glycemic control, be addressed. A large body of evidence exists that supports a range of interventions to improve diabetes outcomes. These standards of care are intended to provide clinicians, patients, researchers, payors, and other interested individuals with the components of diabetes care, treatment goals, and tools to evaluate the quality of care. While individual preferences, comorbidities, and other patient factors may require modification of goals, targets that are desirable for most patients with diabetes are provided. These standards are not intended to preclude more extensive evaluation and management of the patient by other specialists as needed. For more detailed information, refer to Bode (Ed.): Medical Management of Type 1 Diabetes (1), Burant (Ed): Medical Management of Type 2 Diabetes (2), and Klingensmith (Ed): Intensive Diabetes Management (3). The recommendations included are diagnostic and therapeutic actions that are known or believed to favorably affect health outcomes of patients with diabetes. A grading system (Table 1), developed by the American Diabetes Association (ADA) and modeled after existing methods, was utilized to clarify and codify the evidence that forms the basis for the recommendations. The level of evidence that supports each recommendation is listed after each recommendation using the letters A, B, C, or E.