Trump fires chief US lawyer who defied him on migrant ban

Washington, Apr 28: After nearly three weeks in an intensive care unit in Los Angeles, doctors treating 41-year-old Broadway actor Nick Cordero for COVID-19 were forced to amputate his right leg.

The flow of blood had been impeded by a blood clot: yet another dangerous complication of the disease that has been bubbling up in frontline reports from China, Europe and the United States.

To be sure, so-called "thrombotic events" occur for a variety of reasons among intensive care patients, but the rates among COVID-19 patients are far higher than would be otherwise expected.

"I have had 40-year-olds in my ICU who have clots in their fingers that look like they'll lose the finger, but there's no other reason to lose the finger than the virus," Shari Brosnahan, a critical care doctor at NYU Langone said.

One of these patients is suffering from a lack of blood flow to both feet and both hands, and she predicts an amputation may be necessary, or the blood vessels may get so damaged that an extremity could drop off by itself.

Blood clots aren't just dangerous for our limbs, but can make their way to the lungs, heart or brain, where they may cause lethal pulmonary embolisms, heart attacks, and strokes.

A recent paper from the Netherlands in the journal Thrombosis Research found that 31 percent of 184 patients suffered thrombotic complications, a figure that the researchers called "remarkably high" -- even if extreme consequences like amputation are rare.

Behnood Bikdeli, a doctor at New York-Presbyterian Hospital, assembled an international consortium of experts to study the issue. Their findings were published in the Journal of The American College of Cardiology.

The experts found the risks were so great that COVID-19 patients "may need to receive blood thinners, preventively, prophylactically," even before imaging tests are ordered, said Bikdeli.

What exactly is causing it? The reasons aren't fully understood, but he offered several possible explanations.

People with severe forms of COVID-19 often have underlying medical conditions like heart or lung disease -- which are themselves linked to higher rates of clotting.

Next, being in intensive care makes a person likelier to develop a clot because they are staying still for so long. That's why for example people are encouraged to stretch and move around on long haul flights.

It's also now clear the COVID-19 illness is associated with an abnormal immune reaction called "cytokine storm" -- and some research has indicated this too is linked to higher rates of clotting.

There could also be something about the virus itself that is causing coagulation, which has some precedent in other viral illnesses.

A paper in the journal The Lancet last week showed that the virus can infect the inner cell layer of organs and of blood vessels, called the endothelium. This, in theory, could interfere with the clotting process.

According to Brosnahan, while thinners like Heparin are effective in some patients, they don't work for all patients because the clots are at times too small.

"There are too many microclots," she said. "We're not sure exactly where they are."

Autopsies have in fact shown some people's lungs filled with hundreds of microclots.

The arrival of a new mystery however helps solve a slightly older one.

Cecilia Mirant-Borde, an intensive care doctor at a military veterans hospital in Manhattan, told AFP that lungs filled with microclots helped explain why ventilators work poorly for patients with low blood oxygen.

Earlier in the pandemic doctors were treating these patients according to protocols developed for acute respiratory distress syndrome, sometimes known as "wet lung."

But in some cases, "it's not because the lungs are occupied with water" -- rather, it's that the microclotting is blocking circulation and blood is leaving the lungs with less oxygen than it should.

It has just been a little under five months since the virus emerged in Wuhan, China, and researchers are learning more about its impact every day.

"While we react surprised, we shouldn't be as surprised as we were. Viruses tend to do weird things," said Brosnahan.

While the dizzying array of complications may seem daunting, "it's possible there'll be one or a couple of unifying mechanisms that describe how this damage happens," she said.

"It's possible it's all the same thing, and that there'll be the same solution."

Paris, Jun 29: More than half a million people have been killed by the novel coronavirus, nearly two thirds of them in the United States and Europe, according to an news agency tally at 2200 GMT Sunday based on official sources.

The official death count for the disease now stands at 500,390 deaths from 10,099,576 cases recorded worldwide. The United States has suffered the highest death count (125,747), followed by Brazil (57,622) and the United Kingdom (43,550).

The tallies, using data collected by AFP from national authorities and information from the World Health Organization (WHO), probably reflect only a fraction of the actual number of infections.

Many countries are testing only the most serious cases.

Tehran, Jan 7: The Iranian Parliament on Tuesday ratified a motion dubbed as "harsh revenge", that considers all members of the US Pentagon and those responsible for the death of Major General Qasem Soleimani as "terrorist forces".

The triple-urgency motion is a modification of a previously ratified bill on April 23, 2019, that designated the US Central Command (CENTCOM) as a terrorist organization in retaliation to the same designation imposed on Iran's Islamic Revolutionary Guard Corps (IRGC) by Washington, the Tehran-based Mehr News Agency said in a report.

Parliament Speaker Ali Larijani said in Tuesday's open session that in the previous anti-US law, CENTCOM was designated as a terrorist entity.

"Today, following the cruel US measure in assassinating General Soleimani, the responsibility of which was accepted by the US President, we modify the previous law and announce that all members of Pentagon, commanders, agents and those responsible for the martyrdom of Gen Soleimani will be considered as terrorist forces," Larijani was quoted as saying in the report.

All of Iran nation supports the resistance, he added.

The modified law also allows withdrawal of $223 million to the IRGC's Quds Force from the National Development Fund of Iran for the next two months, added Larijani.

He said that the Supreme Leader Ayatollah Ali Khamenei's permission to withdraw the fund has been obtained, the Mehr report added.

Following its ratification, MPs chanted anti-US slogans at the Parliament.

Soleimani and his son-in-law and Abu Mahdi al-Muhandis, the second-in-command of Iraq's Popular Mobilization Front (PMF), along with eight other people were killed in the January 3 drone attack ordered by US President Donald Trump.

Soleimani, 63, was the elite Quds Force chief in charge of IRGC operations outside Iran, and has been on the ground in Syria and Iraq supervising militias backed by Tehran.

The Quds Force holds sway over a large number of militias across the region ranging from Lebanon to Syria and Iraq.

The attack has led to widespread condemnation in Iran. Supreme Leader Khamenei and President Hassan Rouhani has vowed revenge on the US.

On Sunday, Iranian MP Abolfazl Aboutorabi threatened to attack the heart of American politics.

During an open session of the Iranian Parliament on Sunday afternoon, President Trump was called a "terrorist in a suit" after he threatened to hit 52 Iranian sites hard if Tehran attacks Americans or US assets.