Rapid worldwide spread of Coronavirus Disease 2019 (COVID-19) has resulted in a global pandemic.
This review article provides emergency physicians with an overview of the most current understanding ...of COVID-19 and recommendations on the evaluation and management of patients with suspected COVID-19.
Severe Acute Respiratory Syndrome coronavirus 2 (SARS-CoV-2), the virus responsible for causing COVID-19, is primarily transmitted from person-to-person through close contact (approximately 6 ft) by respiratory droplets. Symptoms of COVID-19 are similar to other viral upper respiratory illnesses. Three major trajectories include mild disease with upper respiratory symptoms, non-severe pneumonia, and severe pneumonia complicated by acute respiratory distress syndrome (ARDS). Emergency physicians should focus on identifying patients at risk, isolating suspected patients, and informing hospital infection prevention and public health authorities. Patients with suspected COVID-19 should be asked to wear a facemask. Respiratory etiquette, hand washing, and personal protective equipment are recommended for all healthcare personnel caring for suspected cases. Disposition depends on patient symptoms, hemodynamic status, and patient ability to self-quarantine.
This narrative review provides clinicians with an updated approach to the evaluation and management of patients presenting to the emergency department with suspected COVID-19.
•Coal as a methanogenic substrate is discussed.•The process of bioconverting coal to methane is reviewed.•Ways to enhance methane production, such as bioaugmentation, biostimulation and pretreatment ...are presented.•Approaches for purifying methane in biogas are reviewed.•Future research directions are recommended.
The biological conversion of coal to methane can be an efficient and environmentally friendly means of utilizing the current coal reserves, including those that are difficult to utilize with conventional methods. Understanding the details of microbial coal degradation leading up to methanogenesis is essential in order to establish new energy production techniques and industrial processes that are cost- and energy-effective. Various approaches, such as bioaugmentation, biostimulation and physical, chemical and biological pretreatment for the purpose of enhancing methane yield are reviewed. Specifically for biostimulation which holds great promise for the success of biogasification, detailed reviews are provided on elucidating the composition of a microbial community, developing suitable nutrient solutions, and the in situ application of laboratory generated results. In addition, future research directions for maximizing methane production from coal are recommended.
Waning immunity and declining anatomic and physiologic defenses render the elder vulnerable to a wide range of infectious diseases. Clinical presentations are often atypical and muted, favoring ...global changes in mental status and function over febrile responses or localizing symptoms. This review encompasses early recognition, evaluation, and appropriate management of these common infections specifically in the context of elders presenting to the emergency department. With enhanced understanding and appreciation of the unique aspects of infections in the elderly, emergency physicians can play an integral part in reducing the morbidity and mortality associated with these often debilitating and life-threatening diseases.
Coronavirus disease of 2019 (COVID-19) has resulted in millions of cases worldwide. As the pandemic has progressed, the understanding of this disease has evolved.
This first in a two-part series on ...COVID-19 updates provides a focused overview of the presentation and evaluation of COVID-19 for emergency clinicians.
COVID-19, caused by Severe Acute Respiratory Syndrome coronavirus 2 (SARS-CoV-2), has resulted in significant morbidity and mortality worldwide. Several variants exist, including a variant of concern known as Delta (B.1.617.2 lineage) and the Omicron variant (B.1.1.529 lineage). The Delta variant is associated with higher infectivity and poor patient outcomes, and the Omicron variant has resulted in a significant increase in infections. While over 80% of patients experience mild symptoms, a significant proportion can be critically ill, including those who are older and those with comorbidities. Upper respiratory symptoms, fever, and changes in taste/smell remain the most common presenting symptoms. Extrapulmonary complications are numerous and may be severe, including the cardiovascular, neurologic, gastrointestinal, and dermatologic systems. Emergency department evaluation includes focused testing for COVID-19 and assessment of end-organ injury. Imaging may include chest radiography, computed tomography, or ultrasound. Several risk scores may assist in prognostication, including the 4C (Coronavirus Clinical Characterisation Consortium) score, quick COVID Severity Index (qCSI), NEWS2, and the PRIEST score, but these should only supplement and not replace clinical judgment.
This review provides a focused update of the presentation and evaluation of COVID-19 for emergency clinicians.
Primary disasters may result in mass casualty events with serious injuries, including crush injury and crush syndrome.
This narrative review provides a focused overview of crush injury and crush ...syndrome for emergency clinicians.
Millions of people worldwide annually face natural or human-made disasters, which may lead to mass casualty events and severe medical issues including crush injury and syndrome. Crush injury is due to direct physical trauma and compression of the human body, most commonly involving the lower extremities. It may result in asphyxia, severe orthopedic injury, compartment syndrome, hypotension, and organ injury (including acute kidney injury). Crush syndrome is the systemic manifestation of severe, traumatic muscle injury. Emergency clinicians are at the forefront of the evaluation and treatment of these patients. Care at the incident scene is essential and focuses on treating life-threatening injuries, extrication, triage, fluid resuscitation, and transport. Care at the healthcare facility includes initial stabilization and trauma evaluation as well as treatment of any complication (e.g., compartment syndrome, hyperkalemia, rhabdomyolysis, acute kidney injury).
Crush injury and crush syndrome are common in natural and human-made disasters. Emergency clinicians must understand the pathophysiology, evaluation, and management of these conditions to optimize patient care.
We demonstrate a method that uses the pillars on a stamp to cut and exfoliate graphene islands from a graphite and then uses transfer printing to place the islands from the stamp into the device ...active-areas on a substrate with a placement accuracy potentially in nanometers. The process can be repeated to cover all device active-areas over an entire wafer. We also report the transistors fabricated from the printed graphene. The transistors show a hole and electron mobility of 3735 and 795 cm2/V-s, respectively, and a maximum drive-current of 1.7 mA/μm (at V DS = 1 V), which are among the highest reported for room temperature. The effects of various transferring and fixing layers on sticking graphenes to a stamp and to a substrate, respectively, were also investigated.
We report fabrication and characterization of a novel real-time, label-free DNA detector, that uses a long nanofluidic channel to stretch a DNA strand and a nanogap detector (with a gap as small as 9 ...nm) inside the channel to measure the electrical conduction perpendicular to the DNA backbone as it moves through the gap. We have observed electrical signals caused by 1.1 kilobase-pair (kbp) double-stranded (ds)-DNA passing through the gap in the nanogap detectors with a gap equal to or less than 13 nm.
Abstract
The opioid epidemic has increased hospital admissions for serious infections related to opioid abuse. Our findings demonstrate that addiction medicine consultation is associated with ...increased treatment for opioid use disorder (OUD), greater likelihood of completing antimicrobial therapy, and reduced readmission rates among patients with OUD and serious infections requiring hospitalization.
Terrorist attacks against emergency departments Jasani, Gregory; Alfalasi, Reem; Liang, Stephen Y.
The American journal of emergency medicine,
February 2023, 2023-02-00, 20230201, Letnik:
64
Journal Article
Recenzirano
Odprti dostop
Emergency departments (EDs) play an integral role in a community's response to disaster. Terrorist attacks targeting EDs have the potential to disrupt the emergency response apparatus. Understanding ...prior attacks against EDs can yield important lessons to mitigate the impact of future violence.
In this review, the authors used the Global Terrorism Database to conduct a search on terrorist attacks targeting EDs between 1970 and 2018. Using the search terms “doctor,” “nurses,” “hospital,” “healthcare,” “clinic,” “vaccinators,” and “vaccinations,” a total of 2322 healthcare-specific incidents were isolated. The database was further narrowed down to terrorist attacks targeting EDs, using the search terms “emergency,” “emergency department,” and “emergency ward.”
A total of six attacks involving five countries were isolated. These attacks occurred between 1991 and 2016, with the majority involving the use of explosive devices, killing a total of 57 victims and leaving 26 wounded.
Attacks against EDs, while rare, have the potential to lead to loss of life through both the direct attack and subsequent disruptions to healthcare.
(Basic awareness and understanding of antimicrobial resistance and prevailing mechanisms can aid emergency physicians in providing appropriate care to patients with infections due to a ...multidrug-resistant organism (MDRO). Empiric treatment of MDRO infections should be approached with caution and guided by the most likely pathogens based on differential diagnosis, severity of the illness, suspected source of infection, patient-specific factors, and local antibiotic susceptibility patterns. Newer broad-spectrum antibiotics should be reserved for critically ill patients where there is a high likelihood of infection with an MDRO.).
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