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The American Journal of Emergency... Jul 2024Stevens Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are serious conditions that carry a high rate of morbidity and mortality. (Review)
Review
INTRODUCTION
Stevens Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are serious conditions that carry a high rate of morbidity and mortality.
OBJECTIVE
This review highlights the pearls and pitfalls of SJS/TEN, including presentation, diagnosis, and management in the emergency department (ED) based on current evidence.
DISCUSSION
SJS/TEN is a rare, delayed hypersensitivity reaction resulting in de-epithelialization of the skin and mucous membranes. The majority of cases are associated with medication or infection. Clinicians should consider SJS/TEN in any patient presenting with a blistering mucocutaneous eruption. Evaluation of the skin, mucosal, pulmonary, renal, genital, and ocular systems are essential in the diagnosis of SJS/TEN, as well as in the identification of complications (e.g., sepsis). Laboratory and radiological testing cannot confirm the diagnosis in the ED setting, but they may assist in the identification of complications. ED management includes stabilization of airway and breathing, fluid resuscitation, and treatment of any superimposed infections with broad-spectrum antibiotic therapy. All patients with suspected SJS/TEN should be transferred and admitted to a center with burn surgery, critical care, dermatology, and broad specialist availability.
CONCLUSIONS
An understanding of SJS/TEN can assist emergency clinicians in diagnosing and managing this potentially deadly disease.
Topics: Stevens-Johnson Syndrome; Humans; Emergency Service, Hospital; Prevalence
PubMed: 38631147
DOI: 10.1016/j.ajem.2024.04.001 -
Royal Society Open Science Aug 2023Magnitude information is often correlated in the external world, providing complementary information about the environment. As if to reflect this relationship, the...
Magnitude information is often correlated in the external world, providing complementary information about the environment. As if to reflect this relationship, the perceptions of different magnitudes (e.g. time and numerosity) are known to influence one another. Recent studies suggest that such magnitude interaction is similar to cue integration, such as multisensory integration. Here, we tested whether human observers could integrate the magnitudes of two quantities with distinct physical units (i.e. time and numerosity) as abstract magnitude information. The participants compared the magnitudes of two visual stimuli based on time, numerosity, or both. Consistent with the predictions of the maximum-likelihood estimation model, the participants integrated time and numerosity in a near-optimal manner; the weight of each dimension was proportional to their relative reliability, and the integrated estimate was more reliable than either the time or numerosity estimate. Furthermore, the integration approached a statistical optimum as the temporal discrepancy of the acquisition of each piece of information became smaller. These results suggest that magnitude interaction arises through a similar computational mechanism to cue integration. They are also consistent with the idea that different magnitudes are processed by a generalized magnitude system.
PubMed: 37564065
DOI: 10.1098/rsos.230153 -
Problemy Sotsial'noi Gigieny,... Oct 2023In order to identify the basic patterns of behavior that reflect the attitude of Russians to their health, a large corpus of relevant scientific literature was analyzed,...
In order to identify the basic patterns of behavior that reflect the attitude of Russians to their health, a large corpus of relevant scientific literature was analyzed, as well as actual statistical data and the results of representative sociological studies concerning various aspects of both self-preserving and self-destructive behavior of Russians. As a result, four basic models of behavior were formed and described, which differ in a set of positive and negative attitudes and characteristic lines of behavior in relation to one's health («a convinced healthy lifestyle person», «a beginner healthy lifestyle person», «irresponsible» and «self-destructive»). Based on the analysis of statistics and sociological information, it was concluded that even the behavioral model of a «beginner healthy lifestyle person» is implemented by a very minority of Russians. At best, the majority of the population adheres to the «irresponsible» pattern of behavior that involves refusing or reducing the consumption of alcohol and tobacco, but not assuming a rational diet, adequate sleep, physical and medical activity. Hence the task of everyone who has the opportunity to influence citizens, including medical workers, to convey to them the idea that health and longevity are achieved only through systematic and comprehensive efforts. In addition, a number of common misconceptions and unrealistic expectations related to healthy lifestyles were highlighted. Attention is drawn to the fact that subjects capable of exerting an educational impact on citizens, including medical specialists, should not only provide patients with useful knowledge, but also try to protect them from misconceptions and unfounded expectations.
Topics: Humans; Diet; Health Behavior; Healthy Lifestyle; Longevity; Attitude to Health
PubMed: 38069866
DOI: 10.32687/0869-866X-2023-31-s2-1081-1086 -
Sheng Wu Gong Cheng Xue Bao = Chinese... Oct 2023Anti-reflective nanocoatings that mimic the eyes of fruit flies are biodegradable materials with great market potential for a variety of optical devices that require...
Anti-reflective nanocoatings that mimic the eyes of fruit flies are biodegradable materials with great market potential for a variety of optical devices that require anti-reflective properties. Microbial expression of retinin provides a new idea for the preparation of nanocoatings under mild conditions compared to physicochemical methods. However, the current expression level of retinin, the key to anti-reflective coating, is low and difficult to meet mass production. In this study, we analyzed and screened the best expression hosts for -derived retinin protein, and optimized its expression. Chinese hamster ovary (CHO) cells were identified as the efficient expression host of retinin, and purified retinin protein was obtained. At the same time, the preparation method of lanolin nanoemulsion was explored, and the best anti-reflective ability of the nano-coating was determined when the ratio of specific concentration of retinin protein and wax emulsion was 16:4, the pH of the nano-coating formation system was 7.0, and the temperature was 30 ℃. The enhanced antireflective ability and reduced production cost of artificial antireflective nanocoatings by determining the composition of nanocoatings and optimizing the concentration, pH and temperature of system components may facilitate future application of artificial green degradable antireflective coatings.
Topics: Animals; Cricetinae; CHO Cells; Emulsions; Cricetulus; Drosophila; Eye Proteins; Drosophila Proteins
PubMed: 37877404
DOI: 10.13345/j.cjb.230119 -
Journal of Clinical Medicine Jan 2024: Interest in 3D printing for orthopedic surgery has been increasing since its progressive adoption in most of the hospitals around the world. The aim of the study is to... (Review)
Review
: Interest in 3D printing for orthopedic surgery has been increasing since its progressive adoption in most of the hospitals around the world. The aim of the study is to describe all the current applications of 3D printing in patients undergoing hip surgery of any type at the present time. : We conducted a systematic narrative review of publications indexed in MedLine through the search engine PubMed, with the following parameters: 3D printing AND (orthopedics OR traumatology) NOT tissue engineering NOT scaffold NOT in vitro and deadline 31 July 2023. After reading the abstracts of the articles, papers were selected according to the following criteria: full text in English or Spanish and content related to hip surgery. Those publications involving experimental studies (in vitro or with anatomical specimens) or 3D printing outside of hospital facilities as well as 3D-printed commercial implants were excluded. Results are presented as a reference guide classified by disease, including the used software and the steps required for the development of the idea. : We found a total of 27 indications for in-house 3D printing for hip surgery, which are described in the article. : There are many surgical applications of 3D printing in hip surgery, most of them based on CT images. Most of the publications lack evidence, and further randomized studies should be encouraged to assess the advantages of these indications.
PubMed: 38276105
DOI: 10.3390/jcm13020599 -
Geriatrie Et Psychologie... Mar 2024Cognitive performance of older adults is very often inferior to that of younger adults on a variety of laboratory tests assessing basic functions such as memory,... (Review)
Review
Cognitive performance of older adults is very often inferior to that of younger adults on a variety of laboratory tests assessing basic functions such as memory, inhibition, or attention. Classic hypotheses and theories share the idea that these cognitive deficits are irreversible, due to profound cerebral changes. In this review article, we develop a more positive conception of aging, according to which cognitive deficits are not all irreversible, and can even be partially if not completely reversible. To this end, we present some of the most illustrative research on the reversibility of the effects of aging on cognition. We show how subtle contextual manipulations can change older adults' motivation and strategy, which improve their cognitive performance. We also show that guidance toward the selection of the most appropriate strategy, whether explicit as in selectivity paradigms or implicit as in dual-task procedures, can increase older adults' cognitive performance. We finally describe the hypotheses and theories that both account for low cognitive performance in old age and ways to reverse the effects of cognitive aging.
Topics: Humans; Aged; Cognition Disorders; Cognitive Dysfunction; Cognition; Cognitive Aging; Aging
PubMed: 38573147
DOI: 10.1684/pnv.2024.1144 -
Pneumologie (Stuttgart, Germany) Feb 2024Non-invasive and invasive ventilation have become essential for therapy in acute and chronic respiratory failure. More than one-third of patients in intensive care units...
Non-invasive and invasive ventilation have become essential for therapy in acute and chronic respiratory failure. More than one-third of patients in intensive care units receive invasive ventilation, and the number of ventilated patients in out-of-hospital care is also steadily increasing. While normalization of blood gases was considered the most significant goal in past decades, and the idea that mechanical ventilation also poses dangers played little role, the dominant thought at present is the application of ventilation from the most protective point of view possible. Because fundamental change in equipment technology is likely to be difficult, improvement of protective ventilation and further development of understanding of pathophysiologic processes in acute and chronic respiratory failure will continue to be of great importance in the future. This article summarizes different aspects of the technical basis of noninvasive and invasive ventilation and their practical implementation.
Topics: Humans; Noninvasive Ventilation; Respiratory Insufficiency; Respiration, Artificial; Lung; Intensive Care Units
PubMed: 38364876
DOI: 10.1055/a-2229-3854 -
Sheng Wu Gong Cheng Xue Bao = Chinese... Oct 2023The biofilms formed by pathogenic microorganisms seriously threaten human health and significantly enhance drug resistance, which urgently call for developing drugs...
The biofilms formed by pathogenic microorganisms seriously threaten human health and significantly enhance drug resistance, which urgently call for developing drugs specifically targeting on biofilms. Chitooligosaccharides extracted from shrimp and crab shells are natural alkaline oligosaccharides with excellent antibacterial effects. Nevertheless, their inhibition efficacy on biofilms still needs to be improved. (SP) is a microalga with negatively charged surface, and its spiral structure facilitates colonization in the depth of the biofilm. Therefore, the complex of and chitooligosaccharides may play a synergistic role in killing pathogens in the depth of biofilm. This research first screened chitooligosaccharides with significant bactericidal effects. Subsequently, @Chitooligosaccharides (SP@COS complex was prepared by combining chitooligosaccharides with through electrostatic adsorption. The binding of the complex was characterized by zeta potential, z-average size, and fluorescence labeling. Ultraviolet-visible spectroscopy (UV-Vis) showed the encapsulation efficiency and the drug loading efficiency reached up to 90% and 16%, respectively. The prepared SP@COS2 exhibited a profound synergistic inhibition effect on bacterial and fungal biofilms, which was mainly achieved by destroying the cell structure of the biofilm. These results demonstrate the potential of -chitooligosaccharides complex as a biofilm inhibitor and provide a new idea for addressing the harm of pathogenic microorganisms.
Topics: Humans; Spirulina; Anti-Bacterial Agents; Chitosan; Biofilms; Chitin
PubMed: 37877396
DOI: 10.13345/j.cjb.230146 -
NeuroImage Nov 2023There is considerable debate over how visual speech is processed in the absence of sound and whether neural activity supporting lipreading occurs in visual brain areas....
There is considerable debate over how visual speech is processed in the absence of sound and whether neural activity supporting lipreading occurs in visual brain areas. Much of the ambiguity stems from a lack of behavioral grounding and neurophysiological analyses that cannot disentangle high-level linguistic and phonetic/energetic contributions from visual speech. To address this, we recorded EEG from human observers as they watched silent videos, half of which were novel and half of which were previously rehearsed with the accompanying audio. We modeled how the EEG responses to novel and rehearsed silent speech reflected the processing of low-level visual features (motion, lip movements) and a higher-level categorical representation of linguistic units, known as visemes. The ability of these visemes to account for the EEG - beyond the motion and lip movements - was significantly enhanced for rehearsed videos in a way that correlated with participants' trial-by-trial ability to lipread that speech. Source localization of viseme processing showed clear contributions from visual cortex, with no strong evidence for the involvement of auditory areas. We interpret this as support for the idea that the visual system produces its own specialized representation of speech that is (1) well-described by categorical linguistic features, (2) dissociable from lip movements, and (3) predictive of lipreading ability. We also suggest a reinterpretation of previous findings of auditory cortical activation during silent speech that is consistent with hierarchical accounts of visual and audiovisual speech perception.
Topics: Humans; Lipreading; Speech Perception; Brain; Auditory Cortex; Phonetics; Visual Perception
PubMed: 37757989
DOI: 10.1016/j.neuroimage.2023.120391 -
Journal of Clinical Nursing Apr 2024To map evidence of the existing virtual reality-based dementia educational programmes and the effects of these educational programmes on dementia formal and informal... (Review)
Review
AIM
To map evidence of the existing virtual reality-based dementia educational programmes and the effects of these educational programmes on dementia formal and informal caregivers.
DESIGN
A scoping review.
METHODS
A comprehensive search of nine databases was conducted to find studies from the inception of the databases to October 2023. Two authors independently screened the titles and abstracts related to the eligibility criteria. Full texts of potentially relevant studies were read by one author and checked by a second. Data extraction and synthesis using NVivo 12 were undertaken by one author and checked by two other authors.
RESULTS
Nineteen studies published between 2002 and 2022. The four randomised controlled studies and five qualitative studies were of moderate to good methodological quality. The 10 quasi-experimental studies were of weak to moderate quality. Fifteen virtual reality-based educational programmes had a positive influence on formal and informal caregivers, including improving caregivers' perceptions changing attitudes towards people with dementia, while the nursing competence of formal caregivers did not improve in short term. Educational programmes that covered dementia-related information and care strategies better improved the knowledge level of dementia formal and informal caregivers.
CONCLUSIONS
The qualitative and quantitative studies of moderate to good quality included in this study support the idea that virtual reality-based dementia educational programmes may be a safe and effective way and have potential benefits for improving knowledge, perceptions, attitudes and nursing competence.
IMPACT
This scoping review will provide an emerging teaching model for formal and informal caregivers of people with dementia and help them better understand the types and the influence of virtual reality-based dementia educational programmes.
REPORTING METHOD
PRISMA-ScR.
NO PATIENT OR PUBLIC CONTRIBUTION
Not required as this review in accordance with the aim to map existing literature from the dementia formal and informal caregivers' perspective.
PubMed: 38685766
DOI: 10.1111/jocn.17198