RESUMEN
On 30 January 2020, the World Health Organization (WHO) declared that the outbreak of a coronavirus disease-2019 (COVID-19) was a public health emergency of international concern. The WHO guidance states that patients with (COVID-19) should be managed by staff wearing appropriate personal protective equipment; however, working whilst wearing personal protective equipment is unfamiliar to many healthcare professionals. We ran high-fidelity, in-situ simulation of high-risk procedures on patients with COVID-19 in a negative-pressure side room on our intensive care unit (ICU). Our aim was to identify potential problems, test the robustness of our systems and inform modification of our standard operating procedures for any patients with COVID-19 admitted to our ICU. The simulations revealed several important latent risks and allowed us to put corrective measures in place before the admission of patients with COVID-19. We recommend that staff working in clinical areas expected to receive patients with COVID-19 conduct in-situ simulation in order to detect their own unique risks and aid in the creation of local guidelines of management of patients with COVID-19.
Asunto(s)
Betacoronavirus , Infecciones por Coronavirus , Unidades de Cuidados Intensivos , Pandemias , Neumonía Viral , COVID-19 , Infecciones por Coronavirus/prevención & control , Infecciones por Coronavirus/terapia , Infecciones por Coronavirus/transmisión , Humanos , Pandemias/prevención & control , Admisión del Paciente , Neumonía Viral/prevención & control , Neumonía Viral/terapia , Neumonía Viral/transmisión , SARS-CoV-2 , Simulación del EspacioRESUMEN
Early predictors of prognosis in comatose patients post cardiac arrest help inform decisions surrounding continuation or withdrawal of treatment and provide a framework on which to better inform relatives of the likely outcome. Markers defined prior to the widespread use of therapeutic hypothermia post arrest may no longer be reliable and an up-to-date analysis of the literature is presented.
Asunto(s)
Daño Encefálico Crónico/diagnóstico , Daño Encefálico Crónico/etiología , Coma , Paro Cardíaco Extrahospitalario/complicaciones , Paro Cardíaco Extrahospitalario/fisiopatología , Estado Vegetativo Persistente/diagnóstico , Estado Vegetativo Persistente/etiología , Daño Encefálico Crónico/fisiopatología , Daño Encefálico Crónico/terapia , Toma de Decisiones Clínicas , Coma/fisiopatología , Electroencefalografía/estadística & datos numéricos , Familia/psicología , Humanos , Hipotermia Inducida/estadística & datos numéricos , Inutilidad Médica/psicología , Paro Cardíaco Extrahospitalario/terapia , Estado Vegetativo Persistente/fisiopatología , Valor Predictivo de las Pruebas , Pronóstico , Recuperación de la Función , Tasa de SupervivenciaAsunto(s)
Neoplasias Encefálicas/diagnóstico , Neoplasias Encefálicas/secundario , Carcinoma/diagnóstico , Carcinoma/secundario , Encefalitis/diagnóstico , Neoplasias Pulmonares/patología , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Encéfalo/patología , Encéfalo/fisiopatología , Neoplasias Encefálicas/patología , Carcinoma/patología , Trastornos del Conocimiento/etiología , Confusión/etiología , Trastornos de la Conciencia/etiología , Diagnóstico Diferencial , Progresión de la Enfermedad , Encefalitis/etiología , Encefalitis/fisiopatología , Resultado Fatal , Cefalea/etiología , Humanos , Imagen por Resonancia Magnética , Masculino , Persona de Mediana Edad , Convulsiones/etiología , Tomografía Computarizada por Rayos XRESUMEN
The trifunctional aziridine XAMA-7 (CAS 57116-45-7) has been used to form crosslinks between a deep red-violet copper cluster of the type Cu(I)8Cu(II)6pen12Cl5- (pen=penicillamine) and molecules with biological activity such as d-biotin and proteins. A complex containing biotin, bovine serum albumin and the copper cluster displayed activity toward affinity columns of avidin on Agarose, and the red-violet pigment was immobilized on the gel. This interaction was completely blocked in gels which had been pretreated with d-biotin carboxylic acid. The free and biologically active versions of the cluster have some potential for biomedical applications. For example, the short-lived positron emitter 64Cu (suitable for positron tomography) may be carried in the cluster's structure. The cluster is paramagnetic, but it is a relatively weak effector of water proton spin-lattice relaxation. Other members of this structural group of inorganic compounds may have better magnetic properties, and the crosslinking reaction with aziridines appears to be generally applicable to the group.
