Understanding the Impact of SARS-CoV-2 on Lung Endothelial Cells: Brief Mechanisms Unveiled.

As the world grapples with the coronavirus-19 (COVID) pandemic, more reports are coming in regarding Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) in endotheliopathy. It is a vascular condition in which endothelial cell injury or damage inflicts anatomical and functional changes in the endothelium, significantly impacting the physiological process and function. Previously, it was assumed that SARS-CoV-2 infects respiratory epithelial cells via spike glycoproteins present on the surface of the virus. However, severe cases and different autopsy studies described the clandestine role of this virus in infecting endothelial cells other than epithelial cells. It was observed that SARS-CoV-2 targets the pulmonary and extrapulmonary systems to damage the microvasculature and affect respiratory functioning, resulting in the onset of endotheliopathy, thrombosis, inflammation, pulmonary edema, and fibrosis. Such deleterious events are the consequence of the hyperactive immune response initiated by the SARS-CoV-2 infection, leading to pulmonary and extrapulmonary complications. However, the molecular mechanism behind endotheliopathy and other complications caused by this virus is elusive and will be unraveled by covering recent literature in this mini-review.

Can Mobile Videocall Assist Laypersons' Use of Automated External Defibrillators? A Randomized Simulation Study and Qualitative Analysis.

OBJECTIVE: To investigate the feasibility of mobile videocall guidance to facilitate AED use by laypersons. Design, setting, and participants. A total of 90 laypersons were randomized into three groups: the mobile video call-guided, voice call-guided, and non-guided groups. Participants were exposed to simulated cardiac arrest to use an AED, and guided by video calls, voice calls, or were not guided. We recorded the simulation experiments as a videoclip, and other researchers who were blinded to the simulation assessed the performance according to the prespecified checklist after simulations. Outcomes measure and analysis. We compared the performance score and time intervals from AED arrival to defibrillation among the three groups and analyzed the common errors. RESULTS: There was no significant difference among the three groups in terms of baseline characteristics. Performance scores in the checklist for using AED were higher in the mobile video call-guided group, especially in the category of "Power on AED" and "Correctly attaches pads" than in the other groups. However, the time interval to defibrillation was significantly longer in the mobile video call-guided group. CONCLUSIONS: Mobile video call guidance might be an alternative method to facilitate AED use by laypersons. Therefore, further well-designed research is needed to evaluate the feasibility of this approach in OHCA.

A 3-Dimensional Analysis of the Fracture Planes in Pediatric Lateral Humeral Condyle Fractures for Image-Based Pin Positioning During Fixation.

OBJECTIVE: To determine the 3-dimensional morphology of pediatric lateral condylar physeal fractures using 3-dimensional computed tomography (3D-CT) and to identify optimal pin positions for percutaneous pinning. DESIGN: Prospective case series of consecutively treated patients. SETTING: Tertiary university hospital setting. PATIENTS: Preoperative 3D-CTs in pediatric surgical candidates diagnosed with lateral condylar physeal fractures. INTERVENTION: Closed reduction and percutaneous pinning was performed. MAIN OUTCOME MEASURES: Reconstructed images of the distal humerus were aligned accordingly to determine the coronal (α), sagittal (ß), and axial tilt (γ) angles of the fracture plane. Both α and ß were also measured on plain radiography. Image-based position of the 2 pins was calculated preoperatively using 3D-CT, based on anteroposterior and lateral views. Final angle of pins was measured on postoperative radiographs. RESULTS: A total of 29 fractures were assessed. 3D-CT reconstruction images of fractures showed a posterolateral fracture fragment with reference to the long axis of the humerus. The mean α, ß, and γ were 62 degrees [95% confidence interval (CI), 59-64], 69 degrees (95% CI, 65-72), and 36 degrees (95% CI, 34-38). Both α and ß measured on plain radiography were not significantly different from 3D-CT measurements (P = 0.6712, 0.6218). Average postoperative pin angles were 144 degrees (95% CI, 140-147) and 161 degrees (95% CI, 158-165) for the proximal pin, and 118 degrees (95% CI, 114-122) and 115 degrees (95% CI, 110-120) for the distal pin, on anteroposterior and lateral views, respectively, resulting in similar trajectories to the preoperatively calculated pin positions. CONCLUSION: Our study adds to the current knowledge by providing an image-based angular reference of the fracture configuration in pediatric lateral humeral condyle fractures, which may be used during percutaneous pinning. LEVEL OF EVIDENCE: Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.