Indications and Recommendations for Tracheostomy in Trauma Population With COVID-19 Infection: A Review of the Literature

2021 ◽  
pp. 000313482110547
Author(s):  
Jacqueline Barbera-Mirza ◽  
Kelvin Chan ◽  
Kevin Newsome ◽  
Mark McKenny ◽  
Adel Elkbuli
Keyword(s):  
Geriatric Patients ◽  
Percutaneous Tracheostomy ◽  
Wait Time ◽  
Mortality Rates ◽  
Early Mortality ◽  
Review Of The Literature ◽  
Trauma Population ◽  
Single Use ◽  
Maintenance Techniques

This review explores the current body of evidence pertaining to tracheostomy placement in COVID-19 seropositive patients and summarizes the research by tracheostomy indications, timing, and procedure. Literature review was performed in accordance with the 2020 PRISMA guidelines and includes 12 papers discussing protocols for adult patients seropositive for COVID-19. The studies demonstrated high mortality rates after tracheostomy, especially in geriatric patients, and suggested a multifactorial determination of whether to perform a tracheostomy. There was inconclusive data regarding wait time between testing seropositive, tracheostomy, and weaning off of ventilation. COVID-19 generally reaches highest infectivity between days 9 and 10; furthermore, high early mortality rates seen in COVID-19 may confound mortality implicated by tracheostomy placement. Due to the aerosol-generating nature of tracheostomy placement, management and maintenance, techniques, equipment, and personnel should be carefully considered and altered for COVID-19 patients. With surgical tracheostomy, literature suggested decreased usage of electrocautery; with percutaneous tracheostomy, single-use bronchoscope should be used. The nonemergent exchange of tracheostomy should be done only after the patient tested negative for COVID-19. Placement of tracheostomy should only be considered in COVID-19 patients who are no longer transmissible, with rigorous attention to safety precautions. Understanding procedures for airway maintenance in a respiratory disease like COVID-19 is imperative, especially due to current shortages in ventilators and PPE. However, because of a lack of available data and its likelihood of change as more data emerges, we lack complete guidelines for tracheostomy placement in COVID-19 seropositive patients, and those existing will likely evolve with the disease.

DETERMINATION OF THE TYPE OF A SINGLE-USE GRENADE LAUNCHER BASED ON ITS COMPOSITE PARTS AND FRAGMENTS OF REACTIVE GRENADE FOUND AT THE PLACE OF ACCIDENT

2017 ◽  
Vol 17 ◽  
pp. 245-252
Author(s):  
V. V. Somov
Keyword(s):  
Combustion Chamber ◽  
Structural Features ◽  
Outlet Section ◽  
Technical Expertise ◽  
Jet Engine ◽  
Size Ofthe ◽  
Single Use ◽  
Nozzle Block ◽  
Considerable Damage

In carrying out an investigation into the explosion, among others, the investigative version of the use of a single-use reactive grenade launcher is being considered. The most common for criminal explosions are applied grenade launchers RPG-18, RPG-22, RPG-26. Their use is due to a number of such properties as small size and weight, which makes it possible to transfer them covertly, the range of the shot significantly exceeding the range of the hand grenade throw, the high detonating effect of the rocket grenade explosion. The single-use rocket launchers are generally of the same design. Their differences are in the features of the components construction and dimensional characteristics, which are given in the article. On the basis of expert practice, details ofgrenade launchers that remain at the site of the explosion and have the least damage are determined. These details are the objects of investigation of the explosion technical expertise. These objects include launchers of grenade launchers and rocket parts ofjet grenades. The design features of the launchers, their dimensional characteristics and marking symbols make it possible to determine their belonging to a specific type of jet grenade launchers. Missile parts of jet grenades differ in the form of the combustion chamber of the jet engine, nozzle, in the size ofthe outlet section of the nozzle, in the form and size of the stabilizerfeathers. To determine the belonging of the rocket part of the grenade to a specific type ofjet grenade launcher, it’s necessary to establish a set of structural features and dimensional characteristics. At considerable damage of the combustion chamber of the jet engine, as a rule, the nozzle block remains intact that allows to define diameter of critical section of a nozzle, and on it to establish type of the used single-use grenade launcher.

Historisitas dan Tujuan Aturan Umur Minimal Perkawinan dalam Perundang-Undangan Keluarga Islam di Indonesia

2019 ◽  
Vol 2 (2) ◽  
pp. 163-177
Author(s):  
Nur Wahid
Keyword(s):  
Sexually Transmitted Diseases ◽  
Mortality Rates ◽  
Early Marriage ◽  
Premature Births ◽  
Sexually Transmitted ◽  
Minimum Age ◽  
Psychological Maturity ◽  
Strongly Agree ◽  
Age Of Marriage

This paper examines the minimum age requirement for marriage in Indonesian family law legislation in Indonesia historically. Determination of the minimum age for marriage in various countries is the result of ijtihad by considering the principle of physical and psychological maturity. In Indonesian marriage legislation sating that marriage is only permitted if the man reaches the age of 19 (nineteen) years and the woman has reached 16 (sixteen) years. Early marriage has several risks such as potential premature births, birth defects, maternal depression rates, maternal mortality rates, risk of contracting sexually transmitted diseases. Therefore, the authors strongly agree that the minimum age of marriage in Indonesia changed to 19 years

scholarly journals Early mortality and freshwater forage fish recruitment: nonnative alewife and native rainbow smelt interactions in Lake Champlain

2019 ◽  
Vol 76 (5) ◽  
pp. 806-814
Author(s):  
Paul W. Simonin ◽  
Lars G. Rudstam ◽  
Patrick J. Sullivan ◽  
Donna L. Parrish ◽  
Bernard Pientka
Keyword(s):  
Climate Change ◽  
Distribution Patterns ◽  
Mortality Rates ◽  
Early Mortality ◽  
Fish Distribution ◽  
Change Scenario ◽  
Lake Champlain ◽  
Species Introduction ◽  
Rainbow Smelt ◽  
Fish Recruitment

We studied the consequences of a nonnative species introduction and changes in temperature on early mortality and recruitment of native rainbow smelt (Osmerus mordax) and nonnative alewife (Alosa pseudoharengus) in Lake Champlain using a simulation model. Distribution patterns of adults and young-of-the-year (YOY) fish were predicted using a model based on observed distribution of different age groups as a function of temperature and light profiles simulated on a daily basis. Mortality rates averaged over the growing season were calculated as a function of fish densities and overlap between adults and YOY. Survival of YOY rainbow smelt and alewife depended on which predator was most abundant. Rainbow smelt YOY mortality rates are highest when rainbow smelt adults are abundant, and alewife YOY mortality rates are highest when alewife adults are abundant, potentially allowing coexistence. August and September mortality rates were higher in the climate change scenario because of increased overlap of adults and YOY of both species. These results indicate that accounting for spatiotemporal fish distribution patterns can be important when forecasting the interacting effects of climate change and aquatic invasive species on fish recruitment.

scholarly journals “Rust stain”: a rare mark in firearm suicide—a case report and review of the literature

2021 ◽  
Author(s):  
Luca Tomassini ◽  
Daniele Paolini ◽  
Anna Maria Manta ◽  
Edoardo Bottoni ◽  
Costantino Ciallella
Keyword(s):  
Case Report ◽  
Medical Examiner ◽  
Experimental Setting ◽  
Review Of The Literature ◽  
Histological Findings ◽  
Porcine Skin ◽  
Manner Of Death ◽  
Prolonged Contact ◽  
Firearm Suicide

AbstractRust stains are marks left by firearms in case of prolonged contact with the cutaneous surfaces. These peculiar signs along with other well-documented findings can guide the medical examiner in the determination of the manner of death, especially in case of firearm suicide. This paper presents the case of a 33-year-old male soldier who committed suicide by using a short-barreled weapon, whose trigger remained in contact with the first finger of his right hand, leading to the formation of a rust stain that perfectly reproduced its design. The forensic examination of the scene, the external cadaveric inspection, and the autopsy are described. For the evaluation of the histological findings typical of rust spots, the authors decided to replicate the phenomenon in an experimental setting using porcine skin. In order to provide an exhaustive overview on the formation and the features of rust stains, a review of the forensic literature concerning this rare mark was performed.

Intra-abdominal Inferior Vena Cava Injuries: Operative Strategies and Outcomes

2020 ◽  
pp. 000313482097339
Author(s):  
Christine A. Castater ◽  
Margo Carlin ◽  
Virginia D. Parker ◽  
Chris Sciarretta ◽  
Deepika Koganti ◽  
...  
Keyword(s):  
Inferior Vena Cava ◽  
Inferior Vena ◽  
Vena Cava ◽  
Mortality Rates ◽  
Volume Resuscitation ◽  
Vascular Injuries ◽  
Trauma Centers ◽  
Review Of The Literature ◽  
Hemorrhage Control ◽  
Operative Strategies

Visceral vascular injuries are relatively uncommon even in busy urban trauma centers. The inferior vena cava (IVC) is the most frequently injured visceral vein and can be a complex operative challenge. Despite advances in early volume resuscitation, improved transport times, prompt operative intervention, and hemorrhage control, mortality rates have remained largely unchanged. This article conducts an in-depth review of the literature surrounding IVC injuries and a detailed discussion of operative strategies and management as survivability is ultimately dependent on the grade of injury, location, and the presence of hemorrhagic shock.

scholarly journals Summary of the Available Molecular Methods for Detection of SARS-CoV-2 during the Ongoing Pandemic

2021 ◽  
Vol 22 (3) ◽  
pp. 1298
Author(s):  
Fabio Arena ◽  
Simona Pollini ◽  
Gian Maria Rossolini ◽  
Maurizio Margaglione
Keyword(s):  
Genetic Variability ◽  
Viral Genome ◽  
Molecular Detection ◽  
In Silico Analysis ◽  
Laboratory Diagnosis ◽  
Mortality Rates ◽  
Genomic Evolution ◽  
Review Of The Literature ◽  
The Uk ◽  
Silico Analysis

Since early 2020, the COVID-19 pandemic has caused an excess in morbidity and mortality rates worldwide. Containment strategies rely firstly on rapid and sensitive laboratory diagnosis, with molecular detection of the viral genome in respiratory samples being the gold standard. The reliability of diagnostic protocols could be affected by SARS-CoV-2 genetic variability. In fact, mutations occurring during SARS-CoV-2 genomic evolution can involve the regions targeted by the diagnostic probes. Following a review of the literature and an in silico analysis of the most recently described virus variants (including the UK B 1.1.7 and the South Africa 501Y.V2 variants), we conclude that the described genetic variability should have minimal or no effect on the sensitivity of existing diagnostic protocols for SARS-CoV-2 genome detection. However, given the continuous emergence of new variants, the situation should be monitored in the future, and protocols including multiple targets should be preferred.

Estimation of annual mortality rates caused by early mortality syndromes (EMS) and their impact on salmonid stock–recruit relationships

2006 ◽  
Vol 63 (9) ◽  
pp. 1968-1981 ◽  
Author(s):  
Catherine G.J Michielsens ◽  
Samu Mäntyniemi ◽  
Pekka J Vuorinen
Keyword(s):  
Atlantic Salmon ◽  
Probabilistic Approach ◽  
Mortality Rates ◽  
Early Mortality ◽  
Stock Recruitment ◽  
The Baltic ◽  
Meta Analyses ◽  
Annual Mortality ◽  
Mortality Estimates ◽  
Related Mortality

In this paper, we demonstrate how information from broodstocks can be combined with lab information on alevins to obtain annual stock-specific mortality estimates from early mortality syndromes (EMS) using a probabilistic approach, how a hierarchical model structure can be used to predict these mortality rates for related, partly sampled, or unsampled stocks, and why these estimates should be used to remove the effect of this mortality on stock–recruit estimates. The approach has been illustrated for Atlantic salmon (Salmo salar) stocks in the Baltic Sea affected by the M74 syndrome. Results indicate that data on the proportion of M74-affected females, commonly used to approximate M74 mortality, overestimate actual M74-related mortality because of a declining trend in mortality among offspring of these females. The stock-specific M74 mortality estimates are used to account for nonstationarity in the stock–recruitment relationship caused by this fluctuating mortality. Because hierarchical meta-analyses assume exchangeability, the effect of M74 mortality is removed before including these stocks within hierarchical stock–recruit analyses of Atlantic salmon stocks, which are commonly unaffected by M74 mortality. Failure to remove the effect of M74 mortality on the stock–recruit data results in underestimation of the stock's productivity and resilience to exploitation, especially in the case of stocks with steep stock–recruit curves.

Hypervitaminosis A in the cat: A case report and review of the literature

2005 ◽  
Vol 7 (6) ◽  
pp. 363-368 ◽  
Author(s):  
Zoe S. Polizopoulou ◽  
George Kazakos ◽  
Michael N. Patsikas ◽  
Nikolaos Roubies
Keyword(s):  
Normal Limit ◽  
Serum Vitamin ◽  
Review Of The Literature ◽  
New Bone Formation ◽  
Hypervitaminosis A ◽  
Nerve Roots ◽  
Canned Food ◽  
Radiographic Findings ◽  
Forelimb Muscles

A case of hypervitaminosis A with secondary entrapment and compression of the left brachial plexus nerve roots is described. A 9-year-old male castrated domestic shorthair, fed a home-made diet based on raw pork liver, was submitted for examination for a left forelimb lameness that evolved to paralysis over a 2-month period. Clinical examination revealed a flaccid paralysis and atrophy of all left forelimb muscles. An ipsilateral Horner's syndrome was also noted. Radiological examination of the cervical and thoracic spine showed massive new bone formation at the ventral aspect of the second cervical to sixth thoracic vertebra. The diagnosis of hypervitaminosis A was made, based on the clinical and radiographic findings, as well as the determination of serum vitamin A concentration, which was 630 μg/dl, three times above the upper normal limit for this species. Despite the unfavourable initial prognosis, the cat progressively regained function of the affected limb approximately 6 months after the diet was changed to a commercial canned food.

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