738 research outputs found
Critical Care Requirements Under Uncontrolled Transmission of SARS-CoV-2
Objectives. To estimate the critical care bed capacity that would be required to admit all critical COVID-19 cases in a setting of unchecked SARS-CoV-2 transmission, both with and without elderly-specific protection measures. Methods. Using electronic health records of all 2432 COVID-19 patients hospitalized in a large hospital in Madrid, Spain, between February 28 and April 23, 2020, we estimated the number of critical care beds needed to admit all critical care patients. To mimic a hypothetical intervention that halves SARS-CoV-2 infections among the elderly, we randomly excluded 50% of patients aged 65 years and older. Results. Critical care requirements peaked at 49 beds per 100â000 on April 1-2 weeks after the start of a national lockdown. After randomly excluding 50% of elderly patients, the estimated peak was 39 beds per 100â000. Conclusions. Under unchecked SARS-CoV-2 transmission, peak critical care requirements in Madrid were at least fivefold higher than prepandemic capacity. Under a hypothetical intervention that halves infections among the elderly, critical care peak requirements would have exceeded the prepandemic capacity of most high-income countries. Public Health Implications. Pandemic control strategies that rely exclusively on protecting the elderly are likely to overwhelm health care systems.S
Stabilisation of the superoxide anion in bis(fluorosulfonyl)imide (FSI) ionic liquid by small chain length phosphonium cations: Voltammetric, DFT modelling and spectroscopic perspectives
Ionic liquids (ILs) containing the bis(fluorosulfonyl)imide anion, FSI, have been investigated as electrolytes for metal-air batteries. Full chemical reversibility is found for the reduction of oxygen to superoxide at 60 degrees C under short time scale conditions of cyclic voltammetry at a glassy carbon electrode when the IL contains the small chain length triisobutyl(methyl)phosphonium rather than a pyrrolidinium cation. DFT calculations suggest that this is a consequence of the higher ion pair association energy and shorter intermolecular distance associated with the interaction of the superoxide anion with the phosphonium cation. Stabilization on longer timescales was also established by spectroscopic techniques when the phosphonium based ILs were exposed to KO2. Studies on superoxide stability in related ionic liquids containing the triisobutyl(methyl)phosphonium cation with the fluorosulfonyl(trifluoromethanesulfonyl)imide, FTFSI, or bis(trifluoromethanesulfonyl)imide, TFSI, anions are also reported.
Algunas amenazas actuales a la confidencialidad en medicina
Social, technical and legal conditions of the current practice of medicine
make it necessary to insist on certain actions and circumstances that may
jeopardize the confidentiality of information, offered by patients to their
health providers. Therefore, some effects of the current Chilean law are
analyzed in this respect, regarding access to data from the clinical record
of a patient. Also, the risks of putting certain data on social networking
sites are analyzed, as well as some of its effects on clinical practice. The
reasons because of mandatory reporting of diseases, meaning danger to
public health, is allowed, are mentioned. We also discuss the difficulties
involved in managing the results of preventative health screenings and its
knowledge by third parties, as well as some possible violations of personal
privacy, regarding dissemination of some people health information and
its further mention or figuration in mass media. We conclude that it is a
must for both physicians and other health team members, to safeguard
confidentiality of data to which they have had access, as well as the need to
know the relevant law, in order to respect human dignity of patients, each
one as a person. We address the attention to the possibility that, practicing
in a different way, it could endanger the reliability of clinical records, also
impairing the quality of peopleâs health care.
(Rev Med Chile 2015; 143: 358-366)
Key words: Access to Information; Confidentiality; Information Dissemination;
Medical Records; Social Networkin
Respecting patient intimacy
IndexaciĂłn: Web of Science; Scielo.Transparency as a general rule for all our professional acts casts doubts about the statement of the Hippocratic Oath that says "Whatever I see or hear in the lives of my patients, I will keep secret, as considering all such things to be private". Medical secrecy protects the intimacy of patients, who reveal to their physicians their most hidden secrets aiming to recover their health. Therefore, physicians should receive those secrets with reverence and care, as servers and not as their owners. The values associated with the respect for personal intimacy are the anthropological basis of medical confidentiality. A medical act is performed by definition between two equally honorable individuals. Therefore, the professional honors the trust of his patient, maintaining strict confidence of what is revealed. Therefore, medical secrecy must be strengthened rather than weakened, pursuing common wealth and dignity.http://ref.scielo.org/cf3mx
An ethical and medical perspective on the voluntary termination of pregnancy
IndexaciĂłn: Web of Science; Scielo.âVoluntary termination of pregnancyâ can refer to actions intended to make a delivery easier, to provide medical care to the fetus, or to protect the life or health of the mother. All of these are proper medical actions and are by definition voluntary. In other cases, the expression denotes a termination of pregnancy before the embryo or fetus is viable, leading to the death of the latter. This action is constitutive of abortion under current Chilean law. The product of conception living being, who develops in the womb during pregnancy, is an individual, both in the sense that it is different from its mother and father, and in that it is a biological individual. For these reasons, such living being constitutes another patient in itself. The free and voluntary medical action of health care professionals is geared toward disease prevention or health recovery and medical terminations of pregnancy, as distinguished from abortion, are not criminalized in our country. Therefore, the idea of legalizing abortive terminations of pregnancy so that they become âlegitimate health care servicesâ is a call to the medical community, which should engage in a debate about the meaning and consequences of an eventual mandate of the State that would be at odds with the Hippocratic tradition. A woman can feel that her health is at risk due to her pregnancy, and she certainly has the right to request medical help. Health professionals should care both at the medical and emotional level for all those who require their services, especially when such persons are undergoing situations of vulnerability and distress. When requested to perform an abortion, the physician faces dilemmas that should be addressed in line with the present state of the medical art.http://ref.scielo.org/c4ypf
Compulsive sexual behavior disorder in 42 countries: Insights from the International Sex Survey and introduction of standardized assessment tools
© 2023 The Author(s). This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License (CC BY-NC), https://creativecommons.org/licenses/by-nc/4.0/Background and aims Despite its inclusion in the 11th revision of the International Classification of Diseases, there is a virtual paucity of high-quality scientific evidence about compulsive sexual behavior disorder (CSBD), especially in underrepresented and underserved populations. Therefore, we comprehensively examined CSBD across 42 countries, genders, and sexual orientations, and validated the original (CSBD-19) and short (CSBD-7) versions of the Compulsive Sexual Behavior Disorder Scale to provide standardized, state-of-the-art screening tools for research and clinical practice. Method Using data from the International Sex Survey (N = 82,243; Mage = 32.39 years, SD = 12.52), we evaluated the psychometric properties of the CSBD-19 and CSBD-7 and compared CSBD across 42 countries, three genders, eight sexual orientations, and individuals with low vs. high risk of experiencing CSBD. Results A total of 4.8% of the participants were at high risk of experiencing CSBD. Country- and gender-based differences were observed, while no sexual-orientation-based differences were present in CSBD levels. Only 14% of individuals with CSBD have ever sought treatment for this disorder, with an additional 33% not having sought treatment because of various reasons. Both versions of the scale demonstrated excellent validity and reliability. Discussion and conclusions This study contributes to a better understanding of CSBD in underrepresented and underserved populations and facilitates its identification in diverse populations by providing freely accessible ICD-11-based screening tools in 26 languages. The findings may also serve as a crucial building block to stimulate research into evidence-based, culturally sensitive prevention and intervention strategies for CSBD that are currently missing from the literature.Peer reviewe
Observation of an Excited Bc+ State
Using pp collision data corresponding to an integrated luminosity of 8.5 fb-1 recorded by the LHCb experiment at center-of-mass energies of s=7, 8, and 13 TeV, the observation of an excited Bc+ state in the Bc+Ï+Ï- invariant-mass spectrum is reported. The observed peak has a mass of 6841.2±0.6(stat)±0.1(syst)±0.8(Bc+) MeV/c2, where the last uncertainty is due to the limited knowledge of the Bc+ mass. It is consistent with expectations of the Bcâ(2S31)+ state reconstructed without the low-energy photon from the Bcâ(1S31)+âBc+Îł decay following Bcâ(2S31)+âBcâ(1S31)+Ï+Ï-. A second state is seen with a global (local) statistical significance of 2.2Ï (3.2Ï) and a mass of 6872.1±1.3(stat)±0.1(syst)±0.8(Bc+) MeV/c2, and is consistent with the Bc(2S10)+ state. These mass measurements are the most precise to date
Bose-Einstein correlations of same-sign charged pions in the forward region in pp collisions at âs=7 TeV
Bose-Einstein correlations of same-sign charged pions, produced in protonproton collisions at a 7 TeV centre-of-mass energy, are studied using a data sample collected
by the LHCb experiment. The signature for Bose-Einstein correlations is observed in the
form of an enhancement of pairs of like-sign charged pions with small four-momentum
difference squared. The charged-particle multiplicity dependence of the Bose-Einstein correlation parameters describing the correlation strength and the size of the emitting source
is investigated, determining both the correlation radius and the chaoticity parameter. The
measured correlation radius is found to increase as a function of increasing charged-particle
multiplicity, while the chaoticity parameter is seen to decreas
Suspected tick-borne flavivirus meningoencephalomyelitis in dogs from the UK: six cases (2021)
Objectives:
Tick-borne encephalitis virus and louping ill virus are neurotropic flaviviruses transmitted by ticks. Epidemiologically, tick-borne encephalitis is endemic in Europe whereas louping ill's predominant geographical distribution is the UK. Rarely, these flaviviruses affect dogs causing neurological signs. This case series aimed to describe the clinical, clinicopathological, and imaging findings, as well as the outcomes in six dogs with meningoencephalitis and/or meningomyelitis caused by a flavivirus in the UK in 2021.
Materials and Methods:
Observational retrospective case-series study. Clinical data were retrieved from medical records of dogs with positive serological or immunohistochemical results from three different institutions from spring to winter 2021.
Results:
Six dogs were included in the study. All dogs presented an initial phase of pyrexia and/or lethargy followed by progressive signs of spinal cord and/or intracranial disease. Magnetic resonance imaging showed bilateral and symmetrical lesions affecting the grey matter of the thalamus, pons, medulla oblongata, and thoracic or lumbar intumescences with none or mild parenchymal and meningeal contrast enhancement. Serology for tick-borne encephalitis virus was positive in five dogs with the presence of seroconversion in two dogs. The viral distinction between flaviviruses was not achieved. One dog with negative serology presented positive immunohistochemistry at post-mortem examination. Three dogs survived but presented neurological sequelae. Three dogs were euthanased due to the rapid progression of the clinical signs or static neurological signs.
Clinical Significance:
These cases raise awareness of the presence of tick-borne encephalitis as an emergent disease or the increased prevalence of louping ill virus affecting dogs in the UK
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