Plos One
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Observational Study
Thromboelastometry profile in critically ill patients: A single-center, retrospective, observational study.
Transfusion therapy is associated with increased morbidity, mortality and costs. Conventional coagulation tests (CCT) are weak bleeding predictors, poorly reflecting coagulation in vivo. Thromboelastometry (ROTEM) provides early identification of coagulation disorders and can guide transfusion therapy by goals, reducing blood components transfusion. ⋯ The predominant ROTEM profile observed in this sample of critically ill patients was normal. In contrast, CCT suggested coagulopathy leading to a possibly unnecessary allogenic blood component transfusion. ROTEM test may avoid inappropriate allogeneic blood products transfusion in these patients.
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The aim of this study was to investigate the clinicopathologic features of lumbar disc herniation (LDH) with endplate degeneration and the association between cartilaginous fragments and inflammatory response to the herniated disc. ⋯ There is an association between LDH with endplate degeneration and cartilaginous herniation, with Modic type 2 predominating. Furthermore, neovascularization and macrophage infiltration, especially if the amount of cartilage is high, are likely to be less frequent in cartilaginous herniation, leading to failure in the spontaneous remission of clinical symptoms.
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Since the shooting of Black teenager Michael Brown by White police officer Darren Wilson in Ferguson, Missouri, the protest hashtag #BlackLivesMatter has amplified critiques of extrajudicial killings of Black Americans. In response to #BlackLivesMatter, other Twitter users have adopted #AllLivesMatter, a counter-protest hashtag whose content argues that equal attention should be given to all lives regardless of race. ⋯ In addition, we show that a significant portion of #AllLivesMatter use stems from hijacking by #BlackLivesMatter advocates. Beyond simply injecting #AllLivesMatter with #BlackLivesMatter content, these hijackers use the hashtag to directly confront the counter-protest notion of "All lives matter." Our findings suggest that Black Lives Matter movement was able to grow, exhibit diverse conversations, and avoid derailment on social media by making discussion of counter-protest opinions a central topic of #AllLivesMatter, rather than the movement itself.
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Objective was to examine the temporal variation of HIV sero-discordancy in select representative countries (Kenya, Lesotho, Mali, Niger, Tanzania, and Zimbabwe) in sub-Saharan Africa at different HIV epidemic scales. A sero-discordant couple is defined as a stable couple (SC) in which one partner is HIV-positive while the other is HIV-negative. ⋯ Sero-discordancy patterns varied with the evolution of the epidemics, and were affected by both epidemic phase and scale. The largest variations were found in high HIV-prevalence countries. The fraction of stable couples that are sero-discordant, as opposed to being sero-concordant positive, was projected to increase with ART scale-up and further HIV incidence decline over the coming two decades. These findings inform strategic planning and resource allocation for interventions among sero-discordant couples.
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Overcrowding is common in most emergency departments (ED). Despite the use of validated triage systems, some patients are at risk of delayed medical evaluation. The objective of this study was to assess the impact of a patient-flow physician coordinator (PFPC) on the proportion of patients offered medical evaluation within time limits imposed by the Swiss Emergency Triage Scale (SETS) and on patient flow within the emergency department of a teaching urban hospital. ⋯ Introducing a physician dedicated to managing patient flow enabled waiting times until first medical consultation to be reduced, yet had no significant benefit for patient flow within the ED, nor did it reduce the number of patients who left without being seen.