Articles: treatment.
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Intestinal ischemia-reperfusion injury is associated with both macrocirculatory and microcirculatory failure. Association of a vasoconstrictor in combination with a vasodilator such as ilomedin may improve macrocirculation parameters, microcirculation perfusion and reduce endothelial dysfunction. The primary objective was to demonstrate a difference in mean arterial pressure (MAP) after intestinal reperfusion with the concomitant administration of norepinephrine and ilomedin during ischemia compared with traditional hemodynamic treatment strategies (fluid resuscitation and vasopressors only). Secondary objectives were to demonstrate an improvement in peripheral and intestinal microcirculatory perfusion and endothelial dysfunction after intestinal reperfusion using this association. ⋯ Early administration of norepinephrine and ilomedin during ischemia improved short-term post-reperfusion sublingual and intestinal microcirculation without worsening macrocirculatory parameters in an intestinal ischemia-reperfusion injury model. However, use of this strategy seemed to worsen both liver and kidney function.
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Recent studies have proposed computed tomography (CT) criteria for posterior ligamentous complex (PLC) injury: disrupted if ≥2 CT findings, indeterminate if single finding, and intact if 0 CT findings. The study aims to validate the CT criteria for PLC injury externally. ⋯ This study externally validates the previously proposed CT criteria for PLC injury. A total of ≥2 positive CT findings or 0 CT findings can be used as criteria for a disrupted PLC (B-type injury) or intact PLC (A-type injuries), respectively, without added MRI. A single CT finding implies indeterminate PLC status and the need for further MRI assessment. The CT criteria will potentially guide MRI indications and treatment decisions for neurologically intact thoracolumbar burst fractures.
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We report a case of mpox in an active duty male on board a naval warship, who presented with a chancre-like penile lesion and ulcerating lymphadenopathy in the setting of a nonreactive treponemal test. Despite empirical therapy for sexually transmitted infections, he developed a fever and a generalized pustular rash. ⋯ This case highlights the obligation of medical providers who care for our military personnel and veterans to offer JYNNEOS vaccine to high-risk individuals. Additionally, with the rise in clade I mpox cases prompting a recent global health emergency declaration by the World Health Organization, it is essential to implement proper testing methods and treatments when considering mpox in the differential diagnosis because of its association with other sexually transmitted infections.
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Anthrax, caused by the bacterium Bacillus anthracis, stands as a formidable threat with both natural and bioterrorism-related implications. Its ability to afflict a wide range of hosts, including humans and animals, coupled with its potential use as a bioweapon, underscores the critical importance of understanding and advancing our capabilities to combat this infectious disease. In this context, exploring futuristic approaches becomes imperative, as they hold the promise of not only addressing current challenges but also ushering in a new era in anthrax management. This review delves into strategies to mitigate the impact of anthrax on global health and security, envisioning a future where our arsenal against anthrax is characterized by precision and adaptability. ⋯ The upcoming advancements in anthrax research will be based on cutting-edge technologies and innovative approaches that demonstrate great potential for prevention, detection, and treatment. These advancements may include the incorporation of synthetic biology techniques such as precise manipulation of biological components, nanoscale diagnostics, and Clustered regularly interspaced short palindromic repeats-based technologies, which could revolutionize our ability to combat anthrax on a molecular level. As these progressive methodologies continue to evolve, the integration of these technologies has the potential to redefine our strategies against anthrax, providing more accurate, personalized, and adaptable approaches to address the challenges posed by this infectious threat.