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Topic Review
Stonefish: venom components, pathology, distribution
There are five species of stonefish within the genus Synanceia: Synanceia horrida (previously referred to as S. trachynis), S. verrucosa, S. alula, S. nana and S. platyrhyncha. Synanceia spp. can grow 35–50 cm in length and have evolved grey and mottled skin to camouflage themselves amongst encrusted rocks and coral for predation and defense. Synanceia species have up to 15 dorsal fin spines that are erected when the fish is disturbed. Stings from this medically important group of fish are known to cause painful and lethal human envenomations. Stonefish are regarded as one of the most venomous fish in the world. Research on stonefish venom has chiefly focused on the in vitro and in vivo neurological, cardiovascular, cytotoxic and nociceptive effects of the venom.
  • 15.5K
  • 17 Jun 2021
Topic Review
Ionizing Radiation
The development of protective agents against harmful radiations has been a subject of investigation for decades. However, effective (ideal) radioprotectors and radiomitigators remain an unsolved problem. Because ionizing radiation-induced cellular damage is primarily attributed to free radicals, radical scavengers are promising as potential radioprotectors. Early development of such agents focused on thiol synthetic compounds, e.g., amifostine (2-(3-aminopropylamino) ethylsulfanylphosphonic acid), approved as a radioprotector by the Food and Drug Administration (FDA, USA) but for limited clinical indications and not for nonclinical uses. To date, no new chemical entity has been approved by the FDA as a radiation countermeasure for acute radiation syndrome (ARS). All FDA-approved radiation countermeasures (filgrastim, a recombinant DNA form of the naturally occurring granulocyte colony-stimulating factor, G-CSF; pegfilgrastim, a PEGylated form of the recombinant human G-CSF; sargramostim, a recombinant granulocyte macrophage colony-stimulating factor, GM-CSF) are classified as radiomitigators. No radioprotector that can be administered prior to exposure has been approved for ARS. This differentiates radioprotectors (reduce direct damage caused by radiation) and radiomitigators (minimize toxicity even after radiation has been delivered). Molecules under development with the aim of reaching clinical practice and other nonclinical applications are discussed. Assays to evaluate the biological effects of ionizing radiations are also analyzed. Ionizing radiation is the energy released by atoms in the form of electromagnetic waves (e.g., X or gamma rays) or particle radiation (alpha, beta, electrons, protons, neutrons, mesons, prions, and heavy ions) with sufficient energy to ionize atoms or molecules.
  • 3.8K
  • 23 Feb 2022
Topic Review
ABC
ABC and its variations are initialism mnemonics for essential steps used by both medical professionals and lay persons (such as first aiders) when dealing with a patient. In its original form it stands for Airway, Breathing, and Circulation. The protocol was originally developed as a memory aid for rescuers performing cardiopulmonary resuscitation, and the most widely known use of the initialism is in the care of the unconscious or unresponsive patient, although it is also used as a reminder of the priorities for assessment and treatment of patients in many acute medical and trauma situations, from first-aid to hospital medical treatment. Airway, breathing, and circulation are all vital for life, and each is required, in that order, for the next to be effective. Since its development, the mnemonic has been extended and modified to fit the different areas in which it is used, with different versions changing the meaning of letters (such as from the original 'Circulation' to 'Compressions') or adding other letters (such as an optional "D" step for Disability or Defibrillation). In 2010, the American Heart Association and International Liaison Committee on Resuscitation changed the recommended order of CPR interventions for most cases of cardiac arrest to chest compressions, airway, and breathing, or CAB.
  • 3.7K
  • 22 Nov 2022
Topic Review
Blood Transfusion Reactions
Blood transfusions have been the cornerstone of life support since the introduction of the ABO classification in the 20th century. The physiologic goal is to restore adequate tissue oxygenation when the demand exceeds the offer. Although it can be a life-saving therapy, blood transfusions can lead to serious adverse effects, and it is essential that physicians remain up to date with the current literature and are aware of the pathophysiology, initial management and risks of each type of transfusion reaction. 
  • 1.8K
  • 31 May 2022
Topic Review
Pathophysiology of Hemorrhagic Shock
The pathophysiology of hemorrhagic shock involves a decrease in systemic oxygen delivery to a level less than what is required to maintain cellular function.
  • 1.8K
  • 03 Nov 2021
Topic Review
Role of N-acetylcysteine in Cystic Fibrosis
N-acetylcysteine is the acetylated form of the amino acid L-cysteine and a precursor to glutathione (GSH). It has been known for a long time as a powerful antioxidant and as an antidote for paracetamol overdose. However, other activities related to this molecule have been discovered over the years, making it a promising drug for diseases such as cystic fibrosis (CF). Its antioxidant activity plays a key role in CF airway inflammation and redox imbalance. Furthermore, this molecule appears to play an important role in the prevention and eradication of biofilms resulting from CF airway infections, in particular that of Pseudomonas aeruginosa.
  • 1.6K
  • 25 Feb 2022
Topic Review
Overcrowding in Emergency Department
Overcrowding in Emergency Departments (EDs) is a phenomenon that is now widespread globally and causes a significant negative impact that goes on to affect the entire hospital.
  • 1.6K
  • 13 Sep 2022
Topic Review
On-Site Medical Management of Avalanche Victims
Avalanche accidents are common in mountain regions and approximately 100 fatalities are counted in Europe each year. The average mortality rate is about 25% and survival chances are mainly determined by the degree and duration of avalanche burial, the patency of the airway, the presence of an air pocket, snow characteristics, and the severity of traumatic injuries. The most common cause of death in completely buried avalanche victims is asphyxia followed by trauma. Hypothermia accounts for a minority of deaths; however, hypothermic cardiac arrest has a favorable prognosis and prolonged resuscitation and extracorporeal rewarming are indicated.
  • 1.5K
  • 13 Oct 2021
Topic Review
FP-C
The Flight Paramedic Certification (FP-C) is an advanced certification that indicates an individual has attained the designation of Certified Flight Paramedic. The FP-C certification exam is administered by the International Board of Specialty Certification (IBSC) and the Board for Critical Care Transport Paramedic Certification (BCCTPC), a not-for-profit organizations responsible for the administration and development of specialty certification exams for critical care professionals. The test is administered by PSI and Applied Measurement Professionals (AMP) to assure compliance with the highest testing standards. This certification is designed to be successfully approved only for experienced paramedics who have demonstrated advanced knowledge of critical care medicine by passing an exam consisting of 125 scored items and 10 unscored items within a 2.5 hour window. As of February 22, 2018 there are 6458 certified flight paramedics worldwide, 494 of whom hold dual certification as a CCP-C. The FP-C, or CCP-C, and/or Critical Care Emergency Medical Transport Program (CCEMTP) certifications are often a requirement to work as a flight paramedic in the United States. The FP-C does not have an associated course, unlike the CCEMTP, although review courses and study guides available. The FP-C is considered comparable in difficultly to the Critical Care Paramedic Certification (CCP-C). Experience in the air medical or critical care transport fields is recommended before attempting to take the exam. However, there is no minimum education component required, and the examination does not require minimum years of experience, therefore new paramedics who have just completed school are eligible to take the exam and receive certification. In addition, there is no practical skills test associated with the examination, unlike the NREMT paramedic exam. Many agencies may require prospective employees to demonstrate practical competency in other courses (TPATC, ATLS-audit, CCEMTP, etc.) prior to being considered for employment. A candidate must hold a current paramedic license and have active certifications in Basic Life Support (BLS), Advanced Cardiac Life Support (ACLS), Pediatric Advanced Life Support (PALS), Prehospital Trauma Life Support (PHTLS), and other advanced certifications.
  • 1.4K
  • 01 Dec 2022
Topic Review
Hypothermia
Hypothermia is a widespread condition all over the world, with a high risk of mortality in pre-hospital and in-hospital settings when it is not promptly and adequately treated. Hypothermia can occur due to unfavorable environmental conditions as well as internal causes, such as pathological states that result in reduced heat production, increased heat loss or ineffectiveness of the thermal regulation system. The consequences of hypothermia affect several systems in the body—the cardiovascular system, the central and peripheral nervous systems, the respiratory system, the endocrine system and the gastrointestinal system—but also kidney function, electrolyte balance and coagulation. 
  • 1.3K
  • 19 Jan 2024
Topic Review
Wearable Sensors and Machine Learning for Hypovolemia Problems
Hypovolemia is a physiological state of reduced blood volume that can exist as either (1) absolute hypovolemia because of a lower circulating blood (plasma) volume for a given vascular space (dehydration, hemorrhage) or (2) relative hypovolemia resulting from an expanded vascular space (vasodilation) for a given circulating blood volume (e.g., heat stress, hypoxia, sepsis). The external environment and the user's level of physical activity can exacerbate hypovolemic challenges to the body. Noninvasive, wearable sensing systems are being developed to track a user's ability to compensate for these challenges. 
  • 1.3K
  • 13 Jan 2022
Topic Review
Gastrointestinal Bleeding Due to NOACs Use
Novel oral anticoagulants (NOACs) are drugs selective for thrombin or activated factor Xa approved for the prevention and treatment of many thromboembolic conditions. They included venous thromboembolism in patients undergoing orthopedic surgery, such as hip or knee arthroplasty, atrial fibrillation, stroke prevention in nonvalvular patients, and pulmonary embolism. NOACs, such as apixaban, edoxaban, dabigatran, rivaroxaban and betrixaban, have become an alternative to vitamin K anticoagulants (i.e., warfarin).
  • 1.3K
  • 22 Nov 2022
Topic Review
Body Mass Index
Increased body mass index (BMI) is a risk factor for cardiovascular disease, stroke, and metabolic diseases. A high BMI may affect outcomes of post-cardiac arrest patients, but the association remains debatable.
  • 1.2K
  • 25 Aug 2021
Topic Review
Point of Care Ultrasound in Chest Pain
It quickly became obvious that emergency ultrasound, or point of care ultrasound (POCUS), has some very interesting aspects in the context of the emergency room (ER), allowing the physician to immediately obtain images of the patient during the first visit and thus rule out major pathologies immediately. Chest pain often is associated with dyspnea or shortness of breath (SOB), which is in itself one of the most common causes of emergency room access. The origin of these symptoms is often sought in heart and lung diseases.
  • 1.1K
  • 15 Jul 2022
Topic Review
Point-of-Care Ultrasound in Upper Airway Sono-Anatomy
Airway management is a common and critical procedure in acute settings, such as the Emergency Department (ED) or Intensive Care Unit (ICU) of hospitals. Many of the traditional physical examination methods have limitations in airway assessment. Point-of-care ultrasound (POCUS) has emerged as a promising tool for airway management due to its familiarity, accessibility, safety, and non-invasive nature. It can assist physicians in identifying relevant anatomy of the upper airway with objective measurements of airway parameters, and it can guide airway interventions with dynamic real-time images. To date, ultrasound has been considered highly accurate for assessment of the difficult airway, confirmation of proper endotracheal intubation, prediction of post-extubation laryngeal edema, and preparation for cricothyrotomy by identifying the cricothyroid membrane. The researchers aim to provide a comprehensive overview of the use of POCUS on upper airway sono-anatomy. In conclusion, POCUS is a valuable tool with multiple applications ranging from pre- and post-intubation management. Clinicians should consider using POCUS in conjunction with traditional exam techniques to manage the airway more efficiently in the acute setting.
  • 1.1K
  • 12 May 2023
Topic Review
Abdominal Compartment Syndrome
Compartment syndrome occurs when increased pressure inside a closed anatomical space compromises tissue perfusion. The sudden increase in pressure inside these spaces requires rapid decompression by means of surgical intervention. In the case of abdominal compartment syndrome (ACS), surgical decompression consists of a laparostomy. 
  • 1.1K
  • 10 Jan 2022
Topic Review
Wearable Bluetooth Triage Healthcare Monitoring System
Triage is the first interaction between a patient and a nurse/paramedic. This assessment, usually performed at Emergency departments, is a highly dynamic process and there are international grading systems that according to the patient condition initiate the patient journey. Triage requires an initial rapid assessment followed by routine checks of the patients’ vitals, including respiratory rate, temperature, and pulse rate. Ideally, these checks should be performed continuously and remotely to reduce the workload on triage nurses; optimizing tools and monitoring systems can be introduced and include a wearable patient monitoring system that is not at the expense of the patient’s comfort and can be remotely monitored through wireless connectivity.
  • 1.1K
  • 14 Apr 2022
Topic Review
Advanced and Invasive Cardiopulmonary Resuscitation Techniques
Despite numerous promising innovations, the chance of survival from sudden cardiac arrest has remained virtually unchanged. Technological advances have been made, user-friendly portable devices have been developed, and advanced invasive procedures have been described that could improve this unsatisfactory situation. Technical aids, such as feedback systems or automated mechanical cardiopulmonary resuscitation (CPR) devices, can improve chest compression quality. The latter, as well as extracorporeal CPR, might serve as a bridge to treatment (with extracorporeal CPR even as a bridge to recovery). Sonography may be used to improve thoracic compressions on the one hand and to rule out potentially reversible causes of cardiac arrest on the other. Resuscitative endovascular balloon occlusion of the aorta might enhance myocardial and cerebral perfusion. Minithoracostomy, pericardiocentesis, or clamshell thoracotomy might resolve reversible causes of cardiac arrest. 
  • 1.1K
  • 20 Dec 2022
Topic Review
Nanomedicine and Brain Tumors
A brain tumor, a tumor that develops within the skull, is an abnormal mass of tissue in which cells grow and multiply out of control. Although more than 150 types of brain tumors have been reported, they are macroscopically divided into primary and metastatic groups. Tumors that arise directly from the brain tissue or surrounding the brain are classified as primary brain tumors.
  • 1.0K
  • 27 Jan 2022
Topic Review
Community Initiatives of OHCA
Early intervention of bystanders (the first links of the chain of survival) have been shown to improve survival and good neurological outcomes of patients suffering out-of-hospital cardiac arrest (OHCA). Many initiatives have been implemented to increase the engagement of communities in early basic life support (BLS) and cardiopulmonary resuscitation (CPR), especially of lay people with no duty to respond.
  • 977
  • 24 Jan 2022
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