Serious Risk Of Death Research Articles

Funding for research on cryptococcal disease: an analysis based on the G-finder report

Members of the genus Cryptococcus are the causative agents of cryptococcal meningitis, a disease mainly associated with HIV-induced immunosuppression. Patients with cryptococcal meningitis are at a serious risk of death. Most patients suffering from cryptococcosis belong to neglected populations. With reduced support for research, new therapies are unlikely to emerge. In this essay, we used the Policy Cures/G-finder platform as a reference database for funding research on cryptococcal disease. Funding for cryptococcal research started being tracked by G-finder in 2013 and has continued to appear in the annual reports ever since. In total, 15 institutions were reported as major funders for research on cryptococcal disease over the years. The US National Institutes of Health (NIH) was the main funder, followed by the UK's Wellcome Trust. The annual analysis suggested slow yearly growth in funding from 2013 to 2021. The development of new tools to prevent and fight cryptococcal disease is urgent but requires improved funding.

Shape-adapted self-gelation hydrogel powder for high-performance hemostasis and wound healing

In the battlefield, accidents, first aid, and hospital environments, uncontrollable bleeding caused by severe wound infections pose a serious risk of death and high costs. However, performing ultrafast hemostasis without any external conditions remains challenging. In this paper, polyacrylic acid, polyacrylamide, tea polyphenols, and Yunnan Baiyao (PAA/PAAm/T/YNBY, PPTY) are used to prepare self-gelling powder with shape adaptability. When the mass fraction of PAA and PAAm is 10 wt% and 8 wt%, the hydrogel can form the most intermolecular hydrogen bonds, exhibiting the best adhesion ability and mechanical strength. When the amount of YNBY was 0.1 wt%, the hydrogel had the most suitable cellular compatibility and hemostatic ability. At this time, the hydrogel powder can achieve the fastest self-gelling (< 3 s), the strongest adhesion (interface adhesion > 499.4 N m − 1), and the fastest hemostatic speed (< 30 s). With the addition of a small amount of YNBY (0.1 wt%), the hemostatic efficiency of the hydrogel can be greatly improved. The combination of hydrogel and YNBY not only prolongs the duration of YNBY ingredient efficacy but also enhances its biocompatibility. This easy-to-use but effective hydrogel can stop bleeding, promote wound healing in emergencies, and has opportunities in functional materials, tissue engineering, biomedical engineering, and clinical medicine.

Active feeding of anadromous white-spotted char Salvelinus leucomaenis at the southern latitudinal rivers

Although starvation poses a serious risk of death, it is a common phenomenon among anadromous salmonids that fast after returning to the river following oceanic feeding migration. To address the effects of geographic environmental factors on their feeding, we examined the river feeding patterns and condition of sea-run migrants of white-spotted char ( Salvelinus leucomaenis) in rivers with latitudinal variation from 38°N to 46°N along the Sea of Japan. The river feeding patterns showed a significant latitudinal trend: char were observed to feed at lower latitudes and fast at higher latitudes. In contrast, the condition factor did not exhibit any latitudinal trends. These findings suggest that the environmental conditions encountered by individuals prior to and after river entry may influence their river feeding. Active feeding by the southern sea-run migrant char may be an adaptive strategy to maintain their body condition in response to the local conditions. This study highlights the importance of rivers not only as spawning and growth habitats for juveniles, but also as feeding habitats for certain anadromous salmonids.

Intrabronchial haemorrhage – the bronchoscopist’s nightmare: A case of major haemoptysis due to pulmonary Dieulafoy’s disease

Massive haemoptysis is a term used to describe a large amount of expectorated blood or rapid rate of bleeding (&gt;100 ml blood in 24 h) and is associated with a serious risk of death. However, there is no clear consensus on its definition [1]. In the present we report the case of a 39-year-old male, investigated for haemoptysis, quickly turning bad during diagnostic flexible bronchoscopy due to a rare condition. The congenital abnormality with displaced right upper lobe segmental bronchus and lack of the apical segment bronchus of the right lower lobetogether with the endoscopic narrow-band imaging were the diagnostic clues for the presence of pulmonary Dieulafoy‘s disease and angiographic glue embolization (n-butyl-2-cyanoacrylate) the treatment of choice.

RMetS Meteorological Masterclass Series: Anticipating floods, droughts and heatwaves

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Modified two-phase dilatancy SPH model for saturated sand column collapse simulations

The high mobility of landslides generates a serious risk of death and property damage. In this study, we develop a two-phase smoothed particle hydrodynamics (SPH) model based on mixture theory to investigate high mobility landslide mechanisms by simulating the process of saturated sand column collapse for different solid volume fractions and permeabilities. The dilatancy coefficient of volume fraction dependence and the Drucker-Prager criterion are introduced into an elastic-perfectly plastic model to describe the solid phase mechanic behavior, and the fluid phase is described as a slightly compressible Newtonian fluid. We present the deposition profile shape and apparent slope evolution trends of collapse examples for different initial solid volumes and permeability changes. We then analyze the effective stress, pore pressure, and velocity during the collapse process of extremely low permeability sand columns to explain the mechanism behind collapse evolution trends. We conclude that shear contraction behavior improves the mobility of the solid-fluid mixture by increasing the pore pressure and decreasing the effective stress, and vice versa. During the shear contraction process of column collapse, the lower permeability, slower seepage rate of the fluid phase, and lower pore pressure diffusion rate result in stronger mobility, but the larger drag force coefficient retards sand column collapse. Numerical simulation results show that the proposed model corrects some limitations of existing three-dimensional SPH models and can be applied to research the motion mechanism of solid-fluid mixtures such as landslides and debris flows.

Gross Negligence (Medical) Manslaughter and the Puzzling Implications of Negligent Ignorance: Rose v R [2017] EWCA Crim 1168.

This commentary explores the Court of Appeal's decision in the case of Rose1 in order to assess the risk of liability for gross negligence manslaughter currently faced by the medical profession in the event that negligence causes the death of a patient. Subtly modifying the test established in Adomako,2Rose confirms that in order to be potentially liable, there must be a serious risk of death that was, rather than ought to have been, obvious/foreseeable to the defendant. Consequently, in more complex cases where the serious risk of death is not immediately obvious, negligently failing to assess risk seems to prevent potential liability on the basis that the putative defendant was in a position of negligent ignorance.

Mood Episode Recovery Changes Gear in the Intrinsic Clock

Bipolar disorder, also known as manic-depressive illness, which affects three out of 200 people is a long-term disease, presents remittent depressive, hypomanic, manic or mixed episodes of illness, and bears a serious risk of death from suicide (Grande et al., 2016). About half of the time patients with bipolar disorder have symptoms impairing their work, social activities or relationships with others. Treatment focuses on preventing the recurrence of episodes and can clearly improve the outcome.

Oxigenación con membrana extracorpórea veno-venosa en el manejo de hipoxemia severa refractaria: indicaciones y propuesta de un protocolo de ingreso

The acute respiratory distress syndrome (ARDS) is an inflammatory disorder of the lung, causing impaired gas exchange, with hypoxemia and respiratory failure. ARDS mortality has not changed significantly a decade after its initial description (1994 -2006). This figure fluctuated around 40% in clinical trials and observational studies. In spite of new interventions with compelling evidence of improvements with protective ventilation, use of neuromuscular-blocking drugs, and the prone position, refractory hypoxemia is still a high mortality condition. Ventilatory management in ARDS patients is a critical determinant of outcome. Ventilator-associated lung injury is a major cause of perpetuation of the systemic inflammatory response, lung fibrosis, and multiple organ dysfunction (MOD). Patients with refractory hypoxemia, despite protective mechanical ventilation are in serious risk of death. extracorporeal membrane oxigenation (ECMO) has been proposed as a rescue therapy in this situation. The extracorporeal life support organization (ELSO) Guidelines recommend that ECMO should be considered in acute respiratory failure from any cause when the risk of mortality is 50% or higher. ELSO guidelines suggest that ECMO must be indicated when the risk death is 80% or greater. However, it is not clear which therapies should be indicated before ECMO, and for how long the patient must kept on these therapies before going on ECMO. In the following review, a protocol for early admission of patients to ECMO is proposed, based on the probability of death and the review of the current management of patients with ARDS.

Effect of clearcutting operations on the survival rate of a small mammal.

Clearcutting is a common timber harvesting technique that represents a significant and abrupt change in habitat conditions for wildlife living in industrial forests. Most research on this type of impact has focused on comparing populations or communities in mature forests/plantations and the resulting clearcut stands. However, this approach does not separate the effect of changes in habitat attributes from direct mortality produced by the intensive use of heavy machinery required for cutting down trees and dragging them to a road. Because knowing the fate of individuals after a disturbance is important for modelling landscape-scale population dynamics in industrial forests, we conducted a study in South-Central Chile to understand the short-term response to clearcutting operations of the long-haired Akodont (Abrothrix longipillis), a forest specialist mouse. Between 2009 and 2013 we radiotracked a total of 51 adult male Akodonts, before, during and after the clearcutting of the pine plantations in which they lived. A minimum of 52.4% of the individuals died as a direct cause of the timbering operations, being crushed by vehicles or logs during logging operations. Our observations suggest that, instead of fleeing the area, the response of long-haired Akodonts to the approaching machinery is to hide under the forest litter or in burrows, which exposes them to a serious risk of death. The real mortality rate associated to clearcutting may be higher than that estimated by us because of some methodological biases (i.e. individuals with crushed radiotransmitters not recorded) and the fact that additional mortality sources may affect the population in the weeks following logging operations (e.g. higher exposure to predation, effects of site preparation for the new plantation, etc).

The role of bone subtraction computed tomographic angiography in determining intracranial aneurysms in non-traumatic subarachnoid hemorrhage.

Background:The presence of blood in the subarachnoid space is an acute pathology with a serious risk of death and complications. The most common etiology (approximately 80%) is intracranial aneurysm.Objectives:The aim of this study was to assess the role of bone subtracted computed tomographic angiography (BSCTA), a novel and noninvasive method for determining and characterizing intracranial aneurysms.Patients and Methods:Sixty consecutive patients with clinically suspected non-traumatic subarachnoid hemorrhage (SAH) were considered to enter the study. The subtraction quality was inadequate in ten patients; thus, they were excluded, leaving 50 patients (84.4%) in the study. Bone subtracted and non-subtracted 3D images were obtained from the BSCTA raw data sets. All images obtained by digital subtraction angiography (DSA), BSCTA, and computed tomographic angiography (CTA) were evaluated for the presence or absence of an aneurysm and the location, minimal sac diameter, and neck size ratio of the aneurysm. DSA was considered as the gold standard during the evaluation of the data.Results:Of the 50 patients who participated in this study, 11 had no aneurysms as determined by both CTA and DSA. Examination of the remaining 39 patients revealed the presence of 51 aneurysms. While 3D-CTA could not detect six aneurysms that were located in the base of the skull, 3D-BSCTA easily detected them. Moreover, five aneurysms were only partially detected by 3D-CTA. According to this data, the sensitivity of 3D-BSCTA and 3D-CTA was calculated as 98% and 86.3%, respectively; the specificity was calculated as 100% and 90.9%, respectively, per aneurysm; and the sensitivity of 100% for 3D-BSCTA and 98% for 3D-CTA was achieved by using combined images with multi-planar reconstruction (MPR) and maximum intensity projection (MIP). BSCTA detected and characterized the aneurysms as well as DSA, and BSCTA and DSA gave concordant results in detecting aneurysms.Conclusions:BSCTA is easily accessible, less time consuming, and most importantly, a non-invasive technique for detecting intracranial aneurysms. It is also suitable for patients who have been referred to emergency services. Therefore, it can be used in emergency conditions and as a first-line diagnostic method in patients with non-traumatic SAH.

Mortalidad a los 2 años en pacientes crónicos confinados en el domicilio

To analyse the relationship between the mortality of the chronically ill confined to their homes and the risk of death predicted by the doctor and other variables. Longitudinal descriptive study. 223 patients were studied over 2 years. Survival was related to the variables measured at the beginning of the follow-up: age, sex, social class, time of confinement, number of diagnoses, hours in bed, evaluation with the Katz index and the Nottingham health profile, number of medicines, family help available, and doctor's opinion on the risk of death. 67% of the patients considered at very serious risk of death died within 6 months, as against 6.91 who died in the same period but had a different prognosis. 40.6% at serious risk died within a year, against 12.4% with a different prognosis. The variables independently associated with higher mortality are: the doctor considering that the risk of death is serious/very serious, OR and 95% CI; 2.57 (1.64-4.03); remaining over 16 hours a day in bed, OR 2.39 (1.31-4.36); being over 80, OR 3.41 (1.74-6.66) and being male, OR 1.61 (1.11-2.33). The prognostic judgement of the general doctor behaved as a predictor of mortality, and may be an indirect indicator of his/her capacity to foresee the need for health services.

Successful One-Stage Resection of Intravenous Leiomyomatosis of the Uterus with Extension into the Heart

Intravenous leiomyomatosis of the uterus is a rare neoplasm characterized by nodular masses of benign smooth muscles with intraluminal growth to the inferior vena cava and, in some cases, to the heart. It may cause abdominal and cardiovascular symptoms and is a serious risk of death when it reaches the tricuspid valve. Surgery is the best treatment and must be applied as soon as possible using cardiopulmonary bypass. The authors report a new case that had cardiac involvement and was successfully resected. The symptoms, imaging diagnosis, pathological and histopathological findings, tumors that mismatched the intravenous leiomyomatosis (IVL), and the use of circulatory arrest and deep hypothermia are discussed. A review of the literature is included.

Successful one-stage resection of intravenous leiomyomatosis of the uterus with extension into the heart

Intravenous leiomyomatosis of the uterus is a rare neoplasm characterized by nodular masses of benign smooth muscles with intraluminal growth to the inferior vena cava and, in some cases, to the heart. It may cause abdominal and cardiovascular symptoms and is a serious risk of death when it reaches the tricuspid valve. Surgery is the best treatment and must be applied as soon as possible using cardiopulmonary bypass. The authors report a new case that had cardiac involvement and was successfully resected. The symptoms, imaging diagnosis, pathological and histopathological findings, tumors that mismatched the intravenous leiomyomatosis (IVL), and the use of circulatory arrest and deep hypothermia are discussed. A review of the literature is included.

Prison cells unhealthy for prisoners, say BMA

Prisoners detained in police cells in Britain are denied the standards of care expected by patients in the NHS, said the British Medical Association, last week. Police officers are expected to identify warning signs in prisoners with head injuries and those with alcohol dependence. The situation is made worse by poor facilities, overcrowding, and a lack of paramedical training, claims the association. There is a “serious risk of death in police custody” for prisoners with alcohol dependency who are left in cells. “Police cells are not designed for detaining even healthy people, never mind those with addiction problems. They are simply too confined,” said Dr …

Intracranial internal carotid artery stenosis.

The advent of EC/IC Bypass surgery has focused attention on selected patients who might benefit from this innovative procedure. There is a poverty of natural history data pertaining to all such lesions. Two centres (Memphis, Tennessee and London, Ontario) pooled their resources to carry out a retrospective review of 58 patients with angiographically-proven intracranial internal carotid artery stenosis. Only 33% of the patients were alive and free from subsequent cerebral vascular events at the end of the mean follow-up of 30 months. Forty-three percent of the patients died during follow-up: 36% due to stroke and 44% because of cardiac disease. Forty-three percent of the patients suffered cerebral vascular events during the follow-up period: there were 17 strokes (29%) including 9 fatal strokes. The incidence of ipsilateral stroke was 19%; 65% of the strokes were appropriate to the stenotic intracranial carotid lesion under study. The annual ipsilateral stroke rate for patients with this lesion was 7.6% per year. This lesion detected on angiography is indicative of severe atheroma, and carries a serious risk of death due to ischemic heart disease or stroke.