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Itay Zmora Yonit Wiener-Well Evan Avraham Alpert 《The American journal of emergency medicine》2019,37(5):1006.e5-1006.e7
Background
Purulent bacterial pericarditis is a rare and potentially fatal disease. The course may be fulminant, and the presentation may pose a diagnostic challenge.Case report
An otherwise healthy 75-year-old male was brought to the emergency department in a state of general deterioration, confusion, and shock. Bedside ultrasound showed a significant pericardial effusion. His condition quickly deteriorated and the resuscitation included emergent bedside pericardiocentesis. The drainage was purulent and later cultures grew out Streptococcus pneumoniae.Why should an emergency physician be aware of this?
Purulent pericarditis is extremely rare but should be considered in the patient with a fulminant infectious process (particularly pneumonia) and signs of pericardial effusion. Treatment should include appropriate antibiotics and early drainage. 相似文献23.
Christopher D Hue Frances S Cho Siqi Cao Cameron R ”Dale” Bass David F Meaney Barclay Morrison III 《Journal of cerebral blood flow and metabolism》2015,35(7):1191-1198
Owing to the frequent incidence of blast-induced traumatic brain injury (bTBI) in recent military conflicts, there is an urgent need to develop effective therapies for bTBI-related pathologies. Blood-brain barrier (BBB) breakdown has been reported to occur after primary blast exposure, making restoration of BBB function and integrity a promising therapeutic target. We tested the hypothesis that treatment with dexamethasone (DEX) after primary blast injury potentiates recovery of an in vitro BBB model consisting of mouse brain endothelial cells (bEnd.3). DEX treatment resulted in complete recovery of transendothelial electrical resistance and hydraulic conductivity 1 day after injury, compared with 3 days for vehicle-treated injured cultures. Administration of RU486 (mifepristone) inhibited effects of DEX, confirming that barrier restoration was mediated by glucocorticoid receptor signaling. Potentiated recovery with DEX treatment was accompanied by stronger zonula occludens (ZO)-1 tight junction immunostaining and expression, suggesting that increased ZO-1 expression was a structural correlate to BBB recovery after blast. Interestingly, augmented ZO-1 protein expression was associated with specific upregulation of the α+ isoform but not the α− isoform. This is the first study to provide a mechanistic basis for potentiated functional recovery of an in vitro BBB model because of glucocorticoid treatment after primary blast injury. 相似文献
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目的 探究高龄产妇产后抑郁的影响因素,为护理人员今后在临床工作中提供个性化的护理服务提供参考依据。方法 采用质性研究中的现象学研究法对2021年12月至2022年4月在内蒙古医科大学附属医院妇产科建档分娩的16例高龄产妇进行半结构式访谈,并以Colaizzi现象学研究方法进行资料分析。结果 提炼出影响高龄产妇产后抑郁的4个主题:躯体性压力源;负性心理体验;社会支持缺乏,矛盾出现;角色转变对高龄产妇的影响。结论 需重视高龄产妇产后的主观感受,加强产前产后健康宣教,构建以家庭为中心的高龄产妇产后护理模型,减少产后抑郁的发生。 相似文献
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In this paper, we introduce a new type of troubled-cell indicator to improve
hybrid weighted essentially non-oscillatory (WENO) schemes for solving the hyperbolic conservation laws. The hybrid WENO schemes selectively adopt the high-order
linear upwind scheme or the WENO scheme to avoid the local characteristic decompositions and calculations of the nonlinear weights in smooth regions. Therefore,
they can reduce computational cost while maintaining non-oscillatory properties in
non-smooth regions. Reliable troubled-cell indicators are essential for efficient hybrid
WENO methods. Most of troubled-cell indicators require proper parameters to detect
discontinuities precisely, but it is very difficult to determine the parameters automatically. We develop a new troubled-cell indicator derived from the mean value theorem
that does not require any variable parameters. Additionally, we investigate the characteristics of indicator variable; one of the conserved properties or the entropy is considered as indicator variable. Detailed numerical tests for 1D and 2D Euler equations are
conducted to demonstrate the performance of the proposed indicator. The results with
the proposed troubled-cell indicator are in good agreement with pure WENO schemes.
Also the new indicator has advantages in the computational cost compared with the
other indicators. 相似文献
29.
Unconditional Positivity-Preserving and Energy Stable Schemes for a Reduced Poisson-Nernst-Planck System 下载免费PDF全文
Hailiang Liu & Wumaier Maimaitiyiming 《Communications In Computational Physics》2020,27(5):1505-1529
The Poisson-Nernst-Planck (PNP) system is a widely accepted model for
simulation of ionic channels. In this paper, we design, analyze, and numerically validate a second order unconditional positivity-preserving scheme for solving a reduced
PNP system, which can well approximate the three dimensional ion channel problem.
Positivity of numerical solutions is proven to hold true independent of the size of time
steps and the choice of the Poisson solver. The scheme is easy to implement without
resorting to any iteration method. Several numerical examples further confirm the
positivity-preserving property, and demonstrate the accuracy, efficiency, and robustness of the proposed scheme, as well as the fast approach to steady states. 相似文献
30.
Sho Yagishita 《Psychiatry and clinical neurosciences》2020,74(2):91-98
Pharmacological studies of antidepressants and atypical antipsychotics have suggested a role of dopamine and serotonin signaling in depression. However, depressive symptoms and treatment effects are difficult to explain based simply on brain‐wide decrease or increase in the concentrations of these molecules. Recent animal studies using advanced neuronal manipulation and observation techniques have revealed detailed dopamine and serotonin dynamics that regulate diverse aspects of motivation‐related behavior. Dopamine and serotonin transiently modulate moment‐to‐moment behavior at timescales ranging from sub‐second to minutes and also produce persistent effects, such as reward‐related learning and stress responses that last longer than several days. Transient and sustained effects often exhibit specific roles depending on the projection sites, where distinct synaptic and cellular mechanisms are required to process the neurotransmitters for each transient and sustained timescale. Therefore, it appears that specific aspects of motivation‐related behavior are regulated by distinct synaptic and cellular mechanisms in specific brain regions that underlie the transient and sustained effects of dopamine and serotonin signaling. Recent clinical studies have implied that subjects with depressive symptoms show impaired transient and sustained signaling functions; moreover, they exhibit heterogeneity in depressive symptoms and neuronal dysfunction. Depressive symptoms may be explained by the dysfunction of each transient and sustained signaling mechanism, and distinct patterns of impairment in the relevant mechanisms may explain the heterogeneity of symptoms. Thus, detailed understanding of dopamine and serotonin signaling may provide new insight into depressive symptoms. 相似文献