Viral hepatitis

Viral hepatitis is the most common serious contagious disease caused by viruses that attack the liver. Approximately 70,000 cases are reported to the Centers for Disease Control each year, representing only a fraction of U.S. cases. There are five types of viral hepatitis currently known: Hepatitis A--formerly called infectious hepatitis; Hepatitis B--formerly called serum hepatitis, and the most serious form; Hepatitis C--formerly called non-A, non-B hepatitis; Hepatitis D--formerly called delta hepatitis; Hepatitis E--formerly called enteric or epidemic non-A, non-B hepatitis. The following Open Forum, prepared by leading EMS experts, explores the differences among the types of hepatitis, signs and symptoms, and EMS implications.     

Managed care: quality management differentiates the product

Comprehensive quality management is a goal that requires major corporate commitment to implement and maintain. The best results in a quality management program will be achieved when all components are tied together in a comprehensive program. To do that, a significant investment in personnel and equipment is required. As the benefits of having a program such as the one as described above become more widely known and accepted, more and more managed care insurers and providers will adopt these or similar standards. The question, "How do you know that patients are getting high-quality and sufficient care?" cannot be answered today by insurers who do not have such a program.     

Prenatal exposure to ionizing radiation and subsequent development of seizures

Seizures are a frequent sequela of impaired brain development and can be expected to affect more children with radiation-related brain damage than children without such damage. This report deals with the incidence and type of seizures among survivors prenatally exposed to the atomic bombing of Hiroshima and Nagasaki, and their association with specific stages of prenatal development at the time of irradiation. Fetal radiation dose was assumed to be equal to the dose to the maternal uterus. Seizures here include all references in the clinical record to "seizure," "epilepsy," or "convulsion." Histories of seizures were obtained at biennial routine clinical examinations starting at about the age of 2 years. These clinical records were used to classify seizures as febrile or unprovoked (without precipitating cause). No seizures were ascertained among subjects exposed 0-7 weeks after fertilization at doses higher than 0.10 Gy. The incidence of seizures was highest with irradiation at the eighth through the 15th week after fertilization among subjects with doses exceeding 0.10 Gy and was linearly related to the level of fetal exposure. This obtains for all seizures without regard to the presence of fever or precipitating causes, and for unprovoked seizures. When the 22 cases of severe mental retardation were excluded, the increase in seizures was only suggestively significant and only for unprovoked seizures. After exposure at later stages of development, there was no increase in recorded seizures.     

急性重度毒蕈中毒性肝炎抢救成功1例

1　病例报告　男 ,16岁 .误食毒蕈后出现恶心 ,呕吐伴有腹痛、腹泻 4d,每日大便 4～ 12次 ,为稀水便 ,有心慌、气短、发热 ,在当地医院以“毒蕈中毒”救治 ,症状无缓解 ,为进一步治疗于 2 0 0 0 - 0 8- 31转入我院 .查体 :T37.8℃ ,P110次·min-1 ,R18次·min-1 ,BP14/ 9k Pa.全身皮肤黄染 ,巩膜重度黄染 ,心肺无阳性体征 .腹平坦 ,上腹部有压痛 ,肌紧张及反跳痛 ,肝脾未触及 ,肝区有叩击痛 ,移动性浊音阳性 .入院后患者出现烦躁 ,意识不清 ,心率时快时慢 ,血压不稳定 .肝功 :T- BIL 2 5 4.1μmol· L-1 ,D- BIL 16 9.5 μmol· L-1 …     

Design of Copolymer-Based Blend Compatibilizers for Mixed Plastic Recycling

Mixed plastic waste recycling represents a significant challenge as the phase separation of different components dictates downgraded performance. Polymer-based compatibilizers can offer a promising solution to address this issue, through effectively reducing surface tension and increasing interfacial strength between distinct components to result in improved mechanical and thermal properties of recycled products. This perspective provides an overview of the fundamental concepts for the rational design of copolymer blend compatibilizers and discusses their recent advances, including both preformed and in situ generated systems. Impacts of key material parameters of compatibilizers, such as chain topology, chemical composition, and block sequence on their performance of remediating mixed plastics are discussed. Additionally, reactive compatibilization strategies are also introduced, including in situ formation of polymers, installing functional groups on mixed plastics, and employing dual compatibilization strategies. Looking forward, there are many research and technology opportunities in this area, especially for enabling the use of blend compatibilizers to practically address mixed plastic wastes at scale. Specifically, future compatibilizer design and application should provide strong competitiveness in both cost and energy savings, and carbon emission reduction. Together, the development of blend compatibilizers is an important step in establishing plastic circular economy and creating a more sustainable future.