Guthriedonaldson1860

Whole blood confers many advantages over component therapy including, but not limited to the transfusion of blood with a physiologic ratio of components, ease of transport and transfusion, less volume of anticoagulants and additives transfused to the patient, and exposure to fewer donors. Whole blood is a tool with reemerging potential that can be implemented in civilian trauma centers with optimal results and less technical demand.Damage control resuscitation should be initiated as soon as possible after a trauma event to avoid metabolic decompensation and high mortality rates. The aim of this article is to assess the position of the Trauma and Emergency Surgery Group (CTE) from Cali, Colombia regarding prehospital care, and to present our experience in the implementation of the "Stop the Bleed" initiative within Latin America. Prehospital care is phase 0 of damage control resuscitation. Prehospital damage control must follow the guidelines proposed by the "Stop the Bleed" initiative. We identified that prehospital personnel have a better perception of hemostatic techniques such as tourniquet use than the hospital providers. The use of tourniquets is recommended as a measure to control bleeding. Fluid management should be initiated using low volume crystalloids, ideally 250 cc boluses, maintaining the principle of permissive hypotension with a systolic blood pressure range between 80- and 90-mm Hg. Hypothermia must be management using warmed blankets or the administration of intravenous fluids warmed prior to infusion. However, these prehospital measures should not delay the transfer time of a patient from the scene to the hospital. To conclude, prehospital damage control measures are the first steps in the control of bleeding and the initiation of hemostatic resuscitation in the traumatically injured patient. Early interventions without increasing the transfer time to a hospital are the keys to increase survival rate of severe trauma patients.Damage Control Resuscitation (DCR) seeks to combat metabolic decompensation of the severely injured trauma patient by battling on three major fronts Permissive Hypotension, Hemostatic Resuscitation, and Damage Control Surgery (DCS). The aim of this article is to perform a review of the history of DCR/DCS and to propose a new paradigm that has emerged from the recent advancements in endovascular technology The Resuscitative Balloon Occlusion of the Aorta (REBOA). Thanks to the advances in technology, a bridge has been created between Pre-hospital Management and the Control of Bleeding described in Stage I of DCS which is the inclusion and placement of a REBOA. We have been able to show that REBOA is not only a tool that aids in the control of hemorrhage, it is also a vital tool in the hemodynamic resuscitation of a severely injured blunt and/or penetrating trauma patient. Devimistat in vivo That is why we propose a new paradigm "The Fourth Pillar" Permissive Hypotension, Hemostatic Resuscitation, Damage Control Surgery and REBOA.

The low frequency of cases and deaths from the SARS-CoV-2 COVID-19 virus in some countries of Africa has called our attention about the unusual behavior of this disease. The ivermectin is considered a drug of choice for various parasitic and viral diseases and shown to have in vitro effects against SARS-CoV-2.

Our study aimed to describe SARS-CoV2 infection and death rates in African countries that participated in an intensive Ivermectin mass campaign carried out to control onchocerciasis and compare them with those of countries that did not participate.

Data from 19 countries that participated in the World Health Organization (WHO) sponsored African Programme for Onchocerciasis Control (APOC), from 1995 until 2015, were compared with thirty-five (Non-APOC), countries that were not included. Information was obtained from https//www.worldometers.info/coronavirus/ database. Generalized Poisson regression models were used to obtain estimates of the effect of APOC status on cumulative SARS-CoV-2 infection and mortality rates.

After controlling for different factors, including the Human Development Index (HDI), APOC countries (vs. non-APOC), show 28% lower mortality (0.72; 95% CI 0.67-0.78) and 8% lower rate of infection (0.92; 95% CI 0.91-0.93) due to COVID-19.

The incidence in mortality rates and number of cases is significantly lower among the APOC countries compared to non-APOC countries. That a mass public health preventive campaign against COVID-19 may have taken place, inadvertently, in some African countries with massive community ivermectin use is an attractive hypothesis. Additional studies are needed to confirm it.

The incidence in mortality rates and number of cases is significantly lower among the APOC countries compared to non-APOC countries. That a mass public health preventive campaign against COVID-19 may have taken place, inadvertently, in some African countries with massive community ivermectin use is an attractive hypothesis. Additional studies are needed to confirm it.This study investigates factors that could explain why the association between the egalitarian gender-role attitudes and the attitudes toward the importance of marriage (marital centrality) differs across societies. Using data from the International Social Survey Programme for 24 countries in 2002 and 2012 and multilevel modeling, we explore whether the Gender Revolution and the Second Demographic Transition frameworks could explain the country-level differences in the association between gender-role attitudes and marital centrality. We find that the negative association between the egalitarian gender-role attitudes and marital centrality is stronger in countries with a higher gender equality level and a higher fertility level. This work highlights the importance of considering the progress of the gender revolution and the second demographic transition to understand the relationship between gender equality and family formation.The scaling laws which relate the peak temperature T M and volumetric heating rate E H to the pressure P and length L for static coronal loops were established over 40 years ago; they have proved to be of immense value in a wide range of studies. Here we extend these scaling laws to dynamic loops, where enthalpy flux becomes important to the energy balance, and study impulsive heating/filling characterized by upward enthalpy flows. We show that for collision-dominated thermal conduction, the functional dependencies of the scaling laws are the same as for the static case, when the radiative losses scale as T -1/2, but with a different constant of proportionality that depends on the Mach number M of the flow. The dependence on the Mach number is such that the scaling laws for low to moderate Mach number flows are almost indistinguishable from the static case. When thermal conduction is limited by turbulent processes, however, the much weaker dependence of the scattering mean free path (and hence thermal conduction coefficient) on temperature leads to a limiting Mach number for return enthalpy fluxes driven by thermal conduction between the the corona and chromosphere.